Summary:
Mental health difficulties, including depression and anxiety, are common among university students and can affect academic performance, social functioning and long-term wellbeing. However, access to mental health services can be limited by stigma, cost, availability of professionals and long waiting times. This highlights the need for accessible approaches to support student mental health. Physical activity may provide one such approach. Previous research has linked regular exercise with lower levels of depression and anxiety, potentially through improvements in mood, stress regulation, cognitive function, self-confidence and social connection. However, much of the existing evidence is based on observational studies, and relatively few randomised controlled trials have examined these effects among university students. This study was a randomised controlled trial involving 120 university students with mild-to-moderate symptoms of depression or anxiety. Participants were randomly assigned to an 8-week team-based sports program, an individual aerobic exercise program, or a waitlist control group. The exercise groups completed three supervised 60-minute sessions each week. Depression, anxiety and psychological resilience were assessed before and after the intervention and again one month later. Both exercise groups experienced substantial reductions in depression and anxiety symptoms compared with the control group, with these improvements maintained at follow-up. Psychological resilience also increased significantly in both exercise groups. However, there were no significant differences between team-based and individual exercise. In conclusion, this study found that structured physical activity, whether delivered through team sports or individual aerobic exercise, may help reduce depression and anxiety and improve psychological resilience among university students. The findings support the potential use of exercise as part of university mental health programs, although further research with larger and more diverse populations and longer follow-up periods is needed.
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Abstract:
Background/objectives: Mental health challenges among Chinese college students represent a significant public health concern. While physical activity is recognized as beneficial for mental health, high-quality randomized controlled trials (RCTs) examining the efficacy of structured interventions and their underlying mechanisms in this population are limited. This study investigated the effects of an 8-week structured physical activity intervention on depression, anxiety, and psychological resilience among Chinese college students, and tested whether resilience mediates the intervention effects. Methods: A three-arm RCT was conducted with 120 students exhibiting mild-to-moderate depression/anxiety symptoms. Participants were recruited through convenience sampling and randomly allocated to a team-based sports group (n = 40), an individual aerobic exercise group (n = 40), or a waitlist control group (n = 40). The 8-week intervention involved three supervised 60-min sessions per week. Outcomes including depressive symptoms (PHQ-9), anxiety symptoms (GAD-7), and psychological resilience (CD-RISC-10) were assessed at baseline, post-intervention, and 1-month follow-up. Data were analyzed using linear mixed-effects models (LMM) for primary outcomes and the PROCESS macro bootstrap mediation procedure for mechanistic pathways. Results: Both exercise groups demonstrated significant, large reductions in depressive and anxiety symptoms compared to the control group at post-intervention (p < 0.001, Cohen’s d = 1.14–1.38), with effects maintained at follow-up. Psychological resilience increased significantly in both intervention groups (p < 0.001). No significant differences were found between the team-based and individual exercise modalities. Mediation analysis revealed that increases in psychological resilience accounted for approximately 45% of the intervention effects on reducing depression and anxiety symptoms. Conclusion: Structured physical activity, whether team-based or individual, appears to be an effective intervention for reducing depression and anxiety and enhancing psychological resilience among Chinese college students. Psychological resilience appears to serve as a significant mediator of these mental health benefits. These findings suggest the integration of structured exercise programs into university mental health promotion strategies. Future research should investigate long-term sustainability through multi-site RCTs, longer follow-up periods, cross-cultural replication, and neurobiological mediating mechanisms.
Article Publication Date: 12/06/2026
DOI: 10.3389/fpsyg.2026.1752242
