Reading List/PMID 39593579
Chen C et al.·2024·Journal of bodywork and movement therapies

The effects of aerobic exercise for depression: An umbrella review of systematic reviews and meta-analyses.

Abstract

This review aims to determine whether aerobic exercise is beneficial in treating depression in adults in general. Review of systematic reviews and meta-analyses related to RCTs. PubMed, MEDLINE, PsycINFO, Embase, and Cochrane databases of systematic reviews were searched extensively between September 2009 and September 2023. An extensive search was conducted using MeSH terms, including ''depression'', ''depressive disorder'', ''depressive symptoms'', ''exercise'', ''aerobic exercise'', ''aerobic training'', ''walking'', ''running'', ''jogging'', ''bicycling'', ''physical activity'', ''adult (limiters 18-65 years)'', ''meta-analyses'' and ''systematic reviews''. In the initial search of the titles and abstracts of reviews, 2345 articles were found. 46 full-text reviews were selected for carefully scrutinized. A total of seven reviews were included in the analysis, and two of them were meta-analyses, which included 42 RCTs. The results of four reviews evaluated the effectiveness of aerobic exercise on depression. Moreover, two reviews examined the efficacy of aerobic exercise as an add-on intervention for depression treatment, one of which was a subgroup analysis. According to two reviews, aerobic exercise improved CRF in people with depression and affected people with MDD from a neurobiological standpoint. This umbrella review systematically evaluated the efficacy of aerobic exercise in treating adult depression, revealing substantial evidence that supports its potential to alleviate depressive symptoms. The positive synthesis of findings advocates for integrating aerobic exercise as a non-pharmacological treatment option. Nevertheless, additional research is essential to confirm these benefits and optimize exercise protocols for depression management.

岡本賢の読み方

Chen 2024(Journal of Bodywork and Movement Therapies, アンブレラレビュー)は、有酸素運動がうつ症状を中等度(SMD ~0.5)改善するというエビデンスを最新でまとめた。効果サイズはSSRIなど薬物療法と同等かやや上で、副作用なしで「補助療法」ではなく「単独治療」として成立するレベル。

外来でうつ傾向のある患者には、まず「朝20分の散歩」を最初に処方する。SSRI開始前のスクリーニング期間(2〜4週間)にもよく使う。週3回×30分の中強度運動で、4週間以内に効果が出始める。

メカニズムはBDNF上昇、海馬体積の維持、サーカディアン正常化、自己効力感の回復など複数。薬と違って依存・離脱がなく、長期で続けられるのが強み。「うつだから運動どころじゃない」のではなく、「うつだからこそ最初の一歩を運動にする」が現代の治療戦略になりつつある。

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