Umbrella review: All types of exercise help mental health symptoms

All modes of physical activity were effective in improving both anxiety and depression, highlighting the need for using exercise “as a mainstay approach” for managing mental health, according to researchers.

Ben Singh, PhD, a research fellow at the University of South Australia’s Allied Health & Human Performance, and colleagues wrote in the British Journal of Sports Medicine that anxiety is the most prevalent mental health disorder and depression is the leading cause of mental health-related disease burden.

“While the benefit of exercise for depression and anxiety is generally recognized, it is often overlooked in the management of these conditions,” they wrote. “Furthermore, many people with depression and anxiety have comorbidities, and [physical activity] is beneficial for their mental health and disease management.”

In an umbrella review, Singh and colleagues searched 12 electronic databases for eligible studies: systematic reviews with meta-analyses of randomized controlled trials that assessed the impacts of increased physical activity on adults with anxiety, depression or psychological distress. They ultimately included 97 reviews that comprised 1,039 trials and 128,119 participants.

Singh and colleagues found that physical activity was effective in managing anxiety and depression symptoms “across numerous populations, including the general population, people with mental illnesses and various other clinical populations.”

More specifically, the researchers found that, compared with usual care across all populations, physical activity had medium effects on:

• anxiety (median effect size = 0.42);
• depression (median effect size = 0.43); and
• psychological distress (effect size = 0.6; 95% CI, 0.78 to –0.42).

The largest improvements were observed in people with depression, healthy individuals, pregnant and postpartum people, and those with HIV and kidney disease, the researchers noted. Additionally, more intense physical activity was linked to greater improvements in symptoms, but the effectiveness of physical activity interventions worsened with longer duration interventions.

“All modes of [physical activity] are effective, with moderate-to-high intensities more effective than low intensity,” the researchers wrote. “Larger benefits are achieved from shorter interventions, which has health service delivery cost implications — suggesting that benefits can be obtained following short-term interventions, and intensive long-term interventions are not necessarily required to achieve therapeutic benefit.”

Singh and colleagues also noted that the effect size reductions in symptoms of anxiety and depression “are comparable to or slightly greater than the effects observed for psychotherapy and pharmacotherapy.”

“Future research to understand the relative effectiveness of [physical activity] compared with (and in combination with) other treatments is needed to confirm these findings,” they wrote.