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Health Sciences › Medicine › Psychiatry and Mental health
Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials
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Conflicts of Interest
Identified Weaknesses
Rating Explanation
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Paper Summary
Paperzilla title
Exercise Works for Depression: A Massive Review Says So (But Blinding Was an Issue)
This large review found that various types of exercise, particularly walking/jogging, yoga, and strength training, are effective for treating depression, comparable to psychotherapy and medication. The effects were larger with higher intensity exercise, and different modalities may be better suited for different age and sex groups, although most studies lacked blinding, potentially inflating effects.
Possible Conflicts of Interest
None identified.
Identified Weaknesses
High risk of bias
Most of the included studies had a high risk of bias due to lack of blinding of participants and staff, which could introduce expectancy effects.
Low certainty of evidence
The certainty of evidence for most comparisons was low or very low due to the high risk of bias, indirectness of some studies, and potential publication bias, although the latter was unlikely to fully account for the observed effects.
Small number of studies for some interventions
Many of the analyses were based on a relatively small number of studies, which limits the strength of the conclusions, particularly for interventions like dance.
Imperfect measure of acceptability
The study used dropout rates as a proxy for acceptability, which may not perfectly reflect adherence to the exercise program.
Unexpected finding regarding autonomy
The study found that increased autonomy was associated with weaker effects of exercise, contrary to the initial hypothesis. This finding needs to be interpreted cautiously and may be due to confounding factors or limitations in how autonomy was measured.
Rating Explanation
This is a strong systematic review and meta-analysis with a large number of studies, providing valuable insights into the effectiveness of exercise for depression. Despite some limitations, the findings are important and have implications for clinical practice. The lack of blinding and reliance on dropout rates as a proxy for adherence prevent a full 5-star rating.
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File Information
Original Title:
Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials
File Name:
bmj-2023-075847.full.pdf
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File Size:
1.76 MB
Uploaded:
July 22, 2025 at 12:56 PM
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