The DOI matches its Crossref record; 44 of the 44 references it cites were found in a registry or an index; none of the 45 sources its claims cite is checked for support yet.
Can physical exercise modulate cortisol level in subjects with depression? A systematic review and meta-analysis
Open accessAbstract
Abstract Introduction: Major depressive disorder (MDD) is a prevalent medical illness that is associated with chronic stress. Patients with MDD can show an imbalance in cortisol levels, which can be restored with the remission of symptoms. Physical exercise training has been used as a tool to promote changes in cortisol levels in healthy individuals. However, it is unknown if exercise can produce the same results in individuals with MDD. Objective: To review evidence of cortisol changes after exercise training in individuals with MDD. Methods: We conducted a search on PubMed, SciELO, LILACS, ISI Web of Knowledge, Scopus, and PsycInfo databases. Random effects meta-analysis was performed and standardized mean difference (SMD) effect size was calculated. Analyses of forest and funnel plots was conducted using Stata v.11.0 software. Results: At first, 463 studies were obtained in the search. After completion of the selection procedure, five articles with seven analyses were included. Type of exercise, frequency of training, cortisol measurement, and type of control group were analyzed. There was a reduction of cortisol levels in the exercise group (SMD = −0.65, 95%CI 1.30-0.01). Moreover, sensitivity analysis and subgroup analyses revealed an effect of type (aerobic exercise) and frequency (five times per week) of exercise on reduction of cortisol levels. However, these results should be interpreted cautiously due to the small number of studies and a substantial heterogeneity among them. Conclusion: Physical exercise promotes a reduction in cortisol levels in individuals with MDD. However, this finding can be influenced by type of exercise, weekly frequency, and type of cortisol measurement.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This systematic review and meta-analysis found a moderate favorable effect of exercise training on reducing cortisol levels in individuals with major depressive disorder (SMD = -0.65; 95%CI -1.30 to 0.01), but the main pooled estimate was not statistically significant (p = 0.054). Subgroup analyses suggested larger reductions for aerobic exercise, five-times-weekly training, urine cortisol measurement, and non-active control groups, though the authors caution these findings are limited by few studies and substantial heterogeneity.
Key findings
- The main random-effects meta-analysis of all trials showed a moderate reduction in cortisol after exercise training: SMD = -0.65 (95%CI -1.30 to 0.01; p = 0.054; I² = 82.7%).
- After sensitivity analysis excluding two trials outside the funnel plot, the effect remained moderate and became statistically significant: SMD = -0.64 (95%CI -1.17 to -0.10; p = 0.019; I² = 28.7%).
- Subgroup analyses found significant reductions for aerobic exercise (SMD = -0.76; 95%CI -1.55 to 0.03), five times per week (SMD = -2.18; 95%CI -2.90 to -1.47), three times per week (SMD = -0.64; 95%CI -1.17 to -0.10), urine cortisol measurement (SMD = -2.18; 95%CI -2.90 to -1.47), and non-active control groups (SMD = -0.99; 95%CI -1.95 to -0.04).
- No significant effects were found for strength training (SMD = -0.05; 95%CI -0.57 to 0.47), exercising twice per week (SMD = 0.05; 95%CI -0.32 to 0.41), saliva cortisol (SMD = -0.88; 95%CI -2.00 to 0.30), plasma cortisol (SMD = -0.26; 95%CI -0.71 to 0.18), or active control groups (SMD = -0.05; 95%CI -0.46 to 0.35).
Methods
- Systematic review and meta-analysis registered in PROSPERO (CRD42018055996), conducted according to PICO and PRISMA, searching PubMed, SciELO, LILACS, ISI Web of Knowledge, Scopus, and PsycInfo up to March 02 2018.
- Inclusion criteria were randomized and controlled studies investigating exercise training effects on cortisol levels in individuals with MDD compared with control groups; MDD was defined by diagnostic interviews or depression screening cut-offs.
- The search yielded 463 studies; after selection, 5 studies with 7 arms and 209 participants (125 intervention vs. 84 control) were included. Random-effects meta-analysis estimated standardized mean differences using Stata v.11.0, with subgroup analyses by exercise type, training frequency, cortisol measurement, and control group type; risk of bias was assessed with the PEDro scale.
Limitations
- The authors state that results should be interpreted cautiously due to the small number of studies and substantial heterogeneity among them regarding exercise type, cortisol measurement, exercise frequency, and control group type.
- The authors state that it is not possible to conclude whether the effect of exercise on cortisol occurs concomitantly with reductions in depressive symptoms, and that the small number of articles did not allow reliable conclusions from subgroup analyses.
- The authors also note that the meta-analysis included both patients with a clinical diagnosis of depression and individuals with depressive symptoms according to scales, so the influence of clinical diagnosis could not be determined; the text makes evident additional concerns including funnel plot asymmetry suggesting possible publication bias and discrepant exercise methodologies.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
0 of 45 cited sources checked · 0 supported · 0 flagged
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, these results should be interpreted cautiously due to the small number of studies and a substantial heterogeneity among them considering type of exercise, type of cortisol measurement, frequency of exercise, and type of control group.”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“a moderate reduction for exercising three times per week (SMD = -0.64;95%CI -1.17 to -0.10)”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Additional information
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Significant reduction in cortisol levels was found for aerobic training (SMD = -0.76;95%CI -1.55 to 0.03)”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Additional information
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Moderate but nonsignificant effects were found for cortisol measured in saliva (SMD = -0.88;95%CI -2.06 to 0.30).”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Additional information
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was a moderate favorable effect of exercise training on reduction of cortisol levels (SMD = -0.65;95% confidence interval [95%CI] -1.30 to 0.01) (Figure 2).”
- Also stated in: § Discussion · plain
“In conclusion, physical exercise promotes a moderate reduction in cortisol levels in MDD individuals.”
- Also stated in: § Abstract · plain
“Houve uma redução dos níveis de cortisol no grupo de exercício.”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Primary findings
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Fortunately, most of the studies assessed in this meta-analysis were classified as good quality according to risk of bias within the studies.”
- Also stated in: § Additional information · plain
“Most studies included in this meta-analysis were classified as good quality (results available in Online-Only Supplementary Table 1).”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Discussion
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Also stated in: § Additional information · plain
None of the sources cited for this claim have been checked yet.
In the paper
“Visual analysis of the funnel plot showed asymmetry of two articles 26,29 (three trials) within the studies,”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Risk of bias across studies
What the sources say
- Not checked yetcites [26] Nabkasorn C, 2006, Effects of physical exercise on depression, neuroendocrine stress hormones and physiological fitness in adolescent females with depressive symptoms, Eur J Public Health source
- Not checked yetcites [29] Krogh J, 2010, Growth hormone, prolactin and cortisol response to exercise in patients with depression, J Affect Disord source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“while no effects were found for strength training (SMD = -0.05;95%CI -0.57 to 0.47)”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Additional information
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“compared to a moderate reduction when the control group was not subjected to any treatment (SMD = -0.99;95%CI -1.95 to -0.44)”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Additional information
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We performed a sensitivity analysis excluding the two trials that were located outside the funnel plot.The recalculated effect was equal to -0.64 (95%CI -1.17 to -0.10;I 2 = 28.7)(Table 2).”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Additional information
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
- Probably not a substantial claim. 16
- It may state two separate claims as one. 13
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The duration of the intervention varied from 8 to 16 weeks for chronic studies.”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Study characteristics
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Cortisol measurement was made in the saliva (n = 1), 25 urine (n = 1), 26 and plasma (n = 3) 29,30,39 of the participants, at different times of the day.”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Study characteristics
What the sources say
- Not checked yetcites [25] Foley LS, 2008, An examination of potential mechanisms for exercise as a treatment for depression: A pilot study, Ment Health Phys Activity source
- Not checked yetcites [26] Nabkasorn C, 2006, Effects of physical exercise on depression, neuroendocrine stress hormones and physiological fitness in adolescent females with depressive symptoms, Eur J Public Health source
- Not checked yetcites [29] Krogh J, 2010, Growth hormone, prolactin and cortisol response to exercise in patients with depression, J Affect Disord source
Strength:plain· not yet calibratedn = 3Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Especially with regard to exercise methodology, the studies were also very discrepant, which may have impacted the results.”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Different types of exercise were used, including aerobic exercise, 25,29,30 Records jogging training, 26 strength training, 29 relaxation exercise, 29 Buddhism walking meditation, 37 traditional walking 39 and stretching.25”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Study characteristics
What the sources say
- Not checked yetcites [25] Foley LS, 2008, An examination of potential mechanisms for exercise as a treatment for depression: A pilot study, Ment Health Phys Activity source
- Not checked yetcites [29] Krogh J, 2010, Growth hormone, prolactin and cortisol response to exercise in patients with depression, J Affect Disord source
- Not checked yetcites [30] Carneiro LS, 2017, Monoamines and cortisol as potential mediators of the relationship between exercise and depressive symptoms, Eur Arch Psychiatry Clin Neurosci source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“After the selection procedure, five studies, with seven arms, were included in the meta-analysis.”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Study selection
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Two of them evaluated cortisol in basal condition, 29,30 one article observed cortisol awakening response, 25 another study assessed cortisol levels after 8 hours of overnight fasting 39 and the last one measured 24 hours of excretions.26”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Study characteristics
What the sources say
- Not checked yetcites [29] Krogh J, 2010, Growth hormone, prolactin and cortisol response to exercise in patients with depression, J Affect Disord source
- Not checked yetcites [30] Carneiro LS, 2017, Monoamines and cortisol as potential mediators of the relationship between exercise and depressive symptoms, Eur Arch Psychiatry Clin Neurosci source
- Not checked yetcites [25] Foley LS, 2008, An examination of potential mechanisms for exercise as a treatment for depression: A pilot study, Ment Health Phys Activity source
Strength:plain· not yet calibratedn = 3Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, the five studies included 209 participants”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Study characteristics
Strength:plain· not yet calibratedn = 209Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“For example, three different types of weekly frequencies were used: two, 29 three 25 and five times per week.26”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Discussion
What the sources say
- Not checked yetcites [29] Krogh J, 2010, Growth hormone, prolactin and cortisol response to exercise in patients with depression, J Affect Disord source
- Not checked yetcites [25] Foley LS, 2008, An examination of potential mechanisms for exercise as a treatment for depression: A pilot study, Ment Health Phys Activity source
- Not checked yetcites [26] Nabkasorn C, 2006, Effects of physical exercise on depression, neuroendocrine stress hormones and physiological fitness in adolescent females with depressive symptoms, Eur J Public Health source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All the studies included were randomized controlled trials (Table 1).”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Study characteristics
Strength:plain· not yet calibratedn = 209Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Second, our meta-analysis involved patients with a clinical diagnosis of depression and individuals with depressive symptoms according to depression scales.”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“However, one study did not present the association between reduced cortisol and improved depressive symptoms, 30 and another found non-significant results.29”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Discussion
What the sources say
- Not checked yetcites [30] Carneiro LS, 2017, Monoamines and cortisol as potential mediators of the relationship between exercise and depressive symptoms, Eur Arch Psychiatry Clin Neurosci source
- Not checked yetcites [29] Krogh J, 2010, Growth hormone, prolactin and cortisol response to exercise in patients with depression, J Affect Disord source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“For example, two studies 25,29 investigated an active control group (stretching and relaxation, respectively), while three studies 26,30,39 investigated a non-active control group.”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Discussion
What the sources say
- Not checked yetcites [25] Foley LS, 2008, An examination of potential mechanisms for exercise as a treatment for depression: A pilot study, Ment Health Phys Activity source
- Not checked yetcites [29] Krogh J, 2010, Growth hormone, prolactin and cortisol response to exercise in patients with depression, J Affect Disord source
- Not checked yetcites [26] Nabkasorn C, 2006, Effects of physical exercise on depression, neuroendocrine stress hormones and physiological fitness in adolescent females with depressive symptoms, Eur J Public Health source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Previous studies have investigated the effect of physical exercise training on MDD and significant reduction of depressive symptoms has been found.[14][15][16]”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Introduction
What the sources say
- Not checked yetcites [14] Moraes H, 2007, O exercício físico no tratamento da depressão em idosos: revisão sistemática, Rev Psiquiatr Rio Gd Sul source
- Not checked yetcites [15] Deslandes AC, 2010, Effect of aerobic training on EEG alpha asymmetry and depressive symptoms in the elderly: a 1-year follow-up study, Braz J Med Bio Res. source
- Not checked yetcites [16] Silveira H, 2010, Effects of exercise on electroencephalographic mean frequency in depressed elderly subjects, Neuropsychobiology source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Previous studies have shown that pharmacological treatment can modulate cortisol levels independently of promoting remission of depressive symptoms. [8][9]][10]”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Introduction
What the sources say
- Not checked yetcites [8] Barden N, 2004, Implication of the hypothalamic-pituitary-adrenal axis in the physiopathology of depression, J Psychiatry Neurosci source
- Not checked yetcites [9] Vreeburg SA, 2013, Salivary cortisol levels and the 2-year course of depressive and anxiety disorders, Psychoneuroendocrinology source
- Not checked yetcites [10] Fischer S, 2017, Hypothalamic-pituitary-adrenal (HPA) axis functioning as predictor of antidepressant response - meta-analysis, Neurosci Biobehav Rev source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“A meta-analysis reinforced that physical exercise is an effective non-pharmacological treatment for depression in older adults.17”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Introduction
What the sources say
- Not checked yetcites [17] Silveira H, 2013, Physical exercise and clinically depressed patients: a systematic review and meta-analysis, Neuropsychobiology source
Strength:boosted· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“The pathophysiology of MDD is related to several neurobiological changes, including hypothalamic-pituitary-adrenal (HPA) axis malfunction and consequent increase [2][3][4] or decrease [5][6][7] in basal cortisol levels.”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Introduction
What the sources say
- Not checked yetcites [2] Gomez R, 2006, The neuropsychological profile of psychotic major depression and its relation to cortisol, Biol Psychiatry source
- Not checked yetcites [3] Murri MB, 2014, HPA axis and aging in depression: systematic review and meta-analysis, Psychoneuroendocrinology source
- Not checked yetcites [4] Lopez-Duran NL, 2009, Hypothalamic-pituitary-adrenal axis dysregulation in depressed children and adolescents: a meta-analysis, Psychoneuroendocrinology source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Physical exercise can modulate cortisol levels after a single session of exercise or after physical exercise training, 20 possibly due to an upregulation of glucocorticoid receptor.21”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Introduction
What the sources say
- Not checked yetcites [20] Moraes HS, 2012, The effect of physical exercise on cortisol levels in older adults: a systematic review, Rev Bras Ativ Fis Saude
- Not checked yetcites [21] Stranahan AM, 2008, Central mechanisms of HPA axis regulation by voluntary exercise, Neuromolecular Med source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“However, although the association between HPA malfunction and MDD has been investigated for five decades, 24 few interventional studies have evaluated the effect of physical exercise on cortisol levels in individuals with MDD, and the few results available are contradictory.”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Introduction
What the sources say
- Not checked yetcites [24] Gibbons J, 1962, Plasma cortisol in depressive illness, J Psychiatr Res source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“A previous study from our laboratory showed that the differences in basal cortisol between MDD and healthy control groups can be modulated by physical performance aspects.23”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Introduction
What the sources say
- Not checked yetcites [23] Moraes H, 2016, Cortisol, DHEA: physical capacity, Arq Neuropsiquiatr source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“The present systematic review and meta-analysis was conducted according to the PICO search strategy 34 and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement.35”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Eligibility criteria
What the sources say
- Not checked yetcites [34] Heneghan C, 2002
- Not checked yetcites [35] Liberati A, 2009, The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration, Ann Intern Med source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Some studies have observed significant effect after aerobic training 25,26 or holistic training, 27,28 while others have shown non-significant changes after strength or aerobic training 29,30 or holistic activities.[31][32][33]”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Introduction
What the sources say
- Not checked yetcites [25] Foley LS, 2008, An examination of potential mechanisms for exercise as a treatment for depression: A pilot study, Ment Health Phys Activity source
- Not checked yetcites [26] Nabkasorn C, 2006, Effects of physical exercise on depression, neuroendocrine stress hormones and physiological fitness in adolescent females with depressive symptoms, Eur J Public Health source
- Not checked yetcites [27] Vedamurthachar A, 2006, Antidepressant efficacy and hormonal effects of Sudarshana Kriya Yoga (SKY) in alcohol dependent individuals, J Affect Disord source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Since changes in diurnal rhythms of cortisol are well known to occur in some cases of MDD 40 and can vary according to time of sampling, 3”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Discussion
What the sources say
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Nonetheless, compliance is poor for 24-hour measures, and renal conditions may affect urinary cortisol levels.42”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Discussion
What the sources say
- Not checked yetcites [42] Hellhammer DH, 2009, Salivary cortisol as a biomarker in stress research, Psychoneuroendocrinology source
Strength:plain· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“This study was registered on the International Prospective Register of Systematic Reviews (PROSPERO) under protocol no.CRD42018055996.”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Protocol and registration
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Risk of bias was assessed according to the Physiotherapy Evidence Database (PEDro) scale, 36 considering the following items:”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Risk of bias in individual studies
What the sources say
- Not checked yetcites [36] Sherrington C, 2000, PEDro. A database of randomized trials and systematic reviews in physiotherapy, Man Ther source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Although a previous meta-analysis has concluded that this factor does not appear to impact the magnitude of change in cortisol levels prevs.post-treatment, 41”
§ modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise > Discussion
What the sources say
- Not checked yetcites [41] McKay MS, 2010, The impact of treatment on HPA axis activity in unipolar major depression, J Psychiatr Res source
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
It is unknown whether exercise training promotes the same cortisol effects in individuals with major depressive disorder as in healthy individuals.
“However, it is still unknown whether exercise training might promote the same cortisol effects in individuals with MDD.”
The paper relies on this without support.
Plasma measurement is the most invasive form of cortisol measurement compared to saliva and urine collections, and is a stressful procedure.
“Plasma measurement is a widely used method, however it is the most invasive form when compared to saliva and urine collections (i.e., a stressful procedure).”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“a meta-analysis exploring the effect of different exercise interventions found that aerobic exercise in patients with major depressive disorder reduced cortisol levels the most compared to strength training (Beserra et al., 2018).”
From The effects of physical activity on cortisol and sleep: A systematic review and meta-analysis. (2022) · cites this paper as Beserra et al., 2018
Experimental — accuracy not yet measuredIn the citing paper
“In addition, 8-week high-frequency (3–5 sessions/week) aerobic exercise significantly increased serotonin and amygdala norepinephrine in the hippocampus of the brain of patients with depression compared to low-frequency (1 session/week) aerobic exercise [105].”
From Systematic review and meta-analysis of the effects of exercise on depression in adolescents (2022) · cites this paper as [105]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Aerobic exercise is called significant despite a nonsignificant result
MajorThe text calls the aerobic-training reduction significant, but Table 2 reports p = 0.059 and a 95% confidence interval that includes zero.
“Significant reduction in cortisol levels was found for aerobic training (SMD = -0.76;95%CI -1.55 to 0.03)”
“| Aerobic | -0.76 | -1.55 to 0.03 | 0.059 | 83.9 | <0.001 |”
Saliva confidence interval differs between text and table
MinorThe saliva subgroup's lower confidence bound is -2.06 in the prose but -2.00 in Table 2.
“SMD = -0.88;95%CI -2.06 to 0.30”
“| Saliva | -0.88 | -2.00 to 0.30 | 0.143 | - | - |”
Plasma confidence interval has conflicting upper bounds
MinorThe prose gives the upper bound as -0.18, while Table 2 gives it as 0.18. The difference changes whether the interval includes zero.
“Plasma measurement detected only a small reduction (SMD = -0.26;95%CI -0.71 to -0.18)”
“| Plasma | -0.26 | -0.71 to 0.18 | 0.249 | 53.8 | 0.070 |”
No-treatment confidence interval has conflicting upper bounds
MinorThe prose reports an upper bound of -0.44 for the no-treatment subgroup, whereas Table 2 reports -0.04.
“SMD = -0.99;95%CI -1.95 to -0.44”
“| No treatment | -0.99 | -1.95 to -0.04 | 0.042 | 82.4 | <0.001 |”
Citations
Cites
Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
(2008) · doi:10.1002/9780470712184 · Cited by 25,048
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00136 · Cited by 10,349
Progressive Statistics for Studies in Sports Medicine and Exercise Science
HOPKINS, W. G., MARSHALL, S. W., BATTERHAM, A. M., & HANIN, J. (2009) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31818cb278 · Cited by 9,128
Stress and disorders of the stress system
Chrousos, G. P. (2009) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2009.106 · Cited by 3,215
Salivary cortisol as a biomarker in stress research
Hellhammer, D. H., Wüst, S., & Kudielka, B. M. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2008.10.026 · Cited by 1,925
Gold, P. W., & Chrousos, G. P. (2002) · Molecular Psychiatry · doi:10.1038/sj.mp.4001032 · Cited by 1,274
Exercise treatment for depression
Dunn, A. L., Trivedi, M. H., Kampert, J. B., Clark, C. G., & Chambliss, H. O. (2005) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2004.09.003 · Cited by 1,208
Exercise for the Treatment of Depression
Knapen, J., Vancampfort, D., Schoubs, B., Probst, M.-T., Sienaert, P. A., Haake, P., Peuskens, J., & Pieters, G. (2009) · The Open Complementary Medicine Journal · doi:10.2174/1876391x00901010078 · Cited by 912
Exercise and Mental Health: Many Reasons to Move
Deslandes, A., Moraes, H., Ferreira, C., Veiga, H., Silveira, H., Mouta, R., Pompeu, F. A. M. S., Coutinho, E. S. F., & Laks, J. (2009) · Neuropsychobiology · doi:10.1159/000223730 · Cited by 609
Self-citationPEDro. A database of randomized trials and systematic reviews in physiotherapy
Sherrington, C., Herbert, R. D., Maher, C. G., & Moseley, A. M. (2000) · Manual Therapy · doi:10.1054/math.2000.0372 · Cited by 508
Flagged first, then by citations
Research works printed but not linked: 1
- Moraes HS, 2012, The effect of physical exercise on cortisol levels in older adults: a systematic review, Rev Bras Ativ Fis Saude, 17, 314
Cited by
Sorted by citations
Items 101–107 of 107
Effect of Exercise and Emotional Well-Being in Competitive Sports
Khati, A., Das, A., & Saha, G. C. (2026) · IGI Global eBooks · doi:10.4018/979-8-3373-6157-4.ch013
de Toledo, L. C., Oliveira, C. C., de Assis, J. G. N., Paiva, L. G., Cabral, L. F., Malaguti, C., & José, A. (2026) · Brazilian Journal of Physical Therapy · doi:10.1016/j.bjpt.2026.101577
The Impact of 30-Minute Jogging Before Iftar on University Students' Mood States During in Ramadan
Wulandari, F. Y., & Priambodo, A. (2025) · COMPETITOR Jurnal Pendidikan Kepelatihan Olahraga · doi:10.26858/cpjok.v17i1.215
Prescribed Interventions to Reduce Depression
Sunzeri, F. (2026) · Springer eBooks · doi:10.1007/978-3-032-14465-2_22
Barba-Medina, R., & Gómez-Velázquez, F. R. (2026) · Psiquiatría Biológica · doi:10.1016/j.psiq.2026.100928
Demirsöz, G., Angelis, M. D., Fontanesi, L., Bertollo, M., & Berchicci, M. (2026) · Mental health and physical activity · doi:10.1016/j.mhpa.2026.100809
Hu, X., & Chen, P. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1933599
Metadata
- Authors
- Beserra, A. H. N., Kameda, P., Deslandes, A. C., Schuch, F. B., Laks, J., & Moraes, H. S. D.
- Affiliations
- Universidade Federal do Rio de Janeiro (BR)
- Universidade Federal do Rio de Janeiro, Brazil; UFRJ, Brazil
- Universidade La Salle (BR)
- Venue
- Trends in Psychiatry and Psychotherapy
- Publisher
- FapUNIFESP (SciELO)
- Published
- 2018-12
- Volume
- 40
- Issue
- 4
- Pages
- 360-368
- ISSN
- 2237-6089 (ISSN-L)
- 2238-0019
- OpenAlex
- W2904844942
- Semantic Scholar
- 14e7f51ae7af2e1bff11badbdaa06f09227cfe57
- Cited by
- 108
- References
- 44
- Citations by year
- 2026: 14 · 2025: 20 · 2024: 17 · 2023: 14 · 2022: 13 · 2021: 10 · 2020: 16 · 2019: 2
- FWCI
- 0.79
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Trends in Psychiatry and Psychotherapy (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- Americanae (AECID Library) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (E-26/203, E-26/, E-26/203.193/2016)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- physical activity, cortisol, major depressive disorder, exercise training, aerobic exercise, chronic stress, depression treatment, exercise frequency
- MeSH terms
- Major Depressive Disorder, Exercise Therapy, Humans, Hydrocortisone, Exercise
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-08, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-08 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
