{"title":"Exercise types for efficacy and adherence in adolescents and young adults with depression: A systematic review with network meta-analysis","authors":"Ting Fan, Geng Li, Chengzhen Liu","doi":"10.1016/j.mhpa.2025.100696","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>While existing research shows that exercise can positively influence depression, it remains uncertain whether the efficacy and adherence of different exercise types on depressed adolescents and young adults differ.</div></div><div><h3>Aims</h3><div>This study performed a network meta-analysis of randomized controlled trials (RCTs) to determine the relative efficacy and adherence of exercise types in adolescents and young adults with depression.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, The Cochrane Library, PsycINFO, Web of Science, Scopus, CNKI, and Wanfang, with the initial search covering studies up to October 2023 and an updated search performed in April 2025 to ensure inclusion of the most recent evidence. Studies comparing the efficacy and adherence of aerobic exercise, resistance exercise, mind-body exercise, or mixed exercise to usual care in adolescents and young adults with depression were included. Network meta-analysis with frequentist approaches was used for analysis in Stata 16.0.</div></div><div><h3>Results</h3><div>We included 48 randomized controlled trials comprising 3872 participants. Aerobic, resistance, mind-body, and mixed exercise interventions all demonstrated significant efficacy in alleviating depressive symptoms (<em>p</em> < 0.05), with adherence rates comparable to those observed in usual care (<em>p</em> > 0.05). Notably, resistance exercise emerged as the most effective approach, ranking highest in both reducing depression (SUCRA = 81.3) and sustaining adherence (SUCRA = 73.29). Additionally, intervention efficacy was significantly moderated by both the duration of the intervention and the average age of participants.</div></div><div><h3>Conclusion</h3><div>These findings highlight the superiority of resistance exercise in treating depression among adolescents and young adults. Moreover, intervention duration and mean participant age were identified as key factors influencing treatment efficacy. Together, these results offer valuable evidence to inform clinical decision-making and enhance current guidelines for managing depression in this vulnerable population.</div></div>","PeriodicalId":51589,"journal":{"name":"Mental Health and Physical Activity","volume":"29 ","pages":"Article 100696"},"PeriodicalIF":2.3000,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Mental Health and Physical Activity","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1755296625000274","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
While existing research shows that exercise can positively influence depression, it remains uncertain whether the efficacy and adherence of different exercise types on depressed adolescents and young adults differ.
Aims
This study performed a network meta-analysis of randomized controlled trials (RCTs) to determine the relative efficacy and adherence of exercise types in adolescents and young adults with depression.
Methods
A comprehensive search was conducted in PubMed, The Cochrane Library, PsycINFO, Web of Science, Scopus, CNKI, and Wanfang, with the initial search covering studies up to October 2023 and an updated search performed in April 2025 to ensure inclusion of the most recent evidence. Studies comparing the efficacy and adherence of aerobic exercise, resistance exercise, mind-body exercise, or mixed exercise to usual care in adolescents and young adults with depression were included. Network meta-analysis with frequentist approaches was used for analysis in Stata 16.0.
Results
We included 48 randomized controlled trials comprising 3872 participants. Aerobic, resistance, mind-body, and mixed exercise interventions all demonstrated significant efficacy in alleviating depressive symptoms (p < 0.05), with adherence rates comparable to those observed in usual care (p > 0.05). Notably, resistance exercise emerged as the most effective approach, ranking highest in both reducing depression (SUCRA = 81.3) and sustaining adherence (SUCRA = 73.29). Additionally, intervention efficacy was significantly moderated by both the duration of the intervention and the average age of participants.
Conclusion
These findings highlight the superiority of resistance exercise in treating depression among adolescents and young adults. Moreover, intervention duration and mean participant age were identified as key factors influencing treatment efficacy. Together, these results offer valuable evidence to inform clinical decision-making and enhance current guidelines for managing depression in this vulnerable population.
期刊介绍:
The aims of Mental Health and Physical Activity will be: (1) to foster the inter-disciplinary development and understanding of the mental health and physical activity field; (2) to develop research designs and methods to advance our understanding; (3) to promote the publication of high quality research on the effects of physical activity (interventions and a single session) on a wide range of dimensions of mental health and psychological well-being (eg, depression, anxiety and stress responses, mood, cognitive functioning and neurological disorders, such as dementia, self-esteem and related constructs, psychological aspects of quality of life among people with physical and mental illness, sleep, addictive disorders, eating disorders), from both efficacy and effectiveness trials;