Digital interoceptive-enhanced exercise for young adults with depression: A randomized controlled trial

Young adults bear a high burden of depressive symptoms, yet scalable first-line options remain limited. Physical activity can help, but its effects are inconsistent. Interoceptive training targets bodily signal processing to improve affect regulation and may potentiate antidepressant effects of digital, remotely delivered exercise. Based on the above rationale, the present study conducted a randomized controlled trial of a digital intervention integrating structured physical activity with interoceptive training. A total of 46 participants with mild to moderate depressive symptoms were enrolled and randomly assigned in a 1:1 ratio to either the intervention condition or the no-intervention condition. Four repeated measurements were taken at baseline, post-test, one-month follow-up, and three-month follow-up. The primary outcome was depressive symptoms at post-test, measured using the PHQ-9. Compared with controls, the intervention condition demonstrated a significant reduction in depressive symptoms at post-test (adjusted mean difference = 3.47 [1.25, 5.70], β = 0.74 [0.26, 1.22], Hedges' g = 0.83, p = 0.003). Secondary outcomes also improved at post-test, including well-being, interoceptive ability (attention regulation and emotional awareness), and physical health (vitality and health transition). However, the reduction in depressive symptoms was not sustained at the one-month or three-month follow-up. Similar attenuation was observed for the secondary outcomes. A digital programme coupling physical activity with interoceptive training produced sizeable short-term improvements in depressive symptoms and related outcomes, while remaining low-intensity and scalable. Larger, longer trials should confirm durability, test mediation, and evaluate cost-effectiveness for implementation.