TY - JOUR
T1 - Exercise, Yoga, and Tai Chi for Treatment of Major Depressive Disorder in Outpatient Settings
T2 - A Systematic Review and Meta-Analysis
AU - Seshadri, Ashok
AU - Adaji, Akuh
AU - Orth, Scotts
AU - Singh, Balwinder
AU - Clark, Matthewm
AU - Frye, Marka
AU - Fuller-Tyszkiewicz, Matthew
AU - McGillivray, Jane
N1 - Funding Information:
Submitted: June 19, 2020; accepted August 31, 2020. Published online: December 31, 2020. Author contributions: Study design: Drs Seshadri, Clark, Frye, Fuller-Tyszkiewicz, and McGillivray. Data collection: Drs Seshadri, Orth, and Adaji. Data analysis: Drs Seshadri, Singh, and Fuller-Tyszkiewicz. Drafting of manuscript: Dr Seshadri. Critical review of manuscript: Drs Singh, Clark, Frye, Fuller-Tyszkiewicz, and McGillivray. Potential conflicts of interest: Dr Clark has received consultant fees from Roche Diabetes Care GmbH. Dr Frye has received grant support from Assurex Health, Mayo Foundation, and Medibio; consultant fees from Actify Neurotherapies, Allergan, Intra-Cellular Therapies, Janssen, Myriad, Neuralstem, Takeda, and Teva; and CME/travel/honoraria from American Physician Institute, CME Outfitters, and Global Academy for Medical Education. Drs Seshadri, Adaji, Orth, Singh, Fuller-Tyszkiewicz, and McGillivray report no conflicts of interest related to the subject of this article. Funding/support: None. Acknowledgments: The authors thank librarians Ann Farrell and Larry Prokop (Mayo Clinic, Rochester, New York), who helped with the literature search, and Lori Solmonson and Angie Lam (Mayo Clinic, Rochester, New York), who performed a thorough review of the manuscript in preparation for article submission. The acknowledged individuals report no conflicts of interest related to the subject of this article. Additional information: The data that support the findings of this study are available on request from Dr Seshadri (Seshadri.Ashok@mayo.edu). The data are not publicly available due to privacy or ethical restrictions. Supplementary material: See accompanying pages.
Publisher Copyright:
© 2020 Physicians Postgraduate Press, Inc.
PY - 2021
Y1 - 2021
N2 - Objective: Exercise, yoga, and tai chi are commonly used complementary approaches for health and wellness. This review aims to synthesize the evidence for exercise, yoga, and tai chi in the outpatient treatment of major depressive disorder. Study Selection: A systematic search of the Ovid MEDLINE, EMBASE, PsycINFO, and Cochrane databases was conducted for randomized controlled trials of exercise, yoga, and tai chi for major depressive disorder. Data Extraction: Standardized mean differences were calculated and meta-analyzed using a random effects multilevel modeling framework. Heterogeneity and subgroup analysis was conducted. Results: Twenty-five studies were included for final analysis (exercise: 15, yoga: 7, tai chi: 3). Overall, metaanalysis showed a moderate significant clinical effect. However, when only studies (6 studies) with the lowest risk of bias were included, the overall effect size was reduced to low to moderate efficacy. Overall quality of evidence was low. Heterogeneity and publication bias were high. Conclusions: The current meta-analysis of outpatient exercise, yoga, and tai chi for treatment of major depressive disorder suggests that adjunctive exercise and yoga may have small additive clinical effects in comparison to control for reducing depressive symptoms. The evidence for tai chi is insufficient to draw conclusions. The concerns with quality of studies, high heterogeneity, and evidence of publication bias preclude making firm conclusions.
AB - Objective: Exercise, yoga, and tai chi are commonly used complementary approaches for health and wellness. This review aims to synthesize the evidence for exercise, yoga, and tai chi in the outpatient treatment of major depressive disorder. Study Selection: A systematic search of the Ovid MEDLINE, EMBASE, PsycINFO, and Cochrane databases was conducted for randomized controlled trials of exercise, yoga, and tai chi for major depressive disorder. Data Extraction: Standardized mean differences were calculated and meta-analyzed using a random effects multilevel modeling framework. Heterogeneity and subgroup analysis was conducted. Results: Twenty-five studies were included for final analysis (exercise: 15, yoga: 7, tai chi: 3). Overall, metaanalysis showed a moderate significant clinical effect. However, when only studies (6 studies) with the lowest risk of bias were included, the overall effect size was reduced to low to moderate efficacy. Overall quality of evidence was low. Heterogeneity and publication bias were high. Conclusions: The current meta-analysis of outpatient exercise, yoga, and tai chi for treatment of major depressive disorder suggests that adjunctive exercise and yoga may have small additive clinical effects in comparison to control for reducing depressive symptoms. The evidence for tai chi is insufficient to draw conclusions. The concerns with quality of studies, high heterogeneity, and evidence of publication bias preclude making firm conclusions.
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U2 - 10.4088/PCC.20r02722
DO - 10.4088/PCC.20r02722
M3 - Article
C2 - 33389843
AN - SCOPUS:85099267363
SN - 1523-5998
VL - 23
JO - The primary care companion for CNS disorders
JF - The primary care companion for CNS disorders
IS - 1
M1 - 20r02722
ER -