Wang Wenli, Liu Hairong, Feng Qiangming, Peng Yuanming, Si Yanran
Faculty for Physical Education, Shanghai International Studies University, Shanghai, China.
Front Psychol. 2025 Jun 13;16:1517492. doi: 10.3389/fpsyg.2025.1517492. eCollection 2025.
The objective of this study is to systematically evaluate the effects of exercise interventions on depressive symptoms and suicidal tendencies in patients with depression, and to investigate the differential impacts of various exercise programs on alleviating depressive symptoms.
Computerized searches were conducted in PubMed, The Cochrane Library, Embase, WOS, EBSCO, CNKI, Wanfang, and VIP databases from their inception to May 5, 2025. Randomized controlled trials assessing the effect of exercise interventions on suicidal tendencies in depressed patients were screened by two independent researchers. The PEDro scale assessed study quality, and GRADEPro evaluated evidence quality. ReMan 5.4.1 was used for Meta-analysis and publication bias test. Standardized mean difference, Odds Ratio, and 95% CI were used as effect statistics.
A total of 5 papers (5 RCTs with 796 patients) were included in this study. The results showed that exercise reduced depressive symptoms (SMD = -0.99, 95% CI [-1.95, -0.03], = 0.04). But did not prevent suicidal ideation (SMD = -1.49, 95% CI [-4.33, 1.35], = 0.30) and incidents of suicidal ideation in depressed patients (OR = 0.79, 95% CI [0.08, 7.67], = 0.84). Among these, the heterogeneity of outcomes for depression was high, with potential influences including patient age, frequency, duration, and period of exercise, leading to moderate quality of evidence. Subgroup analyses showed that exercise had a antidepressant effect in middle-aged patients (SMD = -0.60, 95% CI [-1.06, -0.14], = 0.01) and was effective from with a period of <12 weeks (SMD = -0.76, 95% CI [-1.05, -0.47], < 0.00001), duration >30 min (SMD = -0.89, 95% CI [-1.32, -0.45], < 0.00001), and frequency ≥3 times/week (SMD = -0.60, 95% CI [-1.06, -0.14], = 0.01) had the largest effect size.
Physical exercise was associated with an improvement in depressive symptoms. In contrast, physical exercise did not show a statistically effect on reducing suicidal tendencies and suicide risk among patients. Through subgroup analysis, it was found that the most beneficial intervention for physical exercise to relieve depressive symptoms was ≥3 times/week, lasting >30 min over <12 weeks, and combining various forms of aerobic exercise. For suicidal tendencies, however, a dose-response relationship could not be established due to limited literature.
PROSPERO, Identifier CRD42024568335.
本研究旨在系统评价运动干预对抑郁症患者抑郁症状和自杀倾向的影响，并探讨不同运动方案对缓解抑郁症状的差异影响。
从各数据库建库至2025年5月5日，在PubMed、Cochrane图书馆、Embase、WOS、EBSCO、CNKI、万方和维普数据库中进行计算机检索。由两名独立研究人员筛选评估运动干预对抑郁症患者自杀倾向影响的随机对照试验。采用PEDro量表评估研究质量，GRADEPro评估证据质量。使用ReMan 5.4.1进行Meta分析和发表偏倚检验。采用标准化均数差、比值比和95%置信区间作为效应统计量。
本研究共纳入5篇文献（5项随机对照试验，796例患者）。结果显示，运动可减轻抑郁症状（标准化均数差= -0.99，95%置信区间[-1.95, -0.03]，P = 0.04）。但不能预防抑郁症患者的自杀意念（标准化均数差= -1.49，95%置信区间[-4.33, 1.35]，P = 0.30）和自杀意念事件（比值比= 0.79，95%置信区间[0.08, 7.67]，P = 0.84）。其中，抑郁结局的异质性较高，潜在影响因素包括患者年龄、运动频率、持续时间和运动周期，导致证据质量中等。亚组分析显示，运动对中年患者有抗抑郁作用（标准化均数差= -0.60，95%置信区间[-1.06, -0.14]，P = 0.01），且在运动周期<12周（标准化均数差= -0.76，95%置信区间[-1.05, -0.47]，P < 0.00001）、持续时间>30分钟（标准化均数差= -0.89，95%置信区间[-1.32, -0.45]，P < 0.00001）和频率≥3次/周（标准化均数差= -0.60，95%置信区间[-1.06, -0.14]，P = 0.01）时效果最为显著。
体育锻炼与抑郁症状的改善有关。相比之下，体育锻炼对降低患者自杀倾向和自杀风险未显示出统计学效应。通过亚组分析发现，体育锻炼缓解抑郁症状最有益的干预措施是每周≥3次，持续>30分钟，共<12周，并结合多种形式的有氧运动。然而，由于文献有限，无法建立自杀倾向的剂量反应关系。
PROSPERO，标识符CRD42024568335。
