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The efficacy, mechanisms and implementation of physical activity as an adjunctive treatment in mental disorders: a meta-review of outcomes, neurobiology and key determinants
(World Psychiatry, 2025-05-15) Vancampfort, Davy; Firth, Joseph; Stubbs, Brendon; Schuch, Felipe; Rosenbaum, Simon; Hallgren, Mats; Deenik, Jeroen; Ward, Philip B.; Mugisha, James; Damme, Tine Van; Werneck, André O.
Research examining physical activity interventions for mental disorders has grown exponentially in the past decade. At this critical juncture, there is a need to synthesize the best evidence to guide researchers, clinicians and people with lived experience. This meta‐review aimed to systematically identify and comprehensively evaluate the current evidence about: a) the efficacy of physical activity interventions on mental, cognitive and physical outcomes for individuals with mental disorders; b) the potential neurobiological, psychosocial and behavioral mechanisms underlying the observed effects; and c) the barriers and facilitators for individuals to successfully engage in these interventions. Our systematic search identified 13 meta‐analyses of high methodological quality (i.e., A Measurement Tool to Assess Systematic Reviews, AMSTAR score ≥8) assessing outcomes of physical activity as an adjunctive treatment, which included 256 randomized clinical trials (RCTs) and 12,233 individuals. Large effect sizes were found for adjunctive physical activity interventions in improving attention in children and adolescents with attention‐deficit/hyperactivity disorder (ADHD); reducing depressive symptoms in children, adolescents and adults with depressive disorders; and reducing body mass index in adults with schizophrenia. Moderate effect sizes were found for reductions of hyperactivity, impulsivity and anxiety, and improvements of executive and social functioning in children and adolescents with ADHD; reduction of anxiety symptoms in adults with anxiety disorders; improved physical and psychological quality of life and cardiovascular fitness in adults with depressive disorders; improved daily living skills, overall quality of life and cardiorespiratory fitness in adults with schizophrenia; reduction of depressive symptoms in older people with depressive disorders; and improvements in cognition and functional mobility in older people with dementia. There is, to date, no meta‐analytic evidence for physical activity as a first‐line treatment for people with a mental disorder. Five meta‐analyses, including 89 RCTs and 4,575 individuals, investigated potential underlying mechanisms. There is a very preliminary evidence for an effect of physical activity on circulating levels of kynurenine, growth hormone, tumor necrosis factor‐alpha and brain‐derived neurotrophic factor in people with major depressive disorder. No meta‐analytic evidence could be found for psychosocial or behavioral mechanisms. Based on 15 umbrella or systematic reviews, covering 432 studies and 48 guidelines, six implementation strategies, along with the most evidence‐based behavioral change techniques to support them, were identified. Recommendations to support implementation research in this area were finally formulated.
Twelve Weeks Aerobic Exercise Improves Anxiety and Depression in HIV Positive Clients on Art in Uganda
(İbrahim ERDEMİR, 2024-12-31) Mwebaze, Nicholas ; Nsibambi, Constance Adron Nakayiza ; Ojuka, Edward ; Maghanga, Mshilla
Aim: The study aimed at bridging the gap by assessing the impact of a 12-week aerobic exercise program on anxiety and depression for HIV-positive clients.
Methods: The study, conducted at the General Military Hospital in Uganda, employed a quasi-experimental design. Quantitative data was collected using questionnaires and a sample of 135 people living with HIV on antiretroviral therapy engaged in the study. Quantitative data was analyzed using t-tests, revealing significant reductions in depression and anxiety symptoms among participants.
Results: The findings demonstrated a 58.5% reduction in depression symptoms and a 72% decrease in anxiety symptoms among participants engaged in aerobic exercises. Both groups exhibited improvements, with the experimental group showing greater reductions. The results further revealed that depression and anxiety are two to four times more common in individuals living with HIV than in those without the virus, and depression is also more common in those on HAART than in those without the virus.
Conclusion: The results support the potential of aerobic exercise as a valuable adjunct therapy for people living with HIV on antiretroviral therapy. Well-structured and supervised aerobic exercise was found to be essential for improving the clinical outcomes of PLHIV on ART.
The effectiveness of self-help interventions in the treatment of depressive symptoms in low-and-middleincome countries (LMICs): a meta-analysis
(International Journal of Mental Health, 2025-05-12) Vavani, Boitumelo; Luenen, Sanne van; Garnefski, Nadia; Spinhoven, Philip; Amone-P’Olak, Kennedy; Witlox, Maartje; Kraaij, Vivian
Background: Self-help psychological interventions show great potential to close the treatment gap for depressive symptoms in low-and middle-income countries (LMICs). The current meta-analysis investigated the pooled effect of self-help interventions for people with depressive symptoms in LMICs and moderators of these psychological interventions.
Method: PubMed, Cochrane Register of Randomized Controlled Trials, PsychInfo, Embase, and Sabinet databases were searched between June 2021 and December 2022 to select studies that met pre-defined inclusion criteria. A coding protocol was used to retrieve and code relevant data from selected studies. We measured publication bias and assessed the study quality using the Cochrane Risk of Bias tool. The program ‘Comprehensive Meta-Analysis’ (CMA) was used for the data analysis. Overall effect sizes were calculated to assess the effectiveness of selfhelp programs for depression.
Results: Eighteen studies were included in the meta-analysis. Self-help interventions were found to have a medium positive effect on depressive symptoms at post-test (Hedges’ g = 0.74) and at follow-up (Hedges’ g = 0.82). There was evidence for publication bias. Larger effects were found for studies that were conducted in lower-middle income countries, had at least mild depression as inclusion criterion, reported less than 30% attrition, did not use relaxation techniques, had a low or medium risk of bias, and that used a booklet form of intervention.
Conclusion: This meta-analysis suggests that self-help interventions have a positive effect on people with depressive symptoms in LMICs. The findings could inform the design and implementation of mental health interventions that could prevent or treat depression.
Itikadi za kiuana katika methali za kinyankole na Kiswahili
(Kenyatta, 2023-02) Lubuuka, Yunusu
This research examines gender ideologies in Ankole and Swahili proverbs. The study intended to demonstrate how gender ideologies present gender relations through consent and persuasion between men and women. Ideological beliefs among people, have power of persuasion which makes them to consent to their positions and gender roles on the basis of their sex. Beliefs and attitudes in their day today relations clog in their minds and take things for granted. These beliefs about gender relations which are influenced by consent and persuasion, are rooted in society that is male dominated. This has been arrived at by studying gender relations and how they manifest in gender ideologies. Also, the researcher has critically analyzed proverbs to bring out ideological contradictions and their effects on gender equality through Ankole and Swahili proverbs. To the best of the researcher’s knowlege, there was no in-depth scholary analysis that had been done before that showed gender ideologies present gender relations through consent and persuasion between men and women. This research sought to fill this gap. Proverbs presenting gender ideologies written in four selected Ankole and Swahili anthropology books purposively to satisfy the aim of the study were selected and analyzed. These books are; Enfumu z’omurunyankore Rukiga by Saite (1989), Kamusi ya Methali za Kiswahili by King’ei na Ndaru (1989), Kamusi ya Methali by Wamitila (2001) na Dafina Hazina ya Kiswahili (Seif Al Habsy, 2012). Library data has been collected from books of anthropoloies. Collected data included proverbs presenting gender ideologies in Ankole and Swahili communities. This study has been both a library and a field one. The theories of Ideology, African based Feminism and Deconstructionism have been used. The Ideological theory guided this study as a major theory to analyze different gender ideologies in Ankole and Swahili proverbs and to assess how ideologies influence gender relations by consent and through persuasion. This theoretical perspective has been used to understand clearly the gender ideologies, gender relations, and gendered roles and how those gender ideologies impact on gender equality in Ankole and Swahili proverbs. African based Feminism theory (Steady 1981) has been used. The theory basically focuses on gender equality without discrimination of human beings on the basis of their biological creation. Also, the theory delves into the existing gender differences which are a creation of social practices socially, politically and culturally. This theoretical approach has been used to study clearly gender ideologies, gender relations in relation to roles carried out, rights of women and how those ideologies impact on gender equality through Ankole and Swahili proverbs. The Deconstructionism theory (Abrams na Harpham 2014) has guided this study to analyse the contradictions in proverbs and their impact on gender equality presented in Ankole and Swahili proverbs depicting gender ideologies. This theory has helped in a thorough analysis of proverbs in presenting various meanings which present gender contradictions. Interview guide and recording gadgets were used to collect data from individual respondents and focus groups in the districts of Kiruhura and Sheema in western Uganda and the coastal towns of Mombasa, Lamu, and Zanzibar. Purposive sampling has been used to identify and interview the respondents who are scholars and experts, women and men of average age. Data has been analysed qualitatively and then presented in accordance with the objectives of the study guided by the adopted theories. Eventually, the study has demonstrated how gender ideologies present gender relations through consent and persuasion that exist between men and women. Also, the study has been able to bring out gender ideology contradictions and their impact on gender equality in Ankole and Swahili proverbs.
Effects of a 12-week aerobic dance programme on diastolic blood pressure in stage one hypertensive adults
(Nurtekin ERKMEN, 2024-10) Nahwera, Loyce ; Boit, Edwin Kiptolo ; Nsibambi, Constance Adron Nakayiza ; Maghanga, Mshilla ; Wachira, Lucy-joy
Hypertension, which impacts over 1.5 billion people globally is a crucial health challenge accountable for more than 10.8 million early deaths yearly. Our study used an experimental design to investigate the effects of aerobic dance programme on diastolic blood pressure levels in stage one hypertensive adults over a 12-week period. The study participants were randomly allocated into either the experimental or control groups. Diastolic blood pressure measurements were collected using a mercury sphygmomanometer at baseline and post programme. The 12-week aerobic dance programme entailed three 45-minute sessions per week, at a moderate intensity. The paired samples t-test was used to compare mean differences within the groups with the significance level set at P<0.05. Findings showed that mean diastolic blood pressure of participants in the experimental group was 93.11±3.708 mmHg and 91.61±4.340 mmHg at baseline and post programme while that of the control group was 92.39±3.032 mmHg and 92.06±6.655 mmHg respectively. This implies that there was a marginal reduction of -1.50 mmHg in diastolic blood pressure of the experimental group while the control group remained relatively constant at -0.33mmHg after the programme. Paired sample t-test results confirmed no statistically significant effects (t(17)=1.129, p=.275) for experimental group as well as the control group (t(17)=.257, p=.800). This study concluded that participating in an aerobic dance programme at a moderate intensity for 12 weeks did not statistically significantly reduce diastolic blood pressure of adults with stage one hypertension. Future studies on this population should investigate additional influencing factors and varying training intensity to assess any other effects.