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Adherence to Physical Activity Interventions in Major Depressive Disorder: A Systematic Review and Meta-Analysis.

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Physical activity (PA) interventions for major depressive disorder (MDD) show lower protocol adherence compared to non-PA interventions. However, intervention receipt, retention, and attendance rates were similar, suggesting potential for improved PA intervention design.

Keywords:
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Area of Science:

  • Mental Health Research
  • Exercise Science
  • Clinical Psychology

Background:

  • Non-adherence to physical activity (PA) interventions hinders effectiveness in major depressive disorder (MDD) treatment.
  • Understanding adherence predictors is crucial for optimizing PA interventions in MDD.

Purpose of the Study:

  • To systematically review and meta-analyze adherence outcomes in PA interventions for MDD.
  • To compare adherence rates between PA and non-PA interventions for MDD.
  • To identify predictors of adherence to PA interventions in MDD.

Main Methods:

  • Searched major databases (MEDLINE, PsycINFO, CINAHL Plus, SPORTDiscus) until September 2024.
  • Conducted a systematic review of 97 studies and a meta-analysis of 91 studies.
  • Calculated pooled risk differences and used meta-regression to explore adherence predictors.

Main Results:

  • PA interventions demonstrated significantly lower protocol adherence than non-PA interventions (RD = -0.15).
  • No significant differences were found in intervention receipt, retention, or session attendance between PA and non-PA interventions.
  • Severe baseline depressive symptoms, longer intervention duration, and in-person delivery predicted retention; longer PA sessions predicted receipt; supervised activities predicted attendance.

Conclusions:

  • Individuals with MDD exhibit lower protocol adherence to PA interventions compared to non-PA interventions, though this is based on limited studies.
  • Intervention receipt, retention, and attendance rates were comparable across PA and non-PA interventions.
  • Future research should consider including individuals with greater depressive symptom severity and supervised PA to enhance adherence and intervention design.