title: Preferred intensity exercise for adolescents receiving treatment for depression: a pragmatic randomised controlled trial.
abstract: BACKGROUND
  Exercise has been shown to be effective in treating depression, but trials testing the effect of exercise for depressed adolescents utilising mental health services are rare. The aim of this study was to determine the effectiveness of a preferred intensity exercise intervention on the depressive symptoms of adolescents with depression.
  
  
  METHODS
  We randomly assigned 87 adolescents who were receiving treatment for depression to either 12 sessions of aerobic exercise at preferred intensity alongside treatment as usual or treatment as usual only. The primary outcome was depressive symptom change using the Children's Depression Inventory 2(nd) Version (CDI-2) at post intervention. Secondary outcomes were health-related quality of life and physical activity rates. Outcomes were taken at baseline, post intervention and at six month follow up.
  
  
  RESULTS
  CDI-2 score reduction did not differ significantly between groups at post-intervention (est. 95% CI -6.82, 1.68, p = 0.23). However, there was a difference in CDI-2 score reduction at six month follow-up in favour of the intervention of -4.81 (est. 95% CI -9.49, -0.12, p = 0.03). Health-related quality of life and physical activity rates did not differ significantly between groups at post-intervention and follow-up.
  
  
  CONCLUSIONS
  There was no additional effect of preferred intensity exercise alongside treatment as usual on depressive reduction immediately post intervention. However, effects were observed at six months post-intervention, suggesting a delayed response. However, further trials, with larger samples are required to determine the validity of this finding.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01474837, March 16 2011.
authors.affiliation: School of Health Sciences, University of Nottingham, Nottingham, UK. Timothy.carter@nottingham.ac.uk.
authors.forename: Tim
authors.initials: T
authors.lastname: Carter
authors.affiliation: Division of Psychiatry & Applied Psychology, University of Nottingham, Nottingham, UK. boliang.guo@nottingham.ac.uk.
authors.forename: Boliang
authors.initials: B
authors.lastname: Guo
authors.affiliation: School of Medicine, University of East Anglia, East Anglia, UK. David.A.Turner@uea.ac.uk.
authors.forename: David
authors.initials: D
authors.lastname: Turner
authors.affiliation: Department of Physical Education & Sport Science, University of Thessaly, Trikala, Greece. iomorres@pe.uth.gr.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Morres
authors.affiliation: School of Health Sciences, University of Nottingham, Nottingham, UK. Elizabeth.khalil@nottingham.ac.uk.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Khalil
authors.affiliation: School of Health Sciences, University of Nottingham, Nottingham, UK. emilybrighton@hotmail.co.uk.
authors.forename: Emily
authors.initials: E
authors.lastname: Brighton
authors.affiliation: Specialist CAMHS, Nottinghamshire Healthcare NHS Trust, Nottingham, UK. Marie.armstrong@nottingham.ac.uk.
authors.forename: Marie
authors.initials: M
authors.lastname: Armstrong
authors.affiliation: School of Health Sciences, University of Nottingham, Nottingham, UK. Patrick.callaghan@nottingham.ac.uk.
authors.forename: Patrick
authors.initials: P
authors.lastname: Callaghan
mesh_terms: D000293:Adolescent; D003863:Depression / Q000523:psychology* / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services; D017063:Outcome Assessment, Health Care; D011788:Quality of Life