title: Physical activity interventions and depression in children and adolescents : a systematic review and meta-analysis.
abstract: BACKGROUND
  Evidence suggests chronic physical activity (PA) participation may be both protective against the onset of and beneficial for reducing depressive symptoms.
  
  
  OBJECTIVE
  The aim of this article is to assess the impact of PA interventions on depression in children and adolescents using meta-analysis.
  
  
  METHODS
  Published English language studies were located from manual and computerized searches of the following databases: PsycInfo, The Cochrane Database of Systematic Reviews and The Cochrane Central Register of Controlled Trials, Trials Register of Promoting Health Interventions (TRoPHI; EPPI Centre), Web of Science and MEDLINE.
  
  
  METHODS
  Studies meeting inclusion criteria (1) reported on interventions to promote or increase PA; (2) included children aged 5-11 years and/or adolescents aged 12-19 years; (3) reported on results using a quantitative measure of depression; (4) included a non-physical control or comparison group; and (5) were published in peer-reviewed journals written in English, up to and including May 2011 (when the search was conducted).
  
  
  METHODS
  Studies were coded for methodological, participant and study characteristics. Comprehensive Meta-Analysis version-2 software was used to compute effect sizes, with subgroup analyses to identify moderating characteristics. Study quality was assessed using the Delphi technique.
  
  
  RESULTS
  Nine studies were included (n = 581); most were school-based randomized controlled trials, randomized by individual. Studies used a variety of measurement tools to assess depressive symptoms. The summary treatment effect was small but significant (Hedges' g = -0.26, standard error = 0.09, 95% confidence intervals = -0.43, -0.08, p = 0.004). Subgroup analyses showed that methodological (e.g. studies with both education and PA intervention; those with a higher quality score; and less than 3 months in duration) and participant characteristics (e.g. single-gender studies; those targeting overweight or obese groups) contributed most to the reduction in depression.
  
  
  CONCLUSIONS
  There was a small significant overall effect for PA on depression. More outcome-focused, high-quality trials are required to effectively inform the implementation of programmes to reduce depressive symptoms in children and adolescents.
authors: School of Human Movement Studies, The University of Queensland, Brisbane, QLD, Australia. h.brown1@uq.edu.au
authors: Helen Elizabeth
authors: HE
authors: Brown
authors: Natalie
authors: N
authors: Pearson
authors: Rock E
authors: RE
authors: Braithwaite
authors: Wendy J
authors: WJ
authors: Brown
authors: Stuart J H
authors: SJ
authors: Biddle
mesh_terms: D000293:Adolescent; D002648:Child; D003863:Depression / Q000517:prevention & control*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity