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J Affect Disord. 2017 Mar 1;210:139-150. doi: 10.1016/j.jad.2016.10.050. Epub 2016 Nov 29.

Physical activity and sedentary behavior in people with major depressive disorder: A systematic review and meta-analysis.

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Unilasalle, Canoas, Brazil; Escola de Educação Física, Fisioterapia e Dança, Porto Alegre, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. Electronic address:
KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Centre, Leuven-Kortenberg, Belgium.
Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK.
Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Liverpool NSW 2170, Sydney, Australia; The Black Dog Institute, University of New South Wales, Hospital Road, Prince of Wales Hospital, Randwick 2031, NSW, Australia.
School of Psychiatry, US Australia, Sydney and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia.
Escola de Educação Física, Fisioterapia e Dança, Porto Alegre, Brazil.
Obstetrics and Gynecology Department, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil.
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.



Low levels of physical activity (PA) and sedentary behavior (SB) are independent risk factors for cardiovascular disease and premature mortality in people with major depressive disorder (MDD).


Investigate levels of PA and SB and their predictors in people with MDD.


Electronic databases were searched from inception till 04/2016 for articles measuring PA and SB with a self-report questionnaire (SRQ) or objective measure (e.g. accelerometer) in people with MDD. Random-effects meta-analyses and meta-regression analyses were conducted.


Twenty-four eligible studies were identified including 2901 people with MDD (78.4% female, mean age=54 years; range: 21-77 years). People with MDD spent 126.0min (95%CI=91.9-160.1) per day engaging in all types of PA and spent 8.5hours (95%CI=7.51-9.62) during their waking day being sedentary. Compared to controls, people with MDD spent less time in total PA (SMD=-0.25, 95%CI=-0.03 to 0.15) and moderate to vigorous PA (SMD=-0.30, 95%CI=-0.40 to 0.21) and engaged in higher levels of SB (SMD=0.09, 95%CI=0.01-0.18). The proportion of people with MDD not meeting the recommended PA guidelines was 67.8% (n=13 studies), which was higher in studies relying on objective versus self-report measures (85.7% v 62.1%, p=0.04). People with MDD were more likely than controls to not meeting the recommended PA guidelines (OR = 1.50, 95%CI = 1.10–2.10).


Heterogeneity was evident in most analyses.


Adults with MDD engage in low levels of PA and high levels of SB. PA and SB are independent predictors of mortality, therefore, future lifestyle interventions targeting both the prevention of SB and adoption and maintenance of PA are warranted.


Depression; Depressive symptoms; Exercise; Major depression; Physical activity; Psychiatry; Sedentary behavior

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