Physical activity and depression, anxiety, and self-esteem in children and youth: An umbrella systematic review

Problem: A 2011 review of reviews reported small to moderate associations between physical activity (PA) and depression, anxiety and self-esteem among children and youth (aged 5-17 years). Due to the increase in reviews examining PA and mental health outcomes in children and youth over the past decade, we conducted an umbrella review to determine the current state of the literature, including whether effects were moderated by dose and type of PA, age, sex, or severity of mental illness. Methods: We systematically reviewed literature published from 2010 onwards from six online databases to identify and summarize findings from systematic reviews examining PA and depression, anxiety, and self-esteem outcomes in children and youth. We assessed review quality using the AMSTAR 2 critical appraisal tool. Results: We identified 26 reviews examining depression (n = 16), anxiety (n = 2), and self-esteem (n = 14). Half of the eligible reviews were considered to be of low or critically low quality (n = 13). PA had positive mental health outcomes for children and youth, specifically for reduction in depression/depressive symptoms and improvements in physical self-concept, a self-esteem sub-domain. Little research has examined PA and anxiety. The moderator analyses reviewed revealed stronger effects in populations with clinical diagnoses (e.g. depression) and for interventions consisting of regular, supervised, group-based aerobic exercise. Conclusions: PA appears to be an effective intervention for reducing depression/depressive symptoms and improving physical self-perceptions, although additional high-quality research and moderator analyses are needed to determine what type of PA interventions may result in better mental health outcomes for children and youth.