Wanjau Mary Njeri, Möller Holger, Haigh Fiona, Milat Andrew, Hayek Rema, Lucas Peta, Veerman J Lennert
Public Health & Economics Modelling Group, School of Medicine and Dentistry, Griffith University, Southport, Australia.
School of Population Health, University of New South Wales Sydney, Kensington, Australia.
AJPM Focus. 2023 Feb 4;2(2):100074. doi: 10.1016/j.focus.2023.100074. eCollection 2023 Jun.
Globally, depressive and anxiety disorders are the leading contributors to mental ill health. Physical activity reduces symptoms of depression and anxiety and has been proposed as an adjunct treatment therapy for depression and anxiety. Prospective studies suggest that physical activity may reduce the incidence of depression and anxiety. We conducted a systematic review of reviews with the aim to provide a comprehensive overview of available epidemiologic evidence on the strength of the association between physical activity and incident cases of depression and anxiety and to assess the likelihood of these associations being causal.
We searched Embase and PubMed databases for systematic reviews published between January 1, 2000 and March 19, 2020 that reported findings on the strength of association between physical activity and incidence of depression and anxiety. We updated this search to October 15, 2022. Two reviewers independently assessed the methodologic quality of the included reviews using the Assessment of Multiple Systematic Reviews rating scale. We carried out a narrative synthesis of the evidence. We used the Bradford Hill criteria to assess the likelihood of associations being causal.
The initial search yielded 770 articles, of which 4 remained for data extraction. Two of the included reviews were scored as high quality, and 2 were scored as low quality. From the 2 included reviews that reported pooled estimates, people with high physical activity levels were found to have a decreased risk of incident depression (adjusted RR=0.83, 95% CI=0.76, 0.90) and reduced odds of developing anxiety (adjusted OR=0.74,95% CI=0.62, 0.88) when compared with those with low physical activity levels. We assessed physical activity to be probably causally related to both depression and anxiety.
Our evidence is drawn from systematic reviews of observational data. Further high-quality studies, such as randomized control trials, would help to strengthen the evidence base of the associations between physical activity and depression and anxiety. Nonetheless, our findings provide empirical support for the consideration of physical activity in strategies for the prevention of mental ill health.
在全球范围内，抑郁和焦虑障碍是导致精神健康问题的主要因素。体育活动可减轻抑郁和焦虑症状，并已被提议作为抑郁和焦虑的辅助治疗方法。前瞻性研究表明，体育活动可能会降低抑郁和焦虑的发病率。我们进行了一项综述的系统评价，旨在全面概述关于体育活动与抑郁和焦虑发病病例之间关联强度的现有流行病学证据，并评估这些关联为因果关系的可能性。
我们在Embase和PubMed数据库中检索了2000年1月1日至2020年3月19日期间发表的系统评价，这些评价报告了体育活动与抑郁和焦虑发病率之间关联强度的研究结果。我们将此检索更新至2022年10月15日。两名评审员使用多系统评价评估量表独立评估纳入综述的方法学质量。我们对证据进行了叙述性综合。我们使用布拉德福德·希尔标准评估关联为因果关系的可能性。
初步检索产生了770篇文章，其中4篇留作数据提取。纳入的综述中有2篇被评为高质量,2篇被评为低质量。从2篇报告合并估计值的纳入综述中发现，与体育活动水平低的人相比，体育活动水平高的人发生抑郁的风险降低（调整后RR=0.83，95%CI=0.76，0.90），发生焦虑的几率降低（调整后OR=0.74，95%CI=0.62，0.88）。我们评估体育活动可能与抑郁和焦虑均存在因果关系。
我们的证据来自对观察性数据的系统评价。进一步的高质量研究，如随机对照试验，将有助于加强体育活动与抑郁和焦虑之间关联的证据基础。尽管如此，我们的研究结果为在预防精神健康问题的策略中考虑体育活动提供了实证支持。
