Psychotherapy and exercise therapy for depressive symptoms among college students: A systematic review and meta-analysis of randomized controlled interventions

Xuezhi Li*1 PhD, Debiao Liu1, BSC, Hongwei Liu2 PhD, Li Li3 MPA,  Zhen Liu4 MSc, Minghui Wang5 BSc, Yan Liu1 PhD

1 School of Mental Health, Jining Medical University, China
2 Department of Community Health Sciences, University of Calgary, Canada
3 Jining Taibaihu New District Construction Bureau, China
4 Department of Infertility, Jining City Integrated Hospital of Traditional Chinese and Western Medicine, China
5 School of Teacher Education, Ningbo University, China

Backgrounds: There are a variety of randomized controlled experiments on depression intervention for college students, such as psychotherapy, exercise therapy, combined psychological and sports intervention, music and painting therapy, etc. The aim of this study is to quantify and evaluate the effects of different interventions against depressive symptom among college students.

Methods: We searched all randomized controlled intervention studies from English databases of EBSCOhost, psyINFO, Pubmed, Springlink and Chinese databases of CNKI, Wanfang and Weipu. Revman 5.3 version was used to analyze. Analyses of risk bias, publication bias and sensitivity were also conducted.

Results: A toal of 50 studies were included for systematic review, in which 47 studies  covering 3130 participants were used for meta-analysis. Four scales were used to measure depressive symptom of college students. The effectiveness of psychotherapy measured with SDS, SCL-90, BDI and CES-D was MD=-7.74 (mean difference, 95%CI: -9.54~-5.93), MD=-8.27 (95%CI: -11.52~-5.03), MD=-0.32 (95%CI: -0.46~-0.18) and MD=-11.38 (95%CI: -16.12~-6.63), respectively. The effectiveness of exercise intervention was MD=-5.69 (95%CI: -6.81~-4.70) which was measured with SDS and MD=-0.42 (95%CI: -0.56~-0.29) measured with SCL-90. The effectiveness of combined therapy of psychotherapy and exercise measured with SDS was MD=-3.26 (95%CI: -7.46~0.93) and MD=-0.50 (95%CI: -0.75~-0.25)with SCL-90.

Conclusions: Psychotherapy and exercise therapy have obvious positive effects on depressive symptom of college students. The combined effect of psychotherapy and exercise interventions and the effects of music, painting and reading intervention need further researches. It provides clues and guidance for the potential interventions and policy-making against depressive symptom among college students. A better understanding of these interventions may have important implications for relief of college students’ depression and mitigation the effects of depressive impairments, such as exercise programs and appropriate psychotherapy.

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