Efficacy of Physical Activity in Reducing Depressive Disorder - Literature review Example

Title: Literature Review- Efficacy of Physical Activity in Reducing Depressive Disorder Author’s Name Course Institutional Affiliation May 15th, 2013 EFFICACY OF PHYSICAL ACTIVITY IN REDUCING DEPRESSIVE DISORDER Introduction Depression disorder is the medical illness that affects a person’s feelings, behavior and mood. It changes the moods of the victims and makes them feel sad and blue. More and more adults are affected with depression every year. Without any treatment, the symptoms and effects of depression tend to increase and worsen with time. These characteristics of depression often affect the behavior and relationships of the patients suffering from depression. Is physical activity more reliable in treating depression? In light of the well-documented advantages of physical activity and anti-depressants in the reduction and management of depressive symptoms, it has gradually emerged that promoting the use of either of the interventions must be a priority in public health (Chalder et al, 2012). It has been noted that, physical activity can be a very reliable treatment because it can be recommended to most individuals and does not carry a negative social stigma. Why Choose this Topic The reason for choosing this topic is because of the relationship between the amount of physical activity carried out by a person and the levels of depression and can be beneficial to a psychiatric nurse when it comes to dealing with patients with this disorder.. In explaining this relationship between Physical activity and depression, high levels of social engagement are used and they can be beneficial to both the patients and the psychiatric nurses who are tending to them. The understanding of this concept will enable the nurses to handle any depression cases with ease. Physical activities are also associated with the development of some mental disorder for some studies have indicated that, there is close relationship between physical activities and symptoms of depression and anxiety. The Aim of this Paper The aim of this paper is to review various research literature and their findings in regard to whether physical activity is more effective than anti-depressants in the management and reduction of depressive symptoms in patients. The paper also addresses the implications of these studies by presenting the best evidence that could be used to address the clinical issue, and unearthing the fact that, depression can be curbed by the use of physical activities. Physical activities however are associated with improved psychological well being and therefore have positive impact on the mood and anxiety of an individual and thus may have some influence on a person with depression (Strohle, 2009). The concepts covered in the paper are relevant to the writer in a way that they seek to build an argument that promotes the best practice recommendations in my clinical arena as well as in my work related to dealing with psychiatric patients. This paper provides a literature review of previous research findings on whether physical activity is more effective in reducing depressive symptoms in patients who are suffering from depression as compared to the use of anti-depressants. It is stated that, regular physical activities is correlated to healthy living and reduced risk of all cause mortality. In the same case it is associated with a reduction in depression .The paper identifies the different types of evidence available in regards to this issue, while clearly noting their strengths and weaknesses. The paper aptly summarizes the research findings while evaluating their overall findings, all descriptive statistics in the studies and gives detailed assessments of the assumptions made in the studies. The discussion in the paper is centered on analyzing whether physical activity is more effective in reducing depressive symptoms as compared to administering anti-depressants. Lastly, it then makes recommendations for future research and improvement in this particular clinical area. Search Strategies Articles for review of this study were obtained from various databases by computerized search on the internet. Various databases that were searched include: Medline, Cochrane, Opinion articles from Frontiers Journals, New South Wales Health (NSW) Database Springer Articles and Science Direct.com The key words used are: depression, walking, physical activities and physical exercise. The quality of findings is unquestionable. These sources talk about physical activity, exercise and their role in managing depression and anxiety disorders, the need for promoting physical activity such as walking among depression patients. The exclusion criteria included articles published before 2007. The key words are physical activity, effectiveness, depression. A total of 8 articles were then selected. Walking How Physical Activity Reduces Depression. Depression is a major effect of stress and at most times it is inevitable in a person’s life. Most of the stress affects the body and in manipulates itself to become depression. This is impacted on the human body. Physical activities produce chemicals in the brain which the levels of depression in the brain. Exercise reduces all levels of depression and closely related effects and stimulates the brain. A research was carried out by the Anxiety and Depression Association of America in 2008 and found that physical activities helped to reduce depression. Although the trials were small, the research suggested that physical activity benefits individuals by reducing depression. Many of the researchers noted that walking is also a form of physical activity and should be carried out frequently. The results from the eight researches including that done by the BMJ (Clinical research Ed) in 2012, concluded that physical activity made a lot of difference when used consistently in the management of depression. Studies and researches have been conducted on the effects and the benefits of physical activity when it comes to reducing the symptoms of depression. The studies and researches conducted were to find out the results if physical activities were involved in treating depression. This study proved that physical activity was being preferred in order to control depression and its symptoms. The information was retrieved from a summarization of the random controlled trials. When the study was conducted, different results were collected and compiled to produce one conclusion. Although there was no clear relationship between depression and exercise, the results proved that exercise helped in the reducing of depression symptoms and the relaxation that comes from physical activity was what helped in the reducing depression in patients. When the study was conducted, the results provided facts that using anti-depressants was not safe and this is because they would provide side effects and even be problematic in the future for the patients who use them. When physical activities are compared to using anti-depressants, the patient using anti-depressants is more likely to suffer complications such as cardiovascular diseases and other diseases. (Chalder et al, 2012) pointed out that the patients using physical activity in dealing with antidepressant would be at a lesser risk from getting these complications. Exercise and physical activity is also recommended in treating depression because it provides other advantages and benefits besides reducing the effects of depression. Physical activity helps patients to boost their self-esteem and also gain confidence. This helps the patients because there are less chances of the patient going into depression again in the future after they feel better. (Blake, 2012) says, physical activity is also beneficial because it helps in taking the patents mind of any worries that may be affecting them and making them feel depressed. It is not certain which types of physical activities that are being discussed and can help. But this does not only involve field activities and playing sports. Some fun activities can be grouped as physical activities and they can help in the relieving of depression symptoms. These physical activities may include washing your car, gardening and even playing with your children. Adding small physical activities to the daily schedule and routine can help greatly in reducing depression. Patients working in buildings can use the stairs instead of the elevator or even bike to work instead of using the bus or the personal cars. This may be small types of exercise but if practiced on regular basis can be beneficial to the depression patients. There are however different limitations to the study on how physical activities reduces depression. One limitation is that the use of physical activities has not gained popularity and clarity in the crowds and even in researchers. (Rimer 2012), says that there are also no clear results and hence no clear conclusions. The using of physical activities can help the patients because the feel good chemicals are released and help in the improvement of moods of the patients. This eases depression and decreases the effects caused by the symptoms of depression. How Walking Reduces Depression Walking helps in reducing depression in various ways. A research done by the Mayo clinic staff in 2009 said that walking stimulates the brain to produce chemicals in the brain which reduce depression. These chemicals include the neurotransmitters and the endorphins. They are also known as the feel good chemicals. (Martinsen, 2008), walking also prompts the brain to reduce the amount of immune system chemicals which when produced in large amounts cause depression. The study also suggested that walking will not only help in reducing depression through chemicals but through occupying an individual’s mind with less worries. A study conducted by Mental Health and Physical Activity in 2012 also found that walking as an activity did contribute to a reduction in the levels of depression. A study conducted showed how walking affects depression and how it helps in reducing the effects of depression. The research done concluded that walking usually reduces depression and its effects. The results and findings that were acquired from the research proved that walking reduces the chances of depression and was also an effective treatment for depression. The results from the study and the research proved that walking as a physical activity helped in providing chemicals and hormones that help an individual to reduce their stress levels and the levels in depression in general. The study provided some recommendation that helped in the treatment and reduction of depression in victims and patients. The literature suggested that there should be more walking and physical activity for the individuals. It is also recommended that more research should be carried out on this issue in order to establish the true effects and benefits of walking when it comes to reducing the levels of depression among the patients affected. The study conducted in the research however had numerous limitations and problems were faced on the benefits of walking when it comes to treating and reducing depression. When the study and research was conducted, the main limitation was that the homogeneity of the people made it difficult in categorizing specific physical activities for the population. Also the fact that there are different walking techniques that many different people would opt to use depending on their liking and tastes. Some of the patients opt to walk on treadmills and others opt to go out and walk in the outdoors. It is also difficult to know which other practices are more effective than others. This is because some patients tend to prefer walking with their friends or in groups and other prefer walking alone. It is now difficult to know which are the better way and more effective in reducing depression symptoms. It is still difficult how much walking and how frequent it should be exercised in order to get the maximum amount of benefit and to be careful not to be overdoing the walking because it would be harmful to the body and even increase or worsen the levels of depression. There is however more things which should be looked into and more researches should be conducted in order to find out more on the issue and how to make walking more effective in order to reduce the most amount of depression with the least amount of walking. It is still unclear on the speed at which one should walk and hence leading to the need of carrying out more research on the topic to find out how fast or how slow a patient should walk in order for it to help in the treatment of depression symptoms (Martinsen, 2008). The research also concluded that walking was very cheap and safe as compared to pharmaceutical medicines which are used in the treatment of depression symptoms. It also easily fits into almost everybody’s daily schedule and can be easily undertaken by the patients. Walking also comes with very little side effects and risks as compared to those in medicines. When all these results were compiled together, it was concluded that walking was actually effective in reducing stress levels. How Hormonal Changes and Chemicals Reduce Depression. During physical activities, the body produces chemicals and hormones. They are known as endorphin which reduce the levels of tension and stabilize moods. Due to this, the levels of depression are reduced. Once a person’s body feels good, so does their brain hence improving the wellbeing of an individual. A research carried out by the Harvard health in 2010 claimed that the main cause of depression is the chemical reactions which take place in the brain. The researchers in Harvard Health claim that nerve impulses bring about the releasing of chemicals from a nerve cell to another. When these chemicals are produced, they lead to the depression of individuals. The health researchers believe that depression will come as a result of changes in levels of chemicals in the brain. The main causes of the chemical changes in the body are thinking patterns and personalities. There are different studies which were conducted in order to know how hormones and chemicals affect depression and how they can be used to change and minimize the depression symptoms. (Ströhle, 2009) says that when a patient is stressed or has tension, they cannot be able to produce the chemicals in the body that make an individual feel good and jovial about themselves. When this proceeds for long it causes symptoms which make a person become depressed and have low self-esteem. A study was conducted to see how the chemicals and hormones affect and cause depression. The study and research showed that neurotransmitters were chemicals which are present in the brain and usually facilitate the communication between cells in the nerves. When these neurotransmitters produce chemicals in the brain, they help in the transition of messages in the brain. But if the chemicals produced are too many or too little, they cause the symptoms of depression to occur and thus this causes patients to become sick. Studies and researches have not yet understood and stated clearly how these chemicals make a patient feel depressed. There are also effects caused by hormones and lead to depression in the patients. This is when excess amount of hormones mostly the adrenal hormones are produced by the body and cause depression problems and other psychiatric problems. The studies have proven that in order to minimize the effects of depression, the patient and the medical practitioners can learn how to manipulate these hormones and chemicals. There are however different chemicals and hormones that cause depression in different people. When it comes treating depression using these chemicals, there might be people with two similar levels of depression but they may be caused by different types of chemicals and hormones. The research done by scientists have proven that the chemicals mostly involved in forming the mood of an individual and in the regulating of levels of depression of patients can be differentiated and also can be altered in order to treat the symptoms of depression and reduce the effects. The studies have proven that depression caused by these chemicals is often misdiagnosed and leads to poor treatment which affects the lives of the patients. Studies have suggested that the depression may in turn cause an excess in hormones and hence leading to more effects of depression. This also increases the levels of depression making it worse by the moment. Most of the hormones linked to depression are the hormones produce by the thyroid glands and the sex hormones mostly in women. The different changes of hormones during different life cycles such as menopause and child birth often cause a change in the levels of hormones in women and hence they experience mood swings and mild forms of depression. Study suggested that there are however some women who experience serious symptoms of depression during these different life cycles. The study and research suggested that if the hormonal changes are experienced, medical help should be sort in order to ensure these does not lead to serious cases of depression. Those who are prone to these hormonal changes should also be careful not to have a relapse and fall into depression again once they have completed treatment. Conclusion and recommendations for future research The essay herein has presented a critical literature review of the effectiveness of physical activity in the treatment of depression and associated symptoms. This was in comparison with the use of anti-depressants as an intervention. From the discussion presented in this essay, it can be concluded that the use of physical activity in the management and effective treatment of depression is increasingly being recommended. While other studies have come to the conclusion that exercise and physical activity has much more significant results, other studies indicate that exercise has just the same results as the other interventions. Research suggests that, the effects of exercise on the reduction and elimination of depressive symptoms had only positive outcomes when the results were not compared with the other interventions and other forms interventions. Yet in another research, the authors elaborate on the efficacy of exercise in reducing symptoms of depression. From the results, it clearly indicates that exercise is just as effective as the other interventions in the treatment of depression, and not that it has any other advantageous benefit. It is depicted that, depressive disorders have grown to become a major health concern in the world. The conclusion indicated that the effects of exercise are no any better but they have the same effects on treating depression. It is worth concluding that physical activity makes a lot more of a difference when used consistently in the management of depression. Additionally, those patients who were active in physical activity together with the use of anti-depressants had improved outcomes as compared to those who were only using anti-depressants... However, it is indicated that they cannot encourage physical activity as an effective strategy for the management of depression as compared to the pharmacological use of anti-depressants. There is a growing belief that physical activity and exercise has its own major advantages in improving the mood of patients who are suffering from anxiety and depression. Physical activity has such an anti-depressive effect that it is highly recommended for patients suffering from depression. There is a therapeutic relationship that physical activity might have in the management of depression and anxiety disorders, however, much study need to be conducted to a certain this. Moreover, there are suggestions for future research in the area because of the limitations brought by the limited available evidence on the same. Rethorst et al., (2010), argue that more research ought to be carried out in order to provide more concrete evidence on the efficacy of treating depression with exercise as compared to anti-depressants. Other than carrying out trials on the general populations, the trials can focus on clinical populations so as to produce more viable conclusions. Alternatively, Blake (2012) suggests that due to the small number of intervention studies in this area, more methodological studies are needed in future. This therefore entails that, to have a substantial conclusion of this topic, more research has to be conducted and also the use of larger samples may increase the validity of the results and therefore must be recommended. References Blake, H. (J2012). Physical activity and exercise in the treatment of depression. Frontiers in Psychiatry, 3. Retrieved from http://www.frontiersin.org/Affective_Disorders_and_Psychosomatic_Research/10.3389/fpsyt.2012.00106/full Chalder, M., Wiles, N. J., Campbell, J., Hollinghurst, S. P., Haase, A. M., Taylor, A. H., Fox, K. R., ... Lewis, G. (2012). Facilitated physical activity as a treatment for depressed adults: randomised controlled trial. BMJ (clinical Research Ed.), p. 344. Martinsen, E. W. (2008). Physical activity in the prevention and treatment of anxiety and depression. Nordic Journal of Psychiatry, 62, pp. 25-29. Retrieved from http://informahealthcare.com/doi/abs/10.1080/08039480802315640 New South Wales (NSW) Health, (2010). Physical Activity and Depression. Heart Foundation. Retrieved from http://www.heartfoundation.org.au/SiteCollectionDocuments/Physical-activity-and-depression.pdf Rethorst, C. D., Landers, D. M., Nagoshi, C. T., & Ross, J. T. D. (2010). Efficacy of exercise in reducing depressive symptoms across 5-HTTLPR genotypes. Medicine and Science in Sports and Exercise, 42, 11, pp. 2141-2147. Rimer, J., Dwan, K., Lawlor, D. A., Greig, C. A., McMurdo, M., Morley, W., et al. (2012). Exercise for depression. Cochrane Database Syst. Rev. 7, CD004366. Robertson, R., Robertson, A., Jepson, R., & Maxwell, M. (2012). Walking for depression or depressive symptoms: A systematic review and meta-analysis. Mental Health and Physical Activity, 5, 1, pp. 66-75. Ströhle, A. (2009). Physical activity, exercise, depression and anxiety disorders. Journal of Neural Transmission (Vienna, Austria : 1996), 116, 6, pp. 777-84. Appendix 1 Population Intervention/ Exposure Comparison Outcomes Clinical reason The study focuses on patients comprising of the adult population. This indicates they are all aged between above 18 years. The intervention addressed in this essay is physical activity and its effectiveness in the management and treatment of depression and depressive symptoms. This is in comparison with other forms of interventions such as the pharmacological medicines and the psychotherapy interventions. The intended outcomes include much better positive outcomes for depression patients when exercise and physical activity are used for treatment. Pico Strategy Appendix 2 Literature Review Grind (Summary Table) source Source Type of Literature Methodology Description of study Population Sampling Data Collection Data Analysis Ethics Themes Key findings &Recommendations Limitations Validity/Reliability “Walking for depression or depressive symptoms: A systematic review and meta-analysis”. Mental Health and Physical Activity 2012 Authors: Roberts A Roberts R Jepson R Maxwell M Quantitative Systematic review This study investigates the role played by walking as an activity in reducing the symptoms of depression. The researchers used eight studies of controlled trials on walking and depression that consisted featured a total of 341 different people who suffered from depression. The research searched 11 databases to identify randomized controlled trials of walking as a treatment for depression. The results from the eight studies were extracted and the quality of the trials was assessed. Then the results were pooled together using standard methods. Findings; It was found that walking as an activity did contribute to a reduction in the levels of depression Recommendations; This literature suggested that further research and studies be carried out to establish the real benefits of walking as an activity in the management and reduction of depressive symptoms among depressed patients Limitation; The homogeneity of the people presented an obstacle to the categorization of physical activity for specific populations. Validity; The reliability of the results can be put to question due the fact that some population could not be reached therefore the random clinical trials were not a representative s “Physical activity and exercise in the treatment of depression” Frontiers in Psychiatry 2012 Author: Blake Holly Quantitative Controlled trials This research studies the increased interest in other interventions such as the use of physical activity.The study tries to show how physical activity has gradually become the most preferred alternative treatment. Use of 32 randomized controlled trials consisting of adults aged 18 and over who suffered from depression. The information was retrieved from a summarization of the random controlled trials by a recent review by Cochrane The findings from trials in which exercises were undertaken were compared to findings from trials where there was standard treatment, no treatment or a placebo treatment. This study does not recommend use of antidepressants because they cause major side effects such as increasing the risks of suffering complications such as cardiovascular diseases. The limitation to the results of this study is that the evidence on the effectiveness of physical activity over the use of anti-depressant hasn’t gained much clarity so as to draw conclusive hypothesis. “Facilitated physical activity as treatment for depressed adults: randomized controlled trial”. BMJ(Clinical research Ed)2012 Authors: Chandler M Wiles N.J Campbell J Hollinghurst S.P Hasse A M Taylor A H Fox K R Lewis G Quantitative Random controlled trial The objective of the study was to see if physical activity could be considered in primary care for treating adults suffering from depression.It was carried out to determine the effectiveness of treating depression with physical activity. Use of Pragmatic 2-arm parallel randomized trials comprising of 361 adults aged between 18-69 who had recently contracted their practitioner with symptoms of depression. There was a follow up every four months and the outcomes were measured by the Beck depression invention. The evidence from exercise intervention was compared with that from the reduced antidepressant use over the duration of the trial. The researchers were allowed to carry out their studies at General practices set at Bristol and Exeter. Findings; The results from the research concluded that physical activity made a lot of difference when used consistently in the management ofdepression.Combining both physical exercise and anti-depressants was found to be more effective than the use of anti-depressants alone. The study recommended that more studies be carried out in the future. One limitation to this study was biasness.It was felt that some responses from the participants were biased because they could have been influenced. The short follow up periods and recruitment of participants from non-clinical settings also posed a problem to the study. “Physical activity, exercise, depression and anxiety disorders”. Journal of Neural Transmission 1996 Author: Strohle A Quantitative Systematic review This study looks at the growing belief that physical activity and exercise has major advantages in the improvements of the moods of patients suffering from anxiety and depression. The researchers used a number of cross-sectional studies that composed of control groups that investigated the correlation between habitual exercise levels with low depression. Findings; Physical activity was found to have very positive outcomes on patients with depressive and anxiety disorders. Recommendations; The study recommended that physical activity and exercises be prescribed for patients suffering from depression since they increase benefits to the mental being of patients. In most of these studies it was observed that fitness was not considered since fitness interacted with exercise habits. Therefore the results were not complete. Another limitation was that most of the used cased studies suffered from methodological flaws. “Exercise for depression”. Cochrane Database Syst Rev 7 CD004366 2012 Authors: Rimer J Dwan K Debbie A L Greic C A McMurdo M Morley W Quantitative Clinical trials This study tries to give the reasons why some people prefer exercise and physical activity as an alternative treatment of depression despite the fact that anti-depressants are the primary treatment of depression. 1858 randomly chosen adults of age 18 and over suffering from depression were sampled. The informational data was collected from Cochrane Depression & other relevant websites from between November 2010 to June 2011. Two review authors extracted the data at the end of the trials and they were used to calculate sizes for each trial using the Hedges g method and a standardized mean difference was calculated. Data on the adverse effects was systematically extracted and the “risk of bias” assessments were carried out. Findings: Analysis of the results from the clinical trials that the effects of exercise in the management and treatment of depression did not differ from those of applying cognitive therapy The study concluded that the results of exercise on the management of depression were only positive when it was not compared to other alternative methods of treating depression. The limitation faced was that there was insufficient data to determine the risks, costs and quality of life “Physical activity in the prevention and treatment of anxiety and depression”. Nordic Journal of Psychiatry 2008 Author: Martinsen E W Quantitative Controlled study The study attempts to show how exercise is efficient as an alternative way of intervening for depression. The researchers collected results from time limited and time unlimited therapy. Information collected from case of aerobics vs. psychotherapy and from exercise vs. group meditation and psychotherapy. Then a follow up was conducted a year later It was found that there were many benefits arising from moderate physical exercise in the treatment of depression. The study suggests that exercise may be a good alternative to treating depression. One of the limitations is that some of the participants have fears towards exercises and the exercises themselves were an anxiety inducing stimulus. “Efficacy of exercise in reducing depressive symptoms across 5-HTTL PR genotypes”. Medicine and science in sports and Exercise.2010 Authors: Rethorst C D Landers D M Nagoshi C T Ross J T D Quantitative Control group The study elaborated more on the efficacy of exercise in reducing symptoms of depression. The participant included adults aged between 18-23 The participants were randomly assigned to a 5 week exercise intervention/no treatment control group. They completed the Beck depression inventory before and after the intervention and provided a saliva sample for DNA analysis After the intervention the effect size was calculated to quantify the difference between the exercise and the control group. A group of ANOVAs were used to examine the effects of the exercise on depression. The ANOVA was used to analyze the effect of enterprise intervention across 5-HTT genotypes. Results of the study indicated that exercise is just as effective as any other interventions and had no added benefits. The study concluded that the effects of exercises are the same even on treating depression. Limitation to this study was that the evidence available was limited. “ Physical Activity and Depression” Heart Foundation. Author: New South Wales(NSW)Health 2010 Qualitative Systematic review This research study suggests that physical activity is an effective way of managing depression Review of clinical trials by the Center for Mental Health Research on the use of exercise as treatment for depression. The information is analyzed by comparing the results from the clinical trials on standard treatment and those on physical activity The findings were that there was an increased risk of depression and depressive symptoms amongst people who are barely involved in physical activity. The study recommended that patients should involve themselves in physical activity for an average of 30 minutes per day. The issue of depression patients suffering from cardiovascular diseases and taking part in the exercises was not considered. “Physical Activity reduces the risk of subsequent Depression in Older Adults” American Journal of Epidemiology.2002 Authors: William J S Stephane D Robert E R George A K Quantitative Control trials The study was undertaken to compare the higher levels of physical activity on prevalent and incident depression with or without the exclusion of some disabled subjects. The participant were 1,947 adults from Alameda County aged between 50-94 years The information used and that from previous studies were retrieved from the American journal of epidemiology. The prevalent and incident depression was examined for all the 1,947 subjects using percentages and adjusted ratios. The findings were that physical disability showed a strong association with depression. The study recommended that more studies should be carried out to determine the influence of social relations and chronic conditions in the analyses of physical activity and depression. The possibility of persons with high levels of physical activity being more likely to engage in other beneficial health behaviors was not considered therefore the results were not complete. “The reciprocal relationship between physical activity and depression in older European adults: a prospective cross-lagged panel design using SHARE data” Health Psychol.2011 Authors: Lindwall M Larsman P Hagger MS Quantitative Control trial The aim of this study was to investigate the reciprocal nature of the physical activity-depressive symptom relationship in older adults. The participants were 17,593 older adults from 11 European countries. There was the use of a two-wave cross lagged panel design to analyze the data. The depressive symptoms were measured at baseline and the follow up using the EURO-D scale. The finding was that higher physical activity was associated with lower affective suffering and motivation.The study recommended that regular exercises should be prescribed to older adults to prevent future depressive symptoms in them. The research did not include factors such as health issues that are likely to affect the participants at that age. “Physical activity and depressive symptoms in older adults: 11 year follow-up” Am J Prev Med. 2012 Authors: Ku PW Fox KR Chen LJ Chou P Quantitative Systematic review The purpose of this study was to examine the reciprocal associations between changes in the activity and depressive symptoms. There were 1160 participants aged 67 and above The data used was collected from the Taiwan’s Health and Living Status of the Elderly survey of 1996,1999 and 2007 The data was analyzed with multivariate adjustments. The findings were that physical activity engagement in later life is associated with a lower risk of subsequent depressive symptoms. The physical activity levels was self-reported hence they may have been biased ‘Exercise therapy and mental health in clinical populations: is exercise therapy a worthwhile intervention?” The Royal College of Psychiatrist.2013 Author: Amanda J D Qualitative Systematic review This study was undertaken to determine if exercise is a worthy intervention for treatment of mental illness. The data was collected from a number of case studies on exercise and depression from as early as 1988 The data was analyzed by conducting a meta-analytical review of studies that had investigated the effects of exercise clinical depression. The study recommended that psychologists be more open to use less conventional alternatives such as exercises for treatment of depression. The study recommendation was developed with only psychological adaptations in mind rather than the therapeutic benefits of exercise. Read More