Singh · British journal of sports medicine 2023 · umbrella review · n=97 reviews (1,039 trials, 128,119 participants)

Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews.

Cited 987 times in the scientific literature.

Level 1 - systematic review of randomized trials

Umbrella review synthesizing systematic reviews and meta-analyses of randomized controlled trials

PubMed 36796860 · doi:10.1136/bjsports-2022-106195 · record verified 2026-08-27

What was done

An umbrella review searched 12 electronic databases from inception through January 1, 2022, for systematic reviews with meta-analyses of randomised controlled trials testing physical activity interventions against usual care on depression, anxiety, or psychological distress in adults. Study selection was performed in duplicate by two independent reviewers, and review quality was assessed using the AMSTAR tool.

What was found

Across 97 systematic reviews representing 1,039 trials and 128,119 participants: - Depression symptoms: median effect size = -0.43 (IQR: -0.66 to -0.27) - Anxiety symptoms: median effect size = -0.42 (IQR: -0.66 to -0.26) - Psychological distress: effect size = -0.60 (95% CI: -0.78 to -0.42) Benefits were most pronounced in people with depression, HIV, or kidney disease, pregnant and postpartum women, and healthy individuals. Higher intensity physical activity correlated with larger symptom reductions, whereas effectiveness diminished with longer intervention duration. Most included reviews (n = 77) received a critically low AMSTAR quality rating.

Why it matters

This review synthesizes a vast trial evidence base demonstrating that physical activity confers meaningful reductions in psychological distress, depression, and anxiety across both healthy and clinical populations.

Limits

The vast majority of included reviews (77/97) had critically low methodological quality per AMSTAR assessment. As an overview of reviews, findings rely on secondary syntheses with potential primary trial overlap, and post-intervention maintenance was not reported in the abstract.

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