CHILD & ADOLESCENT PSYCHIATRY
Following the holidays and the start of the New Year, adults often make renewed efforts to exercise. Physical and mental health can be affected positively by an increase in physical activity. Exercise has shown some benefits of improvement in depression for adults, but is there a relationship between exercise and depression in children and adolescents? Some recent studies shed light on this issue.
Physical activity and depression
The relationship between physical activity and major depression in middle childhood was assessed in a prospective study.1 Six-year-old children (N = 795) in a community in Norway were followed up at age 8 and 10 years. Semistructured clinical interviews of parents and children were conducted to evaluate symptoms of major depression at each assessment. Physical activity was assessed using an accelerometer that was worn for 7 days during the assessment periods.
Higher levels of moderate to vigorous physical activity at age 6 predicted fewer major depressive symptoms 2 years later. Similarly, moderate to vigorous physical activity at age 8 predicted fewer major depressive symptoms 2 years later. There was no association between sedentary behavior and depression. On the basis of these findings, the investigators concluded that increasing moderate to vigorous physical activity in children may prevent future symptoms of depression.
The relationship between physical activity and depression was also recently studied in adolescents during the course of 11 years.2 Adolescents (N = 1160) with a mean age of 13 years completed questionnaires at 4 points, up to age 21. Depression was assessed by self-report using the Children’s Depression Inventory. Physical activity was assessed by self-report using the Leisure Time Exercise Questionnaire in which adolescents assessed their activity over the past 7 days and recorded the number of episodes of mild, moderate, and strenuous activity.
It was found that physical activity decreased over time and symptoms of depression increased over time. Higher initial symptoms of depression were associated with greater decreases in physical activity over time. The authors suggest that treatment strategies target symptoms of depression at about age 13 to prevent a decrease in physical activity and an increase in depressive symptoms.
Dr. Wagner is Professor and Chair of the department of psychiatry and behavioral sciences at the University of Texas Medical Branch at Galveston. She is the Child and Adolescent Psychiatry columnist for Psychiatric Times.
1. Zahl T, Steinsbekk S, Wichstrøm L. Physical activity, sedentary behavior, and symptoms of major depression in middle childhood. Pediatrics. 2017;139:e20161711.
2. Gunnell KE, Flament MF, Buchholz A, et al. Examining the bidirectional relationship between physical activity, screen time, and symptoms of anxiety and depression over time during adolescence. Prevent Med. 2016;88:147-152.
3. Carter T, Morres I, Repper J, Callaghan P. Exercise for adolescents with depression: valued aspects and perceived change. J Psychiatr Mental Health Nurs. 2016;23:37-44.
4. Carter T, Guo B, Turner D, et al. Preferred intensity exercise for adolescents receiving treatment for depression: a pragmatic randomised controlled trial. BMC Psychiatry. 2015;15:247.