Review and Special Articles
Physical Activity and the Prevention of Depression: A Systematic Review of Prospective Studies

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Context

Given its high prevalence and impact on quality of life, more research is needed in identifying factors that may prevent depression. This review examined whether physical activity (PA) is protective against the onset of depression.

Evidence acquisition

A comprehensive search was conducted up until December 2012 in the following databases: MEDLINE, Embase, PubMed, PsycINFO, SPORTDiscus, and Cochrane Database of Systematic Reviews. Data were analyzed between July 2012 and February 2013. Articles were chosen for the review if the study used a prospective-based, longitudinal design and examined relationships between PA and depression over at least two time intervals. A formal quality assessment for each study also was conducted independently by the two reviewers.

Evidence synthesis

The initial search yielded a total of 6363 citations. After a thorough selection process, 30 studies were included for analyses. Among these, 25 studies demonstrated that baseline PA was negatively associated with a risk of subsequent depression. The majority of these studies were of high methodologic quality, providing consistent evidence that PA may prevent future depression. There is promising evidence that any level of PA, including low levels (e.g., walking <150 minutes/weeks), can prevent future depression.

Conclusions

From a population health perspective, promoting PA may serve as a valuable mental health promotion strategy in reducing the risk of developing depression.

Section snippets

Context

The WHO has predicted that depression will make one of the greatest contributions to overall global disease burden by the year 2020.1 This prediction is alarming when considering depression’s severity in causing disability.2 Depression is commonly associated with high morbidity and mortality rates, via increased risk of suicide and major implications to brain and somatic functioning.3, 4, 5 Fortunately, the realm of physical activity (PA) shows promising evidence that PA can treat depression

Evidence Acquisition

To conduct this systematic review, the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines13 were followed to ensure that methodologic steps were addressed in completing a comprehensive search.

Study Identification and Selection

The initial search yielded a total of 6363 citations: 2111 in Embase, 1762 in MEDLINE, 1004 in PubMed, 693 in Cochrane, 684 in PsycINFO, and 109 in SPORTDiscus. All abstracts were screened, and 90 studies were found to be potentially eligible for inclusion. After a thorough selection process (Figure 1), 30 studies were included for analyses. A total of 60 studies were excluded (experimental or cross-sectional in design [n=17]; not specific to depression [n=12]; had no cut-off criteria score to

Discussion

The primary objective of this review was to determine if PA (i.e., aerobic PA) can prevent future depression. Promising scientific evidence (25 of 30 studies) demonstrates that baseline PA is negatively associated with a risk of subsequent depression. The majority of these studies were of high methodologic quality, providing a solid indication that PA may prevent future depression. A few studies in the review concluded that the protective effect of PA on depression is specific to women and

Acknowledgments

The corresponding author is funded by the Canadian Institute for Health Research (CIHR), through the Population Level Interventions for Chronic Disease Prevention (PICDIP) training grant.

The authors acknowledge the work of Mehala Subramanieapillai for her time and dedication in assisting with data extraction.

GM is funded by the Canadian Institute for Health Research (CIHR), through the Population Level Interventions for Chronic Disease Prevention (PICDIP) training grant.

No financial disclosures

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