Impact of physical exercise on depression and anxiety in adolescent inpatients: A randomized controlled trial

Abstract

Background: Physical exercise therapy is of proven efficacy in the treatment of adults with depression, but corresponding evidence is lacking in depressed adolescent inpatients. The aim of this study was to document the effect of add-on treatment with structured physical exercise in a clinical population of adolescents hospitalized for depression and anxiety in a psychiatric hospital.

Methods: A group of 52 adolescent inpatients was randomly assigned to a physical exercise or control program three to four times per week over a six-week period (20 hours in total). The primary outcome was the Hospital Anxiety Depression Scale (HADS) for evaluation of depression and anxiety symptoms. Secondary outcomes were psychological self-assessments, diagnostic interviews, and physical examinations.

Results: Six participants were lost in each group, leaving 20 inpatients each in the intervention and control groups. A linear mixed model with F-test revealed a significant interaction in favor of physical exercise in reducing the mean depression score (HADS-D) by 3.8 points [95% (CI), range 1.8 to 5.7], compared to a mean reduction score of 0.7 [95% (CI), range -0,7 to 2.0] in the control group. No significant interaction was found for anxiety symptoms (HADS-A).

Limitations: The investigation was limited to the six-week hospital window and the small sample size prevented exploring differences in social characteristics.

Conclusion: Structured physical exercise add-on therapy integrated into the psychiatric hospitalization of adolescents has led to a reduction in their depressive symptoms, demonstrating its effectiveness in the care of adolescent inpatients with depression.

Keywords: Abbreviations; Adolescents; Anxiety; BDI-13, beck depression inventory (13 items); CDI; Depression; HADS; HAM-D; Physical exercise; Psychiatry; SDS; STAI; VO2max; children depression inventory; hamilton rating scale for depression; hospital anxiety and depression scale; maximal oxygen consumption; state-trait anxiety inventory; zung self-rating depression scale.