Systematic review of the impact of physical activity on depression and anxiety symptoms

Revisión sistemática del impacto de la actividad física en los síntomas de depresión y ansiedad

Muntean Raul-Ioan1; Mihaela Oravițan2

1Faculty of  Law and Social Sciences, Department of Physical Education and Sport, University “1 Decembrie 1918” of Alba Iulia, Alba Iulia, Romania.

2Faculty of Physical Education and Sport, Departament of Physical Therapy and Special Motricity, West University of Timisoara, Timisoara, Romania.

Detalles del artículo:

Número de palabras: 3.886; Tablas: 1; Figuras: 1; Referencias: 20

Recibido: noviembre 2022; Aceptado: diciembre 2022; Publicado: diciembre 2022  

Conflicto de interés: El autor declara que no existen conflictos de interés.

Correspondencia del autor: Muntean Raul Ioan, muntean.raul@uab.ro

Abstract

According to estimates, depression will affect 340 million people globally by 2020, making it the major cause of disability and the second-largest contributor to the global burden of disease. It influences a person's thinking, actions, motivation, emotions, and well-being. Anhedonia is thought to be the primary symptom of depression, which refers to a loss of interest or pleasure in various activities that normally bring individuals happiness. Major depressive disorder and dysthymia are two mood disorders that can cause depression. This review aims to describe the scientific literature that has explored the influence and effect of physical activity on symptoms of depression. Using the electronic databases Scopus, Psycho-info, CINAHL, PubMed and ProQuest, Google Scholar and Research Gate, it was possible to locate publications on this topic using the following keywords: physical activity, physical effort, depression, depressive symptom and anxiety. We were able to identify 16,301 published articles, but of these we chose only 17 articles after applying their eligibility standards for our review.Physical activity has a significant role in reducing the symptoms of depression, anxiety, and stress, independent of the subject's age, gender, or medical condition, as demonstrated by the 17 studies included in this study. The majority of the interventions, which were performed on clinically healthy subjects, persons with medical issues, and pregnant women, involved aerobic and anaerobic exercise programs. Different ages, sexes, and living situations were present among the study individuals. In certain studies, exercise therapies have been used in addition to standard pharmaceutical depression treatment. The physical exercise programs ranged in length from 12 weeks to 6 months overall, with 2-3 sessions per week lasting between 30 and 90 minutes each.

Key words: sports, mental health, physical effort, physical activity, stress

‬ Resumen

Según estimaciones, la depresión afectará a 340 millones de personas en todo el mundo para 2020, lo que la convierte en la principal causa de discapacidad y el segundo factor que más contribuye a la carga mundial de enfermedades. Influye en el pensamiento, las acciones, la motivación, las emociones y el bienestar de una persona. Se cree que la anhedonia es el síntoma principal de la depresión, que se refiere a la pérdida de interés o placer en diversas actividades que normalmente brindan felicidad a las personas. El trastorno depresivo mayor y la distimia son dos trastornos del estado de ánimo que pueden causar depresión. Esta revisión tiene como objetivo describir la literatura científica que ha explorado la influencia y el efecto de la actividad física sobre los síntomas de la depresión. Utilizando las bases de datos electrónicas Scopus, Psycho-info, CINAHL, PubMed y ProQuest, Google Scholar y Research Gate, fue posible localizar publicaciones sobre este tema utilizando las siguientes palabras clave: actividad física, esfuerzo físico, depresión, síntoma depresivo y ansiedad. Pudimos identificar 16.301 artículos publicados, pero de estos elegimos solo 17 artículos después de aplicar sus estándares de elegibilidad para nuestra revisión. La actividad física tiene un papel importante en la reducción de los síntomas de depresión, ansiedad y estrés, independientemente de la edad del sujeto. género o condición médica, como lo demuestran los 17 estudios incluidos en este estudio. La mayoría de las intervenciones, que se realizaron en sujetos clínicamente sanos, personas con problemas médicos y mujeres embarazadas, incluyeron programas de ejercicios aeróbicos y anaeróbicos. Diferentes edades, sexos y situaciones de vida estaban presentes entre los individuos del estudio. En ciertos estudios, las terapias de ejercicio se han utilizado además del tratamiento farmacéutico estándar para la depresión. Los programas de ejercicio físico variaron en duración de 12 semanas a 6 meses en general, con 2-3 sesiones por semana con una duración de entre 30 y 90 minutos cada una.

Palabras claves: deporte, salud mental, esfuerzo físico, actividad física, estrés

INTRODUCTION

Based on the notion that health reflects the physical, mental, and social integrity of the individual and the collectives, We chose to conduct this systematic review to determine the relationship between these components and the significance of their harmony.

Noticing that no studies have been conducted at the national level regarding the importance of correlating mental and physical health in approaches based on physical activity, I believed that such a review of the scientific literature could provide new insights into the mentality of future generations.

Since the beginning of the pandemic produced by the SARS-CoV-2 virus, depression and anxiety have left their imprint on the global population, regardless of age, the primary etiological element being a lack of structured or unorganized physical activity (Heitzman, 2020).

During pandemics and epidemics, there may be mental and social disorders that impair population activity. The anxiety of becoming ill exacerbates the disease. During pandemics, the population endures some worry and anxiety, and psychological illnesses become prevalent (Liu, 2020).

Prior research conducted during the initial phase of the coronavirus pandemic revealed that more than half of respondents assessed the psychological impact as moderate to severe, and around one-third expressed moderate to severe anxiety (Wang, 2020).

The COVID-19 pandemic has had terrible impacts on mental health. The virus resulted in social isolation, worry and suffering, the closure of schools put students, parents, and teachers under stress, the diagnosis took longer than expected, making it more challenging for affected patients to continue receiving treatment, and health care staff burned out. In conclusion, unprecedented measures are being taken to assess the mental health of all citizens.

This review aims to describe the scientific literature that has explored the effect of physical activity on depressive, anxious, and stressful symptoms.

MATERIAL AND METHODS

Using the electronic databases Scopus, Psycho-info, CINAHL, PubMed and ProQuest, Google Scholar, and Research Gate, we identified publications on this issue using the following keywords: physical activity, physical exertion, depression, depressive symptom, anxiety, and stress. In the second phase, a combination of keywords was utilized to achieve the most accurate search results, and papers that examined the influence of physical exercise on the symptoms of depression, anxiety, and stress were selected.

Eligibility requirements

To be considered for inclusion in the review, scientific papers have to satisfy the following criteria:

 - Articles that explored the effect of physical activity on depressive, anxious, and stressful symptoms.

 - Articles accessible in a complete text.

 - Only published/accessible abstracts for published articles.

 Excluded articles from the review:

 - Articles devoid of investigative specifics.

 - Articles that are either systematic reviews or meta-analyses.

 - Content older than 2009.

Figure 1. Prisma flow chart (www.prisma.org)

We used the Prisma protocol to be able to eliminate articles that could not be included in this systematic review. Since from all the databases used we were able to find 16,301 articles, after eliminating duplicate articles (1,687), articles that did not fit in terms of the year of publication, those published in abstract and excluded for other reasons, we remained and we evaluated 168 articles from which we excluded some, we was left with a number of 17 articles that we included in this study.

RESULTS

According to the diagram displayed above (Figure 1), a total of 16,301 items were recognized. It can be shown that, due to the pandemic situation in recent years, there are approximately 150 more papers published annually on this topic.

We chose 17 articles (Table 1) that satisfied the inclusion and exclusion requirements. The results indicate that physical activity is a significant influence in reducing the symptoms of depression, anxiety, and stress, regardless of the subject's age, sex, or medical condition.

Table 1. Included Studies in the Review

The majority of the interventions, which were performed on clinically healthy subjects, persons with medical issues, and pregnant women, involved aerobic and anaerobic exercise programs.

Different ages, sexes, and living situations were present among the study individuals. In certain studies, exercise therapies have been used in addition to standard pharmaceutical depression treatment.

The physical exercise programs ranged in overall length from 12 weeks to 6 months. The physical exercise programs ranged in length from 12 weeks to 6 months overall, with 2-3 sessions per week lasting between 30 and 90 minutes each.

Both active and passive control conditions—including placebos, relaxation training, stretches, routine treatment (drug therapy), cooperative group activities with other participants, and occupational therapy—were recorded.

None of the studies that were reviewed evaluated or provided information on the negative effects of exercise programs (eg, pain, soreness, fatigue, or injury).

DISCUSSION

These studies demonstrate that there is a close relationship between physical activity and the reduction of symptoms of depression, anxiety, and stress. They also demonstrate that endorphins, also known as the "happiness hormone," are produced through physical activity and give the subject, regardless of age, gender, or social status, a sense of well-being.

Studies are conducted on samples ranging from hundreds to millions of people, thus the intimate relationship between the physical and mental is essential for a calm and healthy life on all levels.

The results of the investigations indicated that the group sessions reduced the depression symptoms of the participants.

People who consistently engage in physical activity engage in more positive leisure activities and receive more social support, resulting in improved psychological well-being, which in turn decreases depression. Continued physical activity promotes social support, including the development of friendships, the sharing of emotional support, and the discussion of personal issues. Physical activity can ultimately alleviate depression in daily life and have a favorable effect on mental health.

Physical activity enhances social integration in the setting of society. Moreover, it increases life satisfaction and decreases loneliness.

According to the findings of the studies, physical activity was connected with fewer sleep issues and depressive symptoms.

Finally, we recommend that family members encourage individuals of all ages to engage in physical activity and to participate in activities given by social centers, schools, associations, and sports clubs. These straightforward procedures may contribute to the emotional wellness of loved ones.

CONCLUSIONS

The study demonstrates that physical activity has a significant effect on depressive symptoms. Consistently producing endorphins through physical activity is a crucial component in postponing the development of symptoms.

On the subjects of the studies, intervention with a well-established physical exercise program reduces the incidence of symptoms of depression, anxiety, and stress.

It also demonstrates that physical activity has an effect regardless of the reason for the symptoms, whether they were from failure, the loss of a loved one, or the diagnosis of a medical problem or disease.

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