Physical activity, exercise, and mental health of healthy adolescents: A review of the last 5 years

Abstract

The mental health of adolescents is a priority for successful development. Physical activity (PA) and exercise can have effects on the mental health of adolescents. This review analysed the effect that physical exercise interventions can have on the mental health of healthy adolescents between 10 and 19 years of age. The search was carried out in four databases. PubMed, Web of Science, Scopus and SportDiscuss, were searched up to December 31, 2022, following the general model. Eleven studies were selected, with a total sample of 23 681 participants in 2 435 studies published in the last 5 years involving healthy adolescents. The search process and review of the articles was performed by independent expert investigators. The risk-of-bias and the methodological quality were analysed using the Cochrane scale. The limited and heterogeneous studies conducted so far do not clearly establish the benefits of PA on adolescents’ mental health. However, some PA interventions seem to improve subjective well-being, self-esteem, physical and mental well-being, anxiety, lifestyle, emotional intelligence, depressive mood, and perceived benefit and confidence in healthy adolescents. It is important to design an effective and appropriate physical exercise programme that can be implemented for adolescents to achieve significant effects on their mental health. Studies that did not implement an appropriate exercise program with improvements in adolescent physical fitness showed no changes in psychological variables. Further research is needed to clearly establish that exercise programmes have positive effects on mental health in healthy adolescents.

Keywords

Sport / Psychology / Youth / Mental wellbeing / Physical exercise intervention

CRediT authorship contribution statement

Eva Ruiz-Ranz: Writing - review & editing, Writing - original draft, Visualization, Methodology, Investigation, Formal analysis, Data curation, Conceptualization. Iván Asín-Izquierdo: Writing - review & editing, Writing - original draft, Supervision, Project administration, Methodology, Investigation, Data curation, Conceptualization.

Manuscript registration statement

None.

Data sharing statement

Data are available upon reasonable request.

Ethics approval

The research has complied with all the national regulations and has followed the tenets of the Declaration of Helsinki. The project has been developed following the general standards for reviews.

Funding details

The authors have not declared a specific grant for this research. IAI: Call for requalification of the Spanish university system (Margarita Salas Grants) of the Ministry of Universities of the Government of Spain (Funds linked to the European Recovery Instrument of the European Union).

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledge Statement

None.

References

[1] World Health Organization. Constitution of the World Health Organization-Basic Documents, Forty-fifth ed. Supplement. Geneva, Switzerland: WHO; 2006.

[2] Prince M, Patel V, Saxena S, et al. No health without mental health. Lancet. 2007; 370(9590):859-877. https://doi.org/10.1016/s0140-6736(07)61238-0.

[3] World Health Organization. Mental Health: Facing the Challenges, Building Solutions Mental Health: Facing the Challenges, Building Solutions. Copenhagen, Denmark: World Health Organization; 2005.

[4] Carrazana V. El concepto de salud mental en psicología humanista-existencial. Ajayu. 2003; 1(1):1-19.

[5] Galderisi S, Heinz A, Kastrup M, Beezhold J, Sartorius N. A proposed new definition of mental health. Psychiatr Pol. 2017; 51(3):407-411. https://doi.org/10.12740/pp/74145.

[6] Macaya-Sandoval XC, Pihan-Vyhmeister R, Vicente-Parada B. Evolution of the mental health construct from a multidisciplinary point of view. Rev Hum Med. 2018; 18(2): 338-355.

[7] World Health Organization. Promoting Mental Health: Concepts, Emerging Evidence, Practice. Geneva, Switzerland: World Health Organization; 2005.

[8] Sawyer SM, Azzopardi PS, Wickremarathne D, Patton GC. The age of adolescence. Lancet Child Adolesc Health. 2018; 2(3):223-228. https://doi.org/10.1016/S2352-4642(18)30022-1.

[9] Blakemore SJ. Adolescence and mental health. Lancet. 2019; 393(10185):2030-2031. https://doi.org/10.1016/S0140-6736(19)31013-X.

[10] Bhatia R. Effects of the COVID-19 pandemic on child and adolescent mental health. Curr Opin Psychiatr. 2020; 33(6):568-570. https://doi.org/10.1097/yco.0000000000000651.

[11] Palacio-Ortiz JD, Londoño-Herrera JP, Nanclares-Márquez A, Robledo-Rengifo P, Quintero-Cadavid CP. Psychiatric disorders in children and adolescents during the COVID-19 pandemic. Rev Colomb Psiquiatr. 2020; 49(4):279-288. https://doi.org/10.1016/j.rcp.2020.05.006.

[12] Hageman JR. Children's and families' behavioral and mental health during COVID- 19. Pediatr Ann. 2020; 49(10):e405-e406. https://doi.org/10.3928/19382359-20200922-05.

[13] Calderon VJ. U.S. parents say COVID-19 harming child's mental health. Gallup; 2020. https://news.gallup.com/poll/312605/parents-say-covid-harming-child-mental-health.aspx.

[14] Panchal N, Kamal R, Cox C, Garfield R, Chidambaram P. Mental Health and Substance Use Considerations Among Children during the COVID-19 Pandemic. KFF; 2021. https://www.kff.org/coronavirus-covid-19/issue-brief/mental-health-and-substance-useconsiderations-among-children-during-the-covid-19-pandemic/.

[15] C.S. Mott Children's Hospital:Michigan Medicine. National Poll on Children’s Health. 2021; 38(2):1-2. Mott Poll Report: How the pandemic has impacted teen mental health. https://mottpoll.org/reports/how-pandemic-has-impacted-teen-mental-health

[16] Thompson EC, Thomas SA, Burke TA, et al. Suicidal thoughts and behaviors in psychiatrically hospitalized adolescents pre- and post- COVID-19: a historical chart review and examination of contextual correlates. J Affect Disord Rep. 2021; 4(1): 100100. https://doi.org/10.1016/j.jadr.2021.100100.

[17] UNICEF. The State of the World's Children 2021: On My Mind, Promoting, Protecting and Caring for Children's Mental Health. New York, NY: UNICEF; 2022.

[18] Navarro-Gómez N. Suicide among young people in Spain: facts and possible causes. An analysis of latest data available. Clin Salud. 2017; 28(1):25-31. https://doi.org/10.1016/j.clysa.2016.11.002.

[19] Altunkurek SZ, Bebis H. The effects of wellness coaching on the wellness and health behaviors of early adolescents. Publ Health Nurs. 2019; 36(4):488-497. https://doi.org/10.1111/phn.12608.

[20] Arbinaga F, Fernández-Ozcorta E, Sáenz-López P, Carmona J. The psychological effects of physical exercise: a controlled study of the placebo effect. Scand J Psychol. 2018; 59(6):644-652. https://doi.org/10.1111/sjop.12482.

[21] Ho FKW, Louie LHT, Wong WH-S, et al. A sports-based youth development program, teen mental health, and physical fitness: an RCT. Pediatrics. 2017; 140(4):e20171543. https://doi.org/10.1542/peds.2017-1543.

[22] Kim Y, Park I. Effects of physical activity and psychological modification-based intervention on physical fitness, physical activity and its related psychological variables in female adolescents. Int J Environ Res Publ Health. 2021; 18(18):9510. https://doi.org/10.3390/ijerph18189510.

[23] Luna P, Guerrero J, Cejudo J. Improving adolescents' subjective well-being, trait emotional intelligence and social anxiety through a programme based on the sport education model. Int J Environ Res Publ Health. 2019; 16(10):1821. https://doi.org/10.3390/ijerph16101821.

[24] Parajuli N, Pradhan B, Bapat S. Effect of yoga on cognitive functions and anxiety among female school children with low academic performance: a randomized control trial. Compl Ther Clin Pract. 2022; 48(1):101614. https://doi.org/10.1016/j.ctcp.2022.101614.

[25] Åvitsland A, Leibinger E, Resaland GK, Solberg RB, Kolle E, Dyrstad SM. Effects of school-based physical activity interventions on mental health in adolescents: the School in Motion cluster randomized controlled trial. Ment Health Phys Act. 2020; 19(1):100348. https://doi.org/10.1016/j.mhpa.2020.100348.

[26] Harris N, Warbrick I, Fleming T, Borotkanics R, Atkins D, Lubans D. Impact of highintensity interval training including Indigenous narratives on adolescents' mental health: a cluster-randomised controlled trial. Aust N Z J Publ Health. 2022; 46(6): 794-799. https://doi.org/10.1111/1753-6405.13312.

[27] Resaland GK, Aadland E, Moe VF, Kolotkin RL, Anderssen SA, Andersen JR. Effects of a physical activity intervention on schoolchildren's health-related quality of life: the active smarter kids (ASK) cluster-randomized controlled trial. Prev Med Rep. 2019; 13(1):1-4. https://doi.org/10.1016/j.pmedr.2018.11.002.

[28] Smith JJ, Beauchamp MR, Faulkner G, Morgan PJ, Kennedy SG, Lubans DR. Intervention effects and mediators of well-being in a school-based physical activity program for adolescents: the ‘Resistance Training for Teens’ cluster RCT. Ment Health Phys Act. 2018; 15(1):88-94. https://doi.org/10.1016/j.mhpa.2018.08.002.

[29] Wassenaar TM, Wheatley CM, Beale N, et al. The effect of a one-year vigorous physical activity intervention on fitness, cognitive performance and mental health in young adolescents: the Fit to Study cluster randomised controlled trial. Int J Behav Nutr Phys Activ. 2021; 18(1):47. https://doi.org/10.1186/s12966-021-01113-y.

[30] Wolf S, Seiffer B, Zeibig JM, et al. Is physical activity associated with less depression and anxiety during the COVID-19 pandemic? A rapid systematic review. Sports Med. 2021; 51(8):1771-1783. https://doi.org/10.1007/s40279-021-01468-z.

[31] Okuyama J, Seto S, Fukuda Y, et al. Mental health and physical activity among children and adolescents during the COVID-19 pandemic. Tohoku J Exp Med. 2021; 253(3):203-215. https://doi.org/10.1620/tjem.253.203.

[32] Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med. 2009; 151(4):65-94. https://doi.org/10.7326/0003-4819-151-4-200908180-00136.

[33] Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372(71):1-9. https://doi.org/10.1136/bmj.n71.

[34] Jørgensen L, Paludan-Müller AS, Laursen DRT, et al. Evaluation of the Cochrane tool for assessing risk of bias in randomized clinical trials: overview of published comments and analysis of user practice in Cochrane and non-Cochrane reviews. Syst Rev. 2016; 5(1):80. https://doi.org/10.1186/s13643-016-0259-8.

[35] Andermo S, Hallgren M, Nguyen TTD, et al. School-related physical activity interventions and mental health among children: a systematic review and metaanalysis. Sports Med Open. 2020; 6(1):25. https://doi.org/10.1186/s40798-020-00254-x.

[36] Biddle SJH, Asare M. Physical activity and mental health in children and adolescents: a review of reviews. Br J Sports Med. 2011; 45(11):886-895. https://doi.org/10.1136/bjsports-2011-090185.

[37] Cadenas-Sanchez C, Mena-Molina A, Torres-Lopez LV, et al. Healthier minds in fitter bodies: a systematic review and meta-analysis of the association between physical fitness and mental health in youth. Sports Med. 2021; 51(12):2571-2605. https://doi.org/10.1007/s40279-021-01520-y.

[38] Dale LP, Vanderloo L, Moore S, Faulkner G. Physical activity and depression, anxiety, and self-esteem in children and youth: an umbrella systematic review. Ment Health Phys Act. 2019; 16(1):66-79. https://doi.org/10.1016/j.mhpa.2018.12.001.

[39] Lubans DR, Smith JJ, Morgan PJ, et al. Mediators of psychological well-being in adolescent boys. J Adolesc Health. 2016; 58(2):230-236. https://doi.org/10.1016/j.jadohealth.2015.10.010.

[40] Rodriguez-Ayllon M, Cadenas-Sánchez C, Estévez-López F, et al. Role of physical activity and sedentary behavior in the mental health of preschoolers, children and adolescents: a systematic review and meta-analysis. Sports Med. 2019; 49(9): 1383-1410. https://doi.org/10.1007/s40279-019-01099-5.

[41] Bou-Sospedra C, Adelantado-Renau M, Beltran-Valls MR, Moliner-Urdiales D. Independent and combined influence of physical fitness components on self-esteem in adolescents: DADOS study. Ann Hum Biol. 2021; 48(7-8):550-556. https://doi.org/10.1080/03014460.2022.2032337.

[42] Smouter L, Coutinho SS, Mascarenhas LPG. Associação entre nível de atividade física e autoconceito de autoestima de adolescentes. Ci^encia Saúde Coletiva. 2019; 24(2): 455-464. https://doi.org/10.1590/1413-81232018242.34962016.

[43] Avery G, Johnson T, Cousins M, Hamilton B. The school wellness nurse: a model for bridging gaps in school wellness programs. Pediatr Nurs. 2013; 39(1):13-17.

[44] Bowe AK, Owens M, Codd MB, Lawlor BA, Glynn RW. Physical activity and mental health in an Irish population. Ir J Med Sci. 2019; 188(2):625-631. https://doi.org/10.1007/s11845-018-1863-5.

[45] Sümen A, €Oncel S. Factors that affect healthy lifestyle behaviors of high school students in Turkey: a systematic review. Eur J Ther. 2017; 23(2):74-82. https://doi.org/10.5152/EurJTher.2017.04044.

[46] Marker AM, Steele RG, Noser AE. Physical activity and health-related quality of life in children and adolescents: a systematic review and meta-analysis. Health Psychol. 2018; 37(10):893-903. https://doi.org/10.1037/hea0000653.

[47] Calzada-Rodríguez JI, Denche-Zamorano ÁM, Pérez-Gómez J, et al. Health-related quality of life and frequency of physical activity in Spanish students aged 8-14. Int J Environ Res Publ Health. 2021; 18(17):9418. https://doi.org/10.3390/ijerph18179418.

[48] Yavuz AY, Hacıalioğlu N. The effect of training provided for obese adolescents based on Health Promotion Model on their healthy lifestyle behaviors and life quality. Prog Nutr. 2018; 20(1):146-160. https://doi.org/10.23751/pn.v20i1.6301.

[49] Larun L, Nordheim LV, Ekeland E, Hagen KB, Heian F. Exercise in prevention and treatment of anxiety and depression among children and young people. Cochrane Database Syst Rev. 2006; 3(1):CD004691. https://doi.org/10.1002/14651858.cd004691.pub2.

[50] Fairclough SJ, Tyler R, Dainty JR, et al. Cross-sectional associations between 24-hour activity behaviours and mental health indicators in children and adolescents: a compositional data analysis. J Sports Sci. 2021; 39(14):1602-1614. https://doi.org/10.1080/02640414.2021.1890351.

[51] Doyle CB, Khan A, Burton NW. Knowledge of physical activity guidelines and mental health benefits among Emirati university students. Perspect Public Health. 2019; 139(6):316-319. https://doi.org/10.1177/1757913919834060.

[52] Anthony J, Kinnafick F-E, Papathomas A, Breen K. Physical activity for adolescents with severe mental illness: a systematic scoping review. Int Rev Sport Exerc Psychol. 2020; 16(1):176-209. https://doi.org/10.1080/1750984x.2020.1833360.

[53] Carless D, Douglas K. The Bristol active life project:physical activity and sport for mental health. En:Sports-Based Health Interventions. New York, NY: Springer New York; 2016: 101-115.

[54] Daley AJ. Exercise therapy and mental health in clinical populations: is exercise therapy a worthwhile intervention? Adv Psychiatr Treat. 2002; 8(4):262-270. https://doi.org/10.1192/apt.8.4.262.

[55] Smith PJ, Merwin RM. The role of exercise in management of mental health disorders: an integrative review. Annu Rev Med. 2021; 72(1):45-62. https://doi.org/10.1146/annurev-med-060619-022943.

[56] McDowell CP, MacDonncha C, Herring MP. Brief report: associations of physical activity with anxiety and depression symptoms and status among adolescents. J Adolesc. 2017; 55(1):1-4. https://doi.org/10.1016/j.adolescence.2016.12.004.

[57] Bailey AP, Hetrick SE, Rosenbaum S, Purcell R, Parker AG. Treating depression with physical activity in adolescents and young adults: a systematic review and metaanalysis of randomised controlled trials. Psychol Med. 2018; 48(7):1068-1083. https://doi.org/10.1017/s0033291717002653.

[58] Carter T, Callaghan P, Khalil E, Morres I. The effectiveness of a preferred intensity exercise programme on the mental health outcomes of young people with depression: a sequential mixed methods evaluation. BMC Publ Health. 2012; 12(1):187. https://doi.org/10.1186/1471-2458-12-187.

[59] Nasstasia Y, Baker AL, Lewin TJ, et al. Differential treatment effects of an integrated motivational interviewing and exercise intervention on depressive symptom profiles and associated factors: a randomised controlled cross-over trial among youth with major depression. J Affect Disord. 2019; 259(1):413-423. https://doi.org/10.1016/j.jad.2019.08.035.

[60] Dabidy-Roshan V, Pourasghar M, Mohammadian Z. The efficacy of intermittent walking in water on the rate of MHPG sulfate and the severity of depression. Iran J Psychiatry Behav Sci. 2011; 5(2):26-31.

[61] Dopp RR, Mooney AJ, Armitage R, King C. Exercise for adolescents with depressive disorders: a feasibility study. Depress Res Treat. 2012; 257472(1):1-9. https://doi.org/10.1155/2012/257472.

[62] Jeong YJ, Hong SC, Lee MS, Park MC, Kim YK, Suh CM. Dance movement therapy improves emotional responses and modulates neurohormones in adolescents with mild depression. Int J Neurosci. 2005; 115(12):1711-1720. https://doi.org/10.1080/00207450590958574.

[63] Mohammadi MF. A study and comparison of the effect of team sports (soccer and volleyball) and individual sports (table tennis and badminton) on depression among high school students. Aust J Basic Appl Sci. 2011; 5(12):1005-1011.

[64] Wang X, Cai ZD, Jiang WT, Fang YY, Sun WX, Wang X. Systematic review and metaanalysis of the effects of exercise on depression in adolescents. Child Adolesc Psychiatr Ment Health. 2022; 16(1):16. https://doi.org/10.1186/s13034-022-00453-2.

[65] Minghetti A, Faude O, Hanssen H, Zahner L, Gerber M, Donath L. Sprint interval training (SIT) substantially reduces depressive symptoms in major depressive disorder (MDD): a randomized controlled trial. Psychiatr Res. 2018; 265(1):292-297. https://doi.org/10.1016/j.psychres.2018.04.053.

[66] Carter T, Pascoe M, Bastounis A, Morres ID, Callaghan P, Parker AG. The effect of physical activity on anxiety in children and young people: a systematic review and meta-analysis. J Affect Disord. 2021; 285(1):10-21. https://doi.org/10.1016/j.jad.2021.02.026.

[67] Rahmani-Nia F, Arazi H, Rahimi R, Piri-Kurd K, Hossaini K. Effects of an eight-week circuit strength training program on the body images and anxiety in untrained college students. Med dello Sport. 2011; 64(3):297-308.

[68] Williams PA, Cash TF. Effects of a circuit weight training program on the body images of college students. Int J Eat Disord. 2001; 30(1):75-82. https://doi.org/10.1002/eat.1056.

[69] Borland RL, Cameron LA, Tonge BJ, Gray KM. Effects of physical activity on behaviour and emotional problems, mental health and psychosocial well-being in children and adolescents with intellectual disability: a systematic review. J Appl Res Intellect Disabil. 2022; 35(2):399-420. https://doi.org/10.1111/jar.12961.

[70] Daly-Smith A, Quarmby T, Archbold VSJ, et al. Using a multi-stakeholder experiencebased design process to co-develop the Creating Active Schools Framework. Int J Behav Nutr Phys Activ. 2020; 17(1):13. https://doi.org/10.1186/s12966-020-0917-z.

[71] Troy D, Anderson J, Jessiman PE, et al. What is the impact of structural and cultural factors and interventions within educational settings on promoting positive mental health and preventing poor mental health: a systematic review. BMC Publ Health. 2022; 22(1):524. https://doi.org/10.1186/s12889-022-12894-7.

[72] Rhodes RE, Guerrero MD, Vanderloo LM, et al. Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth. Int J Behav Nutr Phys Activ. 2020; 17(1):74. https://doi.org/10.1186/s12966-020-00973-0.

[73] Casey MM, Harvey JT, Telford A, Eime RM, Mooney A, Payne WR. Effectiveness of a school-community linked program on physical activity levels and health-related quality of life for adolescent girls. BMC Publ Health. 2014; 14(1):649. https://doi.org/10.1186/1471-2458-14-649.

[74] Lubans D, Richards J, Hillman C, et al. Physical activity for cognitive and mental health in youth: a systematic review of mechanisms. Pediatrics. 2016; 138(3): e20161642. https://doi.org/10.1542/peds.2016-1642.

[75] Eather N, Morgan PJ, Lubans DR. Effects of exercise on mental health outcomes in adolescents: findings from the CrossFitTM teens randomized controlled trial. Psychol Sport Exerc. 2016; 26(1):14-23. https://doi.org/10.1016/j.psychsport.2016.05.008.