Impact of Physical Exercise on Depression and Anxiety in Adolescent Inpatients: A Randomized Controlled Trial

Background

• Depression is a leading cause of disability worldwide, affecting adolescents and often leading to adult major depressive disorders.
• Anxiety often precedes depression.
• Physical exercise is effective in treating adult depression but lacks evidence in adolescents.
• This study aims to evaluate the effect of structured physical exercise in adolescents hospitalized for depression and anxiety.

Study Design

• Type: Randomized controlled trial (RCT)
• Participants: 52 adolescent inpatients, aged 12-19, from a psychiatric hospital in Brussels, Belgium.
• Intervention: Participants were assigned to either a physical exercise program or a social relaxation activity (control group).
• Duration: 20 sessions, 1 hour each, over 5-6 weeks.
• Outcome Measures: Primary - Hospital Anxiety and Depression Scale (HADS); Secondary - various psychological assessments and physical fitness measurements.

Eligibility Criteria

• Inclusion: Adolescents aged 12-19, in an educational program, no neurological history, willing to randomize.
• Exclusion: Neurological/psychosis conditions, BMI > P95, cardiovascular restrictions, conduct disorders, etc.

Results

• Participants: 40 completed the study (20 per group after dropouts).
• Primary Outcomes:
  • Depression scores (HADS-D) decreased significantly more in the exercise group (3.8 points) compared to the control group (0.7 points).
  • No significant change in anxiety scores (HADS-A) between groups.
• Secondary Outcomes:
  • Significant improvement in depression symptoms on SDS scale in the exercise group.
  • Cardiovascular fitness (VO2max) improved in the exercise group.
• Other Findings: Participation and enjoyment levels were high in both groups.

Discussion

• Key Findings:
  • Structured exercise significantly reduced depressive symptoms but not anxiety.
  • Exercise also improved cardiovascular fitness and was well-received.
• Theoretical Implications:
  • Positive life experiences and improved therapeutic alliances might contribute to depression alleviation.
  • Exercise may benefit brain functions related to mood disorders.
• Limitations:
  • Small sample size and short hospital window.
  • High dropout rate related to hospitalization challenges.

Conclusion

• Structured physical exercise can be an effective adjunct therapy in psychiatric care for adolescents with depression.
• Future research should explore the long-term effects of exercise and its interaction with other treatments.

Author Contributions and Acknowledgments

• Primary Authors: Arnaud Philippot, Vincent Dubois, Kate Lambrechts, and others.
• Funding: Sponsored by the Baillet-Latour asbl Funds.
• Ethics: Approved by the Université catholique de Louvain ethics committee.

References

• Includes studies on depression and interventions using physical activity, such as Carter et al., 2015; Schuch et al., 2016.