Physical activity, therapy in depression in children and adolescents

Ten thousand steps and more. We know the protective effects of physical activity (PA) against depression in adults. A study by the University of Hong Kong published in February in Jama Pediatrics shows its interest in acting on that of children and adolescents, which can be expressed by acting out, somatic complaints, irritability… Welcome results, especially since mood disorders are on the rise among young people, due in particular to the Covid-19 epidemic, with around one in six teenagers affected.

In this meta-analysis of 21 studies, totaling 2,441 patients, the practice of PA (on average three 50-minute sessions per week, for at least four weeks) is associated with a greater reduction in depressive symptoms than in the control group, in participants aged 13 or older, and in those with a diagnosis of mental illness and/or depression. The hypothesis of Francesco Recchia and his colleagues is that “Those over 13, who are more sedentary, are more receptive than young children, who may be sufficiently active and therefore less sensitive to additional physical activity”.

Future studies should examine the frequency, duration and type of session to determine the ideal dose and mode of intervention, the authors continue. For example, aerobic exercise (running, jumping, etc.), suitable for children, can easily be implemented in physical education classes at school.

Always the fault of the screens

But how does AP act on the symptoms of depression? Although the mechanisms are numerous and not always elucidated, it has been established that, in adults, moving promotes the release of cerebral neurotransmitters (serotonin, dopamine, norepinephrine) which increase the feeling of well-being, activate the reward circuit and reduce stress levels. It also stimulates blood circulation and neurogenesis in the hippocampus. “Neuropsychological models report improved executive functions (planning, coordination, focus, learning)”noted Inserm’s 2019 collective expert appraisal on physical activity. In addition, PA strengthens self-esteem and social interactions. “Among these explanatory mechanisms and processes, the placebo effect cannot be totally excluded”specifies Inserm.

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At the same time, again in adults, it has been established that the presence of depressive symptoms is associated with a level of practice below health recommendations. A finding confirmed among adolescents, 8 out of 10 of whom do not reach the threshold of the recommendations, the screens being singled out.

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