Exercise Interventions in Depressed Populations
There is growing recognition and acceptance of exercise as a useful treatment option for depression among general populations. In a recent systematic review and metaregression analysis of RCTs, Lawlor and Hopker concluded that exercise may be efficacious in reducing symptoms of depression (standardised mean difference in effect size, -1.1; 95% CI: -1.5 - -0.6), although the authors expressed concerns about the quality and small sample size of many studies and the inclusion of individuals without clinical levels of depression. Another meta-analysis excluded studies that did not target clinical levels of depression, were not published in peer-reviewed journals, or did nor provide a non-active comparison group. Results from this meta-analysis of 11 treatment studies of individuals with depression yielded a very large combined effect size (Cohen's d = 1.42; 95% CI: 0.92-1.93), providing convincing statistical evidence to support the use of exercise for the treatment of clinically significant depression.
Furthermore, mean drop out rate for the exercise interventions in this meta-analysis (based on data from 8/11 studies) was approximately 20%, which is similar or better than for antidepressant treatments for depression, which have reported discontinuation rates of between 21% and 31%, depending on the type of drug. This systematic review did not assess the quality of the studies included in the review, and whilst the authors report a large effect size, it is difficult to know what this finding translates to in clinical terms.
The UK National Institute for Clinical Excellence (NICE) guidelines for treating depression recommend that patients be advised about the benefits of exercise. The "At Least Five a Week" report of the United Kingdom Chief Medical Officer also concluded that exercise participation can promote mental health and feelings of well-being. It seems plausible that regular exercise may also have a positive effect in the management of depression, specifically in postpartum women.
J Midwifery Womens Health. 2007;52(1):56-62. © 2007 Elsevier Science, Inc.
Cite this: The Role of Exercise in Treating Postpartum Depression: A Review of the Literature - Medscape - Jan 01, 2007.