[DanBC]

The title of this post does not match the title of the paper.

The report does not say "exercise does not make you less depressed".

The report mentions some of the weaknesses; some comments to the article do a good job at pointing out other weaknesses.

Exercise is not just pushed at people with depression to treat that depression; it's to help with other stuff too:-

* medication side effects (sometimes include weight gain or overeating)

* improving social life

* improving general health

[dlss]

The title matches the results though...

"Results: There was no evidence that participants offered the physical activity intervention reported improvement in mood by the four month follow-up point compared with those in the usual care group; adjusted between group difference in mean Beck depression inventory score −0.54 (95% confidence interval −3.06 to 1.99; P=0.68). Similarly, there was no evidence that the intervention group reported a change in mood by the eight and 12 month follow-up points. Nor was there evidence that the intervention reduced antidepressant use compared with usual care (adjusted odds ratio 0.63, 95% confidence interval 0.19 to 2.06; P=0.44) over the duration of the trial. However, participants allocated to the intervention group reported more physical activity during the follow-up period than those allocated to the usual care group (adjusted odds ratio 2.27, 95% confidence interval 1.32 to 3.89; P=0.003)."

re exercise not being perscribed for depression. Current belief in Positive Pyschology circles (the founder of which invented the above mentioned Beck depression inventory) includes exercise acting as a treatment for depression.

"Besides training new habits and antidepressants, getting better exercise and a healthier diet have proven to have strong effects on mood. In fact, exercise is sometimes called the "miracle" or "wonder" drug - alluding to the wide variety of proven benefits that it provides.[55][56]" -- http://en.wikipedia.org/wiki/Positive_psychology

[xiaoma]

>* The title matches the results though...*

And it disagrees with the results of many, many other studies, some of which even quantify the exercise done instead of just relying on self-reported number of days of exercise.

http://scholar.google.com/scholar?q=exercise+and+depression&...

[mattmcknight]

It doesn't match the results though. The title is it doesn't work for "you". "You" may not be above 14 on the depression scale. "You" may get more than three sessions with a trainer. "You" may be in the part of the sample that did improve their mood.

It's always a stretch to over-generalize to "everyone", or the more annoying "you", from the results of a study when the effect on all people is not going to be the same.

[DanBC]

It's not clear from the report whether they're talking about people who had the intervention and who did exercise, or if they're talking about people who had the intervention but who didn't do the exercise. (Or maybe it is and I just missed it?)

> Nor was there evidence that the intervention reduced antidepressant use

People are recommended to stay on anti-depressants for at least 6 months after feeling well, and for at least two years if they're at risk of relapse.

(http://publications.nice.org.uk/depression-in-adults-quality...)

So it's difficult to use antidepressant use as a guide to whether people feel recovered or not.

It's also unclear whether the intervention offered matches current NICE guidelines, which says

> 1.4.2.4 Physical activity programmes for people with persistent subthreshold depressive symptoms or mild to moderate depression should:

> * be delivered in groups with support from a competent practitioner

> *consist typically of three sessions per week of moderate duration (45 minutes to 1 hour) over 10 to 14 weeks (average 12 weeks).

About prescription: Yes, some people think exercise is a wonder drug. I'm not interested in those people unless they're treating patients. Your wikipedia article says:

> While positive psychology can inform clinical psychology, it is not helpful to stretch beyond this point

I live in the UK. Clinicians should refer to the NICE guidance. The NICE guidance is pretty specific about what constitutes physical exercise. That's because the evidence for exercise isn't great. The Cochrane review (http://summaries.cochrane.org/CD004366/exercise-for-depressi...) has a good summary of the evidence - when you only include high quality reviews there's only small benefits from exercise.

But, even if the benefit for depression from exercise is slim there are other reasons to do exercise, and it's important that people are helped to exercise, especially if they're at risk of self-neglect.

More research is needed. It's great that this study has been done. But it's incredibly frustrating that this one study is reported in terms such as "Exercise does not help depression".