Abstract

Objective

To assess the comparative effectiveness of exercise, antidepressants and their combination for alleviating depressive symptoms in adults with non-severe depression.

Design

Systematic review and network meta-analysis.

Data sources

Embase, MEDLINE, PsycINFO, Cochrane Library, Web of Science, Scopus and SportDiscus.

Eligibility criteria

Randomised controlled trials (1990–present) that examined the effectiveness of an exercise, antidepressant or combination intervention against either treatment alone or a control/placebo condition in adults with non-severe depression.

Study selection and analysis

Risk of bias, indirectness and the overall confidence in the network were assessed by two independent investigators. A frequentist network meta-analysis was performed to examine postintervention differences in depressive symptom severity between groups. Intervention drop-out was assessed as a measure of treatment acceptability.

Results

Twenty-one randomised controlled trials (n=2551) with 25 comparisons were included in the network. There were no differences in treatment effectiveness among the three main interventions (exercise vs antidepressants: standardised mean differences, SMD, −0.12; 95% CI −0.33 to 0.10, combination versus exercise: SMD, 0.00; 95% CI −0.33 to 0.33, combination vs antidepressants: SMD, −0.12; 95% CI −0.40 to 0.16), although all treatments were more beneficial than controls. Exercise interventions had higher drop-out rates than antidepressant interventions (risk ratio 1.31; 95% CI 1.09 to 1.57). Heterogeneity in the network was moderate (τ2=0.03; I2=46%).

Conclusions

The results suggest no difference between exercise and pharmacological interventions in reducing depressive symptoms in adults with non-severe depression. These findings support the adoption of exercise as an alternative or adjuvant treatment for non-severe depression in adults.

Systematic review registration

PROSPERO CRD4202122656.

Details

Title
Comparative effectiveness of exercise, antidepressants and their combination in treating non-severe depression: a systematic review and network meta-analysis of randomised controlled trials
Author
Recchia, Francesco 1 ; Leung, Chit K 1 ; Chin, Edwin C 1 ; Fong, Daniel Y 2 ; Montero, David 1 ; Cheng, Calvin P 3 ; Suk Yu Yau 4 ; Siu, Parco M 1   VIAFID ORCID Logo 

1  Division of Kinesiology, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong 
2  School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong 
3  Department of Psychiatry, The University of Hong Kong, Hong Kong, Hong Kong 
4  Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong 
First page
bjsports-2022-105964
Section
Review
Publication year
2022
Publication date
Sep 2022
Publisher
BMJ Publishing Group LTD
ISSN
03063674
e-ISSN
14730480
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1136/bjsports-2022-105964
ProQuest document ID
2723888977
Copyright
© 2022 Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.