Does physical exercise promote improved Mental Health in individuals with depression? Nursing Assignment Help Writing Service

Does physical exercise promote improved Mental Health in individuals with depression?



Introduction: 2

Background. 3

Aim of the study: 5

Research Question: 5

Research Strategy: 5

Trial selection: 6

Qualitative Appraisal: 6

Summary of the evidence: 7

Dissemination plan. 10

Phase 1A.. 10

Dissemination strategy: 10

Phase 1B.. 10

Dissemination strategy: 10

Phase 2A.. 10

Dissemination strategy: 10

Phase 2B.. 11

Dissemination strategy: 11

Key audience for the dissemination plan: 11

Within the government: 11

The general public: 11

The media: 11

The development agencies. 11

Channels of communication for the dissemination. 11

Discussion: 12

Exercise, physical activity and depression: 12

Exercise, physical activity and as a depression treatment approach: 12

Future Implications: 13

Bibliography. 14

Appendix: 16

PEO Framework. 16

Research strategy – CLINAH search key terms. 16




This report provides a detailed analysis on how physical exercise can improve mental health in adolescents suffering from depression. The background of the study will deliver a clear reasoning for the benefits of physical exercise that are experienced by an individual with depression. As depression is thoughtful issue in different communities and adults influencing their health negatively, this tends to be a most common disorder in relation to mental health with a high chronicity and recurrence rate. (Gulay Tasci, 2018) Risk of increase in depressive patients’ increases with the transition of children to adolescents. (Ramin Mojtabai, 2016)

In the search strategy associated with this study, related use of databases such as CINAHL (Cumulative Index to Nursing and Allied Health Literature) has been used in this study for discussion and provision of a summary of applicable proof selected with respect to the critical appraisal of barriers and key findings and for implemention of these findings. The dissemination plan will be outlined. Although, effective strategies in terms of dissemination and implementation of complex innovations of clinical practices across large systems of healthcare is not much known. Despite, the National Dissemination plan suggests effective dissemination for collaborative depression care in the VA (Veterans Affairs). (Jeffrey L Smith, 2008 )



Depression rather being a lethal disorder is considered as an independent risk factor to other medical conditions such as cardiovascular disease in association with substantial reduction in expectancy of life tending to be a psychologically disabling disorder. Due to direct association of depression with anxiety, depression has been marked as the top target for treatment by the World Health Organization (WHO). (Francis, 2014) Prevalence of unipolar depressive disorders are considered to be the most common health issue in adolescents throughout the world serving as a serving as an important factor of risk for their suicide attempts tending to the 2nd to 3rd leading death reason in adolescents. With the fact, no less than half of the adolescents victims of suicide have been reported suffering from a depressive disorder.

In the development of depression, adolescence is the most important period of risk that needs to be considered as there has been a noticeable increase in the symptoms and major depressive disorder in this period of adolescence. (*Frances Rice, 2017) According to a research, it has been revealed that about 9 percent of the whole teenage group stands with the depression criteria resulting in 1 in 5 teenagers to have a depression history at the same point of adolescence. (Amy H. Cheung, 2018) However, depression in adolescents is known to be viewed by considering it as a sub-form of early-onset of the equivalent disorder in adults due to occurrence of its strong linkage with recurrence later in their respective lives. Such illness tend to possess related clinical features and patterns of the activity of neurons as compared to those in adults. Similarly, prevalence of depression in adolescents is in association with history of disorder in the family. (Prof Anita Thapar, 2012)

Additionally, one of the important and key finding of epidemiology involves the emergence of preponderance in a strong female by 2:1 in the depression predominance in adolescents after puberty. Despite the concerns for differences in sexual determination in post-pubertal onset are not well understood. Due to the reason, depression in adolescents is more closely associated with hormonal changes in a female as compared to chronological age. It is therefore suggested that depression and changes in puberty with respect to hormonal changes are in direct relation in association with brain. (Prof Anita Thapar, 2012)

On the other hand, about 12 to 25 percent of the adolescents are affected by depression for which the treatment is sub-optimally care which can primarily be used for bringing improvement through developing and efficiently utilizing quality indicators (QIs). (R. Eric Lewandowski, 2013) Contradictory, the depression in adolescence seems to be a common health concern and physicians of primary care have the ability to first identify the symptoms. As the symptoms include changes in physical functioning, behaviours, thoughts, and moods. Amongst all adolescents, depression might also involve irritable and sad moods. Differentiation in the normal mood of adolescents, depression tends to enduring and severe resulting in interruption in the ability of adolescent in his/her performance at school, in relation to peers and engaging in activities with respect to their age. (Martha C Tompson, 2000)

Therefore, in context to one of past study, exercise and physical activity have known to positively influence the patient with symptoms of depression in comparison to the treatments with antidepressants. (Petros C Dinas, 2010 )

For expansion of the research literature on mental health, exercise and physical activity affecting the levels of depression in adolescents includes a wide-ranging variety of psychological outcomes influencing quality of life, depression, cognitive functions and decline in self-esteem and mood.

In adolescents, the depression manifestation is known to normally represent the symptoms as same as compared to that of adults, but with exception in the existence of characteristics of phenomenology that are typical in regards to the disorder of depression in their adolescence phase of life. Adolescents who are known to experience depression in their respective lives does not significantly tend to be sad, rather they often seem to show irritated gestures and their instability. They might also tend to have an outburst of emotions and anger at any time as a response to any particular situation in their behaviour.

According to the study conducted by Kazdin and Marcino, an approximate of no less than 80 percent of the depressed adolescents represent their irritating behaviours and loss of energy in them, as well as apathy and marked lacking in their interest towards different aspects in their lives, retardation of psychomotor and hopelessness feelings in association with guilt pleasure, disorders in sleep and particularly problems with appetite, changes in weight difficulty an isolation in concentration and oversleeping.

Some of the other unusual features of depressive adolescents includes poor performance at school, decreased self-esteem, emergence of idea and attempt to suicide and serious behavioural issues particularly use of drugs and abusive alcohol. The abstract thought development is considered to be around the age of 12 years which is known to bring a clear understanding of the death phenomenon. Consequently, both emergence of idea and attempt to suicide which tend to be fatal at extreme level has reached to a greater extent in the adolescents suffering from depressive disorder and so tending to be extremely vulnerable.

In one of the study based on the discussion of the major depression symptoms in adolescents ranges between the ages from 14 to 18 years, in the sample of community in the Depression Project of Oregon Adolescents in the United States of America.

According to a study conducted by Roberts et al. found that the most prevalent symptoms during experiencing depression tends to be depressed mood, disorders in sleep and thinking difficulties which are mainly in association with the problems in concentration and negative thinking and the most stable symptoms during experiencing depression tends to be anhedonia and depressed mood.

While, some of the authors conducted study included Sadler LS and Baron P et. Al called attention to the appearance of differentiation amongst the depression manifestation in female and male adolescents, which emphasis that girls have been reported with increased subjective symptoms such as feelings of anxiety, anger, boredom, emptiness and sadness. (D, 1991) (Baron P, 1993)

Normally, girls are known to be more concerned in terms to admiration, reduced satisfaction in regards to their physical appearance with increased  consciousness about themselves and thus tend to have decrease in their self-esteem whereas it is being reported about boys that they tend to have many other feelings in regards to disdain, defiance and contempt by showing conduction of issues such as miss of classes, run away from their place, violence against physical appearance and substance related to abuse and robberies.

They emphasize “the following should not be considered normal, alerting to the probable presence of depression during adolescence: states of irritability or long lasting and/or excessive depression, prolonged periods of isolation from or hostility towards family and friends, distancing oneself from school or a significant decline in school performance, distancing oneself from group activities, and behaviours such as substance abuse (alcohol and drugs), physical violence, promiscuous sexual activity and running away from home.An adolescent is normally the best source of information as to his/her depressive suffering and his/her schoolmates and friends most easily notice the modifications caused by the pathology. Many authors emphasize that parents and teachers are often not aware of depression in their adolescent children and students”. (Bahls, 2002)

Aim of the study:

As about 10 percent of the adolescents are influenced by the major depressive disorder represent low levels of mood, lack of interest and pleasure, disruption in sleep as well as appetite, reduced self-worth, guilt feelings, concentration deprivation and lack of energy. (Petros C Dinas, 2010 ) Thus, the reason behind conducting this study is to determine the effect of physical exercise in dealing with bringing reduction in the symptoms of depression in adolescents. In this study, it is based on reviewing the evidence published till time for determination of whether physical activity and exercise can be used as a therapy for both acute and chronic disorder in adolescents through use of PEO Framework – see Appendix A.

Research Question:

  1. How physical exercise positively influence the patient with symptoms of depression?
  2. How physical exercise encourages improvement in Mental Health in adolescents with depression?
  3. Does effects of physical exercise leads to a healthy lifestyle through improvement in adolescents’ behaviour?

Research Strategy:

A systematic research approach as a search strategy using CLINAH database search was done for finding of improved quality articles which includes links in association with the aim of the study. CLINAH is the Cumulative Index to Nursing and Allied Health Literature considered to be good research source while conducting a review based on qualitative evidence. According to prior studies, CINAHL is important for review studies based on qualitative analysis that covers in the field of nursing. Thus, the systematic search was performed on CINAHL in association with PsychINFO with the key words and truncation (*) listed in Appendix B. There were initially 655, reduced to 57 papers found however the majority were focused on elderly in care homes and not generalised to all ages. Additionally, they did not all include the use and benefits of physical exercise with depression with respect to adolescents, hence by filtering parameters it was then reduced to 30. However, after further reduction in hope for the best studies, 9 papers were selected.

“Use of CINAHL is primarily in association with for gaining access against the resources which includes publications and journals of nursing containing research papers for evaluation of extended range of titles of the papers such as that influence the physical exercise and individuals who are known to experience depression. Use of Boolean operators is mainly associated wih use of OR and AND purposely for narrowing down the research. Such as through use of general keywords like nurse with the sense of depression tend to give results with the research papers on nurses and their interventions regarding the treatment of depression. Use of particular truncation is mentioned in Appendix B.

Trial selection:

Examination of titles and abstracts was done for removal of irrelevant reports. After the removal of irrelevant reports, further examination was based on full-text reports and abstracts for determination of the compliance with respect to the set standard. The trial was thought to be eligible as it was primarily a randomized trial for clinical concepts regarding effect of physical exercise on the participants with diagnosis of major depression in adolescents in association with a well-recognized and valid system for diagnosis. Thus, results demonstrating abstracts and with full-text reports were selected.

Study trails based on with immediate influence on depression just after a single exercise bout were eliminated in comparison to the groups giving individuals with a long-term relief from depression. Such trials included the allocation of participants to an intervention of exercise in comparison to a control group against studies providing feedback against the use of exercise as an additional approach for treatment. These kinds of interventions of exercise were considered to be a systematic physical intervention with the purpose of increasing strength of muscles and fitness of cardiac muscles.  (Jesper Krogh, Exercise for patients with major depression: a systematic review with meta-analysis and trial sequential analysis , 2017)

Qualitative Appraisal:

In past fifteen years number of researches have been done depressive disorder in adolescents (Ade F Adeniyi, 2011). There is a bidirectional relation between depression and exercise and depression risk can be reduced through high intense exercise (jerstad, 2010). Physical activity has a small significant impact on depression but to reduce the intensity of depressive symptoms in children and adolescents different quality programs should be implemented (Brown, 2013).  Adolescents does not engage in physical activities which affect their mental health. Study has shown that psychological and physiological problems can be improved by variety of regular base physical activities (Ade F Adeniyi, 2011).


According to (Chris Hayward, 1999), symptoms of depression can be better predicted by early pubertal than sequential age. Changes in depressive symptoms are negatively related with changes in physical activity and to reduce the risk of depression intensity of physical activities should be increased (Motl, Birnbaum, Kubik, & Dishman, 2004). According to (Peter, 2014) lower level of leisure-time screen and higher level of physical activities decreases the depression symptoms. During adolescence the most common problem is related to emotions which causes depression. Risk of cardiovascular, sustaining oxygen uptake and other chronic diseases can be reduce with consistent participation in physical activity besides this, it increases the self-esteem and self-consciousness as well (Ade F Adeniyi, 2011).


Summary of the evidence:

Final findings of the CLINAH search were considered to be nine studies based on importance and influence of physical activity and exercise on individuals with depression for improvement of their mental health to lead them towards a healthy lifestyle free of stress. One of the study states “High-intensity interval training (HIIT) is a practicable and time effective method to improve cardiorespiratory fitness and composition of body in populations of adolescent. (Costigan SA, 2015) Association between physical activity and mental health in young people is evident, but research designs are often weak and effects are small to moderate. Evidence shows small but consistent associations between sedentary screen time and poorer mental health. Physical activity has potentially beneficial effects for reduced depression, but the evidence base is limited.

Author Objective Method Findings
Larun LNordheim LVEkeland EHagen KBHeian F. “To assess the effects of exercise interventions in reducing or preventing anxiety or depression in children and young people up to 20 years of age.” A narrative synthesis “Whilst there appears to be a small effect in favour of exercise in reducing depression and anxiety scores in the general population of children and adolescents, the small number of studies included and the clinical diversity of participants, interventions and methods of measurement limit the ability to draw conclusions. It makes little difference whether the exercise is of high or low intensity. The effect of exercise for children in treatment for anxiety and depression is unknown as the evidence base is scarce.”
Barbara Maughan,  Stephan Collishaw,  Argyris Stringaris “To review recent evidence on child and adolescent depression”.


Narrative review “Despite considerable progress in understanding developmental trajectories to depression, more needs to be done to identify disease mechanisms that may serve as intervention targets early in the life course.”
Fazlollah Ghofranipour; Mohsen Saffari; Mahmoud Mahmoudi; Ali Montazeri “To determine demograhcial and psychological determinants of depression among a sample of Iranian male adolescents” Multistage sampling method “Self-efficacy and perceived stress can be related to depression but the role of stress and self-efficacy in the etiology and forming of depression in adolescent are discussed. Therefore, more studies for approval of these associations should be considered.”


Costigan SAEather NPlotnikoff RCTaaffe DRLubans DR. “To evaluate high-intensity interval training for improving health-related fitness in adolescents: a systematic review and meta-analysis.” Comprehensive Meta-analysis “HIIT is a feasible and time-efficient approach for improving cardiorespiratory fitness and body composition in adolescent populations.”
Knapen JVancampfort DMoriën YMarchal Y. “To present clinical guidelines for exercise therapy in depressed patients derived from recent meta-analyses.” Meta-analysis “Physical therapists should be aware, that several characteristics of major depression (e.g. loss of interest, motivation and energy, generalised fatigue, a low self-worth and self-confidence, fear to move, and psychosomatic complaints) and physical health problems interfere with participation in exercise.”
Biddle SJAsare M. “To synthesise reviews investigating physical activity and depression, anxiety, self-esteem and cognitive functioning in children and adolescents and to assess the association between sedentary behaviour and mental health by performing a brief review.” Review research “Association between physical activity and mental health in young people is evident, but research designs are often weak and effects are small to moderate. Evidence shows small but consistent associations between sedentary screen time and poorer mental health.”
Tim Carter, Boliang Guo, David Turner, Ioannis Morres, Elizabeth Khalil, Emily Brighton, Marie Armstrong & Patrick Callaghan “To identify Preferred intensity exercise for adolescents receiving treatment for depression: a pragmatic randomised controlled trial” Random analysis “There was no additional effect of preferred intensity exercise alongside treatment as usual on depressive reduction immediately post intervention. However, effects were observed at six months post-intervention, suggesting a delayed response. However, further trials, with larger samples are required to determine the validity of this finding.”


Saint-Clair Bahls “To provide clear information on this common, severe and not very easily recognized pathology.” Literature review “Nowadays, major depression in children and adolescents is understood to be a common, disabling and recurrent disease, with a high level of morbidity and mortality. It is an important public health problem.”


Dissemination plan

Dissemination plan is used to dole out the researches and findings to the community, region and state to use it as a prolific tool to implement the desired solution. In this research it is imperative to distribute applicable information and findings regarding the physical activities and exercises to curb the menace of depression in adolescents (Froyd, 2001). The dissemination plan of physical activities for adolescent is comprised of following phases which are further divided into two heads

Phase 1A

In this phase it is desirable to raise awareness regarding the usefulness of physical exercise within a particular region or a state

Dissemination strategy:

Suitable regional workshops will be identified which might involve different issues related to the health of adolescent and ensure that the guidelines in regional level physical strategy workshops as well as budget line in the distribution of physical exercise guidelines. Then the copy of documents of physical health guidelines will be sent to all the regional healthcare agencies. These documents must include relevant articles related to the guidelines in health and non-health agencies newsletters. (David Nelson, 2004)

Phase 1B

It is a second subpart of phase 1 in which awareness related to physical activities is raised in professionals, relevant agencies and other stakeholders

Dissemination strategy:

Culturally related published format will be developed for physical practices guidelines for adolescents. These published formats may include leaflets, pamphlets and brochures that must be mailed to all professionals relevant to health and non- health agencies. All health professionals and other stakeholders will be invited on one day workshop regarding the physical health and guidelines for adolescent. And link with various useful health related websites can also be created.

Phase 2A

At this stage relevant agencies and professionals consult and inform the patients or target audience i.e. adolescents regarding the physical exercise guidelines.

Dissemination strategy:

Clinical counselling formats will be developed with the help of guidelines regarding physical activities for adolescents for primary care and other health related service programmes. All healthcare professionals and practitioners are invited to attend the workshops and seminars to explain the guidelines and counselling methodologies.

Phase 2B

It is the last part of phase two in which physical activities guidelines and information is communicated to the communities and general public with the help of internet as well through different media such as print and electronic.

Dissemination strategy:

Coordination of not only social marketing bandwagon and mass communication practices at the national level with primary message of physical exercise guidelines for adolescent but also the national assessment of the effectiveness of marketing campaign on the awareness of the physical practices guidelines at community level. Furthermore, national physical exercise guidelines’ press release will also be collaborated to media groups.

After chalking out the dissemination plan it is also imperative to decide what will be the audience and distributions channels of dissemination plan. The detail regarding it is given in under the following heads:

Key audience for the dissemination plan:

Within the government:

It is further divided into health and non-health sectors.

  • Health sector includes ministry or department of health, hospitals, parochial clinics, other primary healthcare institutes and foundations or agencies related to health promotions
  • Non-health sector comprise of education, sports and youth ministry

The general public:

The general public involves citizens particularly youth, church organizations, educational institutes such as schools, colleges and universities, heads of communities, private health practitioners,  and other key interest groups for example: sporting industry, traditional healers

The media:

Print and electronic both mediums are included under this heading which is based in editors, journalists, media organizations, reporters, and other important media industry professionals.

The political players:

Politicians, political advisors, non-government organizations, and other key interest groups are the key audience under this head.

The development agencies

It includes donor agencies, regional agencies and international agencies e.g. WHO and UNICEF

Channels of communication for the dissemination

In order to disseminate the guidelines regarding physical exercise and its importance for adolescents, different communication can be chosen that might range from electronic to non-electronic media to target the above mentioned audience. Moreover, it is also depend on the nature of information that would be disseminated either it be proactive dissemination strategy i.e. pamphlets, leaflets, or brochures or active dissemination plan such as workshops, seminars and symposiums.

These communication channels include newsletters and bulletins, guidelines documents or pamphlets, internal e-mails, one-to-one counselling, internet websites, training workshops and seminars, meetings and conferences, media interviews, mass media campaign, radio stories, social media and street theatres.


Perceived stress and self-efficacy are found in relation to depression with their role in etiology and forming depression has known to play a major role. Occurrence of depression mainly in youth has been showing a significant increase. Therefore, the reason behind conducting a research study with respect to the relationship of physical activity with depressive symptoms is so far from the actual issue of depression leading adolescents to death. “The weakness of evidence for the beneficial effect of current interventions, along with problems related to low compliance and harms, has resulted in an interest in using alternative interventions. The use of exercise as an intervention has attracted considerable attention, and various forms of exercise varying in intensity have been assessed in a number of randomised clinical trials to test their effectiveness as a treatment for patients with depression.”(Jesper Krogh)

Exercise, physical activity and depression:

Relation of exercise and physical activity are known to have an inverse relation with levels of depression. Thus, a study conducted by Paffenbarger and his colleagues had used questionnaire as their data collection tool whose results showed that individuals with physical activity were known to have low depression levels as compared to those who are non-active peers. (Paffenbarger RS Jr, 1994)

Furthermore, inverse relationship among depression and participation in physical activity has shown lower depression levels as compared to those with high levels of depression in inactive participants. The exercise and physical activity has positively influenced the symptoms of depression with confirmation of general mood in almost in each individuals regardless of their age. Particularly, in children and adolescents, there has been recorded positive influence of exercise in bringing reduction in depression levels and scores of stress. Yet, there are number of studies includes with respect to the diversification in clinical participants, interventions, limitation of measurements for drawing conclusions. (Larun L, 2006)

Comparatively, in adolescents, it has been examined in a prior investigative study that whether daily activity and the participation tendency in exercise are in association with the state of moods in a cohort of students. Conclusively, it has been demonstrated that changes in mood swings tends to be higher in the day time and the exercises along with exercise have strong links with states of mood.

The beneficial effects of physical activity and exercise

on depression symptoms and general mood have been

confirmed in individuals of all ages. In children and ado-

lescents, a small beneficial effect of exercise in reducing

depression and anxiety scores has been recorded, yet the

small number of studies included and the clinical diversity

of participants, interventions and methods of measurement

limit the ability to draw conclusions

The beneficial effects of physical activity and exercise

on depression symptoms and general mood have been

confirmed in individuals of all ages. In children and ado-

lescents, a small beneficial effect of exercise in reducing

depression and anxiety scores has been recorded, yet the

small number of studies included and the clinical diversity

of participants, interventions and methods of measurement

limit the ability to draw conclusions

Exercise, physical activity and as a depression treatment approach:

It is reported by the study conducted using meta-analysis that a large clinical influenced the interventions of exercise and physical activity on the depression symptoms for adolescents of both male and female. (Mead GE, 2009)

There is a moderate clinical effect of the aerobic exercise whereas, the resistance and mixed exercise designated the larger effect sizes. When it is compared with the established treatment such as antidepressants and cognitive behaviour therapy, the exercise has appeared to generate the similar results (Dinas, 2010). It has been showed by the published evidence that the physical activity and exercise intervention are generally successfully in lowering the symptoms of depression among adolescents. For example; a study demonstrated that the patients with the major symptoms of depression receiving training of aerobic exercise performed either in a supervised group setting or at home has significantly achieved the reduction in the depression as compared to the sertraline and greater reduction in depression when it is compared to the placebo controls. In addition to this, the different study revealed that the people with depressive disorder undergoing a exercise program has been in the remission as those who has been taking the medication and exercise combines or standard antidepressant medication (sertraline).
Additional study stipulated that the aerobic exercise program has been successful in lowering the symptoms of depression as compared to the pharmacological and placebo treatment (Hoffman MB, 2009). In line with such outcomes from different studies, a recent study revealed that the 8 month exercise program has been successful in improving the symptoms of depression in the 40 to 60 years old women with depression which is unlike the pharmacological treatment (Carta MG, 2008).

On the basis of evidence presented, it is now cleared that physical activity and exercise tends to positively influence the symptoms of levels of depression that can be compared with the treatments of antidepressants. Reference to the research studies conducted demonstrated “physical activity and exercise are significantly used and can be used in future as a therapeutic approach for the treatment of both acute and chronic depressive disorders in adolescents as well as in individuals of different age considering patients of cardiovascular and hypertensive disease. It is thus supported by the evidence that science specialist of exercise needs to be complemented with the physicians of primary care and specialists of mental health purposely for successful tackling of symptoms and episodes of depression.

Future Implications:

Despite the large number of published trials, further trials with more robust methodology seem still required to establish progress in this field. Also, additional trials from outside North America and Europe may be required for results to be valid for patients in Asia, Africa and South America. To further elaborate on the current findings, we recommend that future trials must include blinded outcome assessors and outcomes assessing quality of life, metabolic effects and long-term effects beyond the intervention. It is also important that future trials systematically collect and report data on death, suicide events, musculoskeletal injuries and other potential adverse effects in both the intervention group as well as in the control group. Moreover, future trials ought to be designed according to the standard protocol items: recommendations for interventional trials (SPIRIT) guidelines and reported according to the consolidated standards for reporting of trials (CONSORT) guidelines and transparently report identified individual participant data enabling individual participant data meta-analyses”.





*Frances Rice, O. E. (2017). Adolescent depression and the treatment gap. MRC Centre for Neuropsychiatric Genetics and Genomics,.

Amy H. Cheung, R. A. (2018). Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part II. Treatment and Ongoing Management. the American Academy of Pediatrics.

Bahls, S.-C. (2002). Depression in childhood and adolescence:clinical features. Jornal de Pediatria.

Baron P, C. T. (1993). Gender differences in the expression of depressive symptoms in middle adolescents: an extension of early findings. Adolescene.

Costigan SA, E. N. (2015). High-intensity interval training for improving health-related fitness in adolescents: a systematic review and meta-analysis. British Jornal of Sports Medicine .

D, .. S. (1991). Depression in Adolescents. Context, Manifestations,. Nurs Clin North Am.

Francis, T. &. (2014). Physical exercise and major depressive disorder in adult patients. In M. S. Afroditi Stathi, Routledge companion to sport and exercise psychology: Global perspectives and fundamental concepts.

Gulay Tasci, S. B. (2018). Effect of exercise on therapeutic response in depression treatment. Psychiatry and Clinical Psychopharmacology.

H.Telzer, E. (2016). Dopaminergic reward sensitivity can promote adolescent health: A new perspective on the mechanism of ventral striatum activation. Developmental Cognitive Neuroscience.

Ioannis D. Morres, A. H.‐C. (2018). Aerobic exercise for adult patients with major depressive disorder in mental health services: A systematic review and meta‐analysis. International Journal of Methods in Psychiatric Research .

Jeffrey L Smith, c. a. (2008 ). Developing a national dissemination plan for collaborative care for depression: QUERI Series. Implementation Science .

Jesper Krogh, C. H. (2017). Exercise for patients with major depression: a systematic review with meta-analysis and trial sequential analysis . Mental health.

Jesper Krogh, C. H. (n.d.). Exercise for patients with major depression: a systematic review with meta-analysis and trial sequential analysis . Mental health.

Knapen J, V. D. (2015). Exercise therapy improves both mental and physical health in patients with major depression. Disability and rehabilation .

Larun L, N. L. (2006). Exercise in prevention and treatment of anxiety and depressionamong children and young people. Cochrane Database Syst Rev.

Longfei Yang, Y. Z. (2015). The Effects of Psychological Stress on Depression. Current Neuropharmacology .

Martha C Tompson, F. M. (2000). Identifying and treating adolescent depression. West Journal of Medicine.

Mead GE, M. W. (2009). Exercise for depression. . Cochrane DatabaseSyst.

Paffenbarger RS Jr, L. I. (1994). Physical activity and personal characteristics associated with depression and suicide in American college men. Acta Psychiatr Scand Supp.

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  1. Eric Lewandowski, M. C. (2013). Evidence for the Management of Adolescent Depression. Pediatrics.

Ramin Mojtabai, M. O. (2016). National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults. PEDIATRICS.




PEO Framework

Population Adolescents with depression
Exposure Physical exercise promoting improved Mental Health
Outcome Improvement in self-worth, wellbeing and physical activity.


Research strategy – CLINAH search key terms

nurs* Sports therap* Positive Depression
psychiatric nurs* Sports Better Melancholy
RMN Exercise Improv* Low mood
mental health nurs* Cardio Motivation Hopelessness
Fitness Enhance Depressed
Lack of energy



Posted on October 29, 2019 in Nursing Assignments

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