Exercise in the Prevention and Treatment of Adolescent Depression: A Promising but Little Researched Intervention

vol. 2 • no. 6 Abstract: Despite a dramatic increase in the number of treatment studies for adolescent major depressive disorder in the past 15 years, the majority being clinical trials of medications and cogni-tive behavioral therapy, response rates have been modest and remission rates low. Moreover, most positive respond-ers posttreatment have many resid-ual symptoms, significant functional impairment, and high rates of relapse. There is a need for the development of new, more effective interventions to treat this severe, chronic condition that usually persists into adulthood with poor long-term outcomes. Findings from preliminary treatment studies suggest that exercise may have the potential to be efficacious as a monotherapy or as part of a combined treatment for ado-lescent major depressive disorder. This review summarizes the findings and analyzes the design flaws of random-ized trials of exercise to treat adolescent depression, offering recommendations on how to design more methodologically sound studies with an emphasis on subject selection criteria; issues related to control conditions, types of diagnostic interviews, and mea-sures needed to establish the diagnosis of depression; types of exercise treat-ments; and appropriate outcome mea-sures. Future studies of exercise to treat and prevent adolescent major depressive disorder need to be comparable to state-of-the-art treatment studies of pharmaco-therapy and cognitive behavioral therapy in this population to more accurately determine its efficacy and potential public health benefits