Abstract：
Depression is a growing public health concern, and exercise is an adjunctive treatment modality to improve depression, but the optimal form of exercise and the optimal dose are still unclear. This systematic review examined the efficacy of four major types of exercise (aerobic, resistance, mixed, and mind-body) on depression, as well as the dose-response relationship between total and specific exercise and depressive symptoms. We included randomized controlled trials that included participants aged 18 years or older with a diagnosis of major depressive disorder or a depressive symptom score above a threshold as determined by a validated screening measure, implemented one or more exercise therapy groups, and assessed depressive symptoms at baseline and follow-up. Forty-six studies (3164 patients) were included in the meta-analysis. Aerobic (standardised mean difference (SMD) = -0.93; 95% CI: -1.25 to -0.62) and mind-body exercise (SMD) = -0.81; 95% CI: -1.19 to -0.42) improved depressive symptoms better compared to controls, followed by mixed (SMD = -0.77; 95% CI: -1.20 to -0.34) and resistance exercise (SMD = -0.76; 95% CI: -1.24 to -0.28). This dose-response meta-analysis showed a U-shaped curve between exercise dose and depressive symptoms. The minimum effective dose was estimated to be 320 metabolic equivalent (METs) -min per week and the optimal response was 860 METs-min per week. These findings lead us to advocate that clinicians carefully select the appropriate dose of exercise based on the patient\'s individual characteristics and needs, in conjunction with psychological care interventions.
摘要：
抑郁症是一个日益增长的公共卫生问题，运动是一种改善抑郁的辅助治疗方式，但运动的最佳形式和最佳剂量仍不清楚。本系统综述检查了四种主要运动类型的功效(有氧运动，阻力,混合,和身心）抑郁症，以及总运动和特定运动与抑郁症状之间的剂量反应关系。我们纳入了随机对照试验，包括年龄在18岁或以上的参与者，这些参与者诊断为重度抑郁症或抑郁症状评分高于阈值，这是通过有效的筛查措施确定的。实施一个或多个运动治疗组，并在基线和随访时评估抑郁症状。46项研究（3164例患者）纳入荟萃分析。与对照组相比，有氧（标准化平均差（SMD）=-0.93；95％CI：-1.25至-0.62）和身心锻炼（SMD）=-0.81；95％CI：-1.19至-0.42）改善了抑郁症状，其次是混合运动（SMD=-0.77；95％CI：-1.20至-0.34）和抵抗运动（SMD=-0.76；95％CI：-1.24至-0.28）。该剂量反应荟萃分析显示，运动剂量与抑郁症状之间呈U形曲线。最小有效剂量估计为每周320代谢当量（MET）-min，最佳反应为每周860MET-min。这些发现引导我们提倡临床医生根据患者的个体特征和需要仔细选择合适的运动剂量,结合心理护理干预。
