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Paeds MH – Higher levels of sport and physical activity and lower levels of sedentary activity are associated with fewer symptoms of depression in the future

Evidence Summary
1.1 Fourteen Studies evaluated the association between performing physical activity and later displaying symptoms of depression.

1.2 Thirteen of these were longitudinal studies. Twelve of these studies were observational, whilst one used an intervention of supervised exercise sessions. The other study was a randomised controlled trial.

1.3 Most of these studies (ten of fourteen) illustrated a reduced risk of developing depressive symptoms in those that performed physical activity in childhood or adolescence.

1.3a In adolescents;
· Those physically active in adolescence were less likely to become depressed after work stress
· Adolescents who consistently participated in team sport reported lower depression scores in early adulthood
· Adolescents with higher frequencies of PA are more resilient to developing depressive symptoms
· Boys reporting to be less physically active had increased risk of anxiety/depression.
· In adolescents already diagnosed with depression, after three months of supervised exercise most had maintained or reduced their depression scores.
· The RCT suggested that implementation of yoga is acceptable and feasible in a secondary school setting and has the potential of playing a protective or preventive role in maintaining mental health

1.3b In children;
· Higher moderate to vigorous physical activity predicted fewer symptoms of major depressive disorder 2 years later
Quality of Evidence
B Moderate
Strength of Recommendation
1B Strong recommendation, but moderate quality evidence as mainly longitudinal studies.
Conclusion
Fourteen Studies evaluated the association between performing physical activity and later displaying symptoms of depression. Children (in the short term) and adolescents who engage in higher frequencies of physical activity are more resilient to developing depressive symptoms later in life.


References
· Jerstad SJ, Boutelle KN, Ness KK, Stice E. Prospective reciprocal relations between physical activity and depression in female adolescents. Journal of consulting and clinical psychology. 2010 Apr;78(2):268.
· McPhie ML, Rawana JS. The effect of physical activity on depression in adolescence and emerging adulthood: A growth-curve analysis. Journal of adolescence. 2015 Apr 1;40:83-92.
· Zahl T, Steinsbekk S, Wichstrøm L. Physical activity, sedentary behavior, and symptoms of major depression in middle childhood. Pediatrics. 2017 Feb 1;139(2):e20161711.
· Colman I, Zeng Y, McMartin SE, Naicker K, Ataullahjan A, Weeks M, Senthilselvan A, Galambos NL. Protective factors against depression during the transition from adolescence to adulthood: findings from a national Canadian cohort. Preventive medicine. 2014 Aug 1;65:28-32.
· Sabiston CM, Jewett R, Ashdown-Franks G, Belanger M, Brunet J, O’Loughlin E, O’Loughlin J. Number of years of team and individual sport participation during adolescence and depressive symptoms in early adulthood. Journal of sport and exercise psychology. 2016 Feb 1;38(1):105-10.
· McPhie ML, Rawana JS. The effect of physical activity on depression in adolescence and emerging adulthood: A growth-curve analysis. Journal of adolescence. 2015 Apr 1;40:83-92.
· Dopp RR, Mooney AJ, Armitage R, King C. Exercise for adolescents with depressive disorders: a feasibility study. Depression research and treatment. 2012;2012.
· Lewis G, Jones PB, Goodyer IM. The ROOTS study: a 10-year review of findings on adolescent depression, and recommendations for future longitudinal research. Social psychiatry and psychiatric epidemiology. 2016 Feb 1;51(2):161-70.
· Fløtnes IS, Nilsen TI, Augestad LB. Norwegian adolescents, physical activity and mental health: The Young-HUNT study. Norsk epidemiologi. 2011 Aug 3;20(2).
· Birkeland MS, Torsheim T, Wold B. A longitudinal study of the relationship between leisure-time physical activity and depressed mood among adolescents. Psychology of Sport and Exercise. 2009 Jan 1;10(1):25-34.
· Feldman E. Active Children: Do Higher Levels of Activity Help Prevent Depression?. Integrative Medicine Alert. 2017 Sep 1;20(9).
· Colman I, Zeng Y, McMartin SE, Naicker K, Ataullahjan A, Weeks M, Senthilselvan A, Galambos NL. Protective factors against depression during the transition from adolescence to adulthood: findings from a national Canadian cohort. Preventive medicine. 2014 Aug 1;65:28-32.

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