[Physical training to treat depression]

According to the Dutch multidisciplinary guideline of 2005 on depression, physical training (including running therapy) is an effective method for treating depression. However, very few reports have appeared about how this therapy should be applied and so far the intervention does not seem to be in general use.

To review the literature from 2001 onwards relating to the extent and method of applying intensive physical training to the treatment of depression.

We searched various databases for articles published since 2001 on the effect of physical training on symptoms of depression and on possible underlying mechanisms. Articles were selected for their relevance according to title and abstract.

The selected articles (n=51) seemed to show that physical training does reduce the symptoms of depression and they provided strong evidence that physical training markedly reduces the chance of subsequent somatic illnesses. We found two recent meta-analyses, one recent well-organised study showing only a slight effect, two later studies showing a dose-response relationship and three studies forming part of an addition strategy. There are interesting neurobiological explanatory models. If health professionals are thinking of introducing physical training for a patient they must realise that the patient will require close supervision by an expert. There are risks involved in making a patient participate in intensive physical exercise.

Physical training is a valuable part of a stepped-care programme for treating patients with mild or moderate depression.