Abstract
PURPOSE: University students are at a greater risk of experiencing poor mental health outcomes including psychological distress, depression, anxiety and suicidal ideations. Exercise as an intervention strategy has established anti-depressive and anxiolytic qualities, yet the effectiveness of exercise for improving mental health outcomes specifically among this high-risk population is yet to be established. We systematically reviewed the literature to determine if exercise has been used as an intervention and its effectiveness at improving mental health in university students. METHODS: Electronic databases (PubMed, Medline, Embase and CINAHL) were searched up until 23rd August 2015. We included randomised controlled trials (RCTs) conducted on university students studying Medicine or Allied Health, where a structured, supervised exercise intervention of ≥4 weeks duration was studied including stress, anxiety and/or depression as outcomes. Standardised mean difference (SMD) was calculated for each outcome and data was analysed and assessed for heterogeneity and bias using RevMan v5.3. RESULTS: The search identified 5,788 articles. Of these, 4 RCT’s were included, studying 607 people (mean age 19.9±1.1yrs), with only 22% male. There was only one aerobic exercise (jogging) intervention; the 3 others were a form of Tai Chi or Yoga. On average sessions went for 45±19mins; 5±1 times a week over 10±4 weeks. When compared to controls, there was no significant reduction in stress (SMD 0.06[-0.13, 0.26]; p=0.54), anxiety (SMD 0.27[-0.12, 0.66]; p=0.18) or depression (SMD -0.29[-1.29, 0.70]; p=0.56). However, it is noted that in the aerobic exercise study, jogging significantly reduced depression (SMD -0.91[-1.44, -0.38]; p<0.05) in males but not females. CONCLUSIONS: Despite considerable evidence regarding the impact of exercise on mental health outcomes in both the general and clinical populations, only a limited number of studies were identified specifically targeting university students. Of these studies, aerobic exercise as an intervention appears promising, but little data is published on this modality. Additional studies of high-quality, including more male participants are required investigating the impact of various exercise prescriptions on the mental health of university students.
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