Introduction
What are the first line treatments for adolescents with depression?
Cognitive Behavioral Therapy (CBT)
Interpersonal Therapy (IPT)
Pharmacotherapy (SSRIs)
Moderate Effects
How many studies did they include in the meta analysis AND what was the overall effect?
K = 8
SMD = -.61
What was the overall N of the study?
N = 11 to 69 participants
Overall N = 297
Was there a significant dose-response relationship? (Based on a moderating assessment)
No
What is a problem with the first line treatments for adolescents with depression?
High rates of relapse
What does this overall effect mean? (use it in a sentence)
Exercise had a significant moderate effect on lowering depression in adolescents.
What was the mean age range of the participants?
15.6-17 years old
There seems to be a curvilinear relationship, with a moderate dose as generally "best". Or changes could be due to psychosocial mechanisms.
What were some differences and/or problems with past metas within this area?
Most looked at both clinical and non-clinical, but some participants did not have any symptoms depression at baseline.
Looked at Dep & Anxiety
High between study heterogeneity
Low quality studies
Name TWO of the inclusion criteria.
1 Mean age of participants fell between 12 and 18 years old.
2 Participants were diagnosed with depressive disorders or had mean levels of depressive symptoms at baseline above the reported clinical cut-off score for the instrument used to measure depressive symptoms.
3 Exercise was either the primary intervention or a significant component of the intervention (defined as exercise engaged in at least twice a week for a minimum duration of 20 min throughout the intervention period). All types of exercise were eligible for inclusion, for example, aerobic exercise, yoga.
4 Inclusion of a control or comparison group.
5 Inclusion of an outcome measure of depressive symptoms.
6 Published in the English language.
7 Published in a peer-reviewed journal.
Who were the clinical participants?
Studies = 3
Of the studies that included clinical samples, two comprised adolescents with diagnoses of major depressive disorder, and one comprised adolescents with primary diagnoses of conduct disorder and dysthymia.
What type of exercise as used in most of the studies?
Aerobic
What does it mean to have high between study heterogeneity?
A high amount of differences between studies.
"Between-study heterogeneity can be caused by genuine differences in the design and conduct of the studies (methodological heterogeneity) or in participants, interventions, exposures, or outcomes evaluated (clinical heterogeneity)."
What was the format for most of the exercise programs?
Group, supervised.
Who were the non-clinical participants?
Studies = 5
One study comprised obese adolescents, two targeted male juvenile offenders, one targeted adolescents with chronic fatigue syndrome and one targeted pregnant adolescents.
High level of between study heterogeneity
Low quality studies
Range of control and comparison groups
Possible publication bias
Small number of included studies
What is the purpose of the Radovic study (current study)?
Can exercise be effective in reducing depressive symptoms amongst adolescents with clinical levels of depression or diagnosed depressive disorders?
Will dose of exercise moderate the effects?
What were the problems indicated in low quality studies?
Lack of intent to treat analysis
Lack of blinded conditions
Not really related to participants...how did they quantify dose of exercise?
They considered frequency of exercise per week and length of exercise intervention.
What was the conclusion of the meta?
The results of the current analysis indicate that exercise is likely to be effective in reducing symptoms of depression amongst adolescents with clinical levels of depression. Given the low risk involved in prescribing exercise, the broad positive effects on health and the present study findings, exercise should be recommended to adolescents with depressive symptoms or diagnosed depressive disorders. Due to the complex aetiology of adolescent depression, exercise will most likely contribute to existing treatment protocols by acting as an adjunct to psychotherapy and/or pharmacotherapy.