Summary:
Depression is a common mental health condition associated with low mood, poor motivation, impaired functioning and significant impacts on quality of life. People with depression also frequently experience sleep disturbances and problems with attention, memory and executive function. Although antidepressant medication and therapy remain the main treatments for depression, limitations such as side effects, cost and access barriers highlight the need for additional approaches. Exercise has gained increasing attention as a potential supportive treatment, with research suggesting benefits from both aerobic and strength-based activities. However, few studies have directly compared different types of exercise, particularly in people with severe depression. This study was a randomised controlled trial that investigated the effects of aerobic exercise and stretching or resistance training as additions to standard treatment in people experiencing severe depression. A total of 273 participants were randomly assigned to receive either conventional treatment alone, conventional treatment plus aerobic exercise, or conventional treatment plus stretching/resistance training. Participants were assessed before and after six weeks using measures of depressive symptoms, sleep quality and cognitive function. The findings showed that both forms of exercise improved depressive symptoms, sleep quality and cognitive function compared with standard treatment alone. Improvements were observed in executive function, with aerobic exercise showing greater benefits for some measures of cognitive performance compared with stretching or resistance training. Both exercise groups also demonstrated improvements in attention and processing speed. Overall, this study suggests that incorporating exercise into standard depression treatment may provide additional benefits for mood, sleep and cognitive function in individuals with severe depression.
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Abstract:
Purpose: To explore the Effects of Exercise Supplementary to Standard Therapy on Cognition and Sleep in Depression. Methods: We randomized 273 inpatients with first-episode severe depression, 234 completed 6 weeks, conventional treatment, conventional treatment combined with aerobic exercises and conventional treatment combined with stretching or resistance training exercises group. Hamilton Depression Scale-24 (HAMD24), Pittsburgh Sleep Quality Index (PSQI), Montreal Cognitive Assessment (MOCA), Chinese Version of the Trail-Making Test (C-TMT), and Stroop Color and Word Test (SCWT) were used to evaluate the patients respectively before and after intervention. The primary analysis estimated was the between-group difference in post-treatment scores at 6 weeks under randomized allocation (post-status estimated); within-group changes were summarized descriptively. Results: After intervention, HAMD24, PSQI, C-TMT-A, and C-TMT-B scores of patients in each group were all lower than those before intervention. HAMD24, PSQI, and C-TMT-A scores of patients in Groups B and C showed lower than those of Group A. C-TMT-B score of patients in Group B was lower than that of Group C, and the score of Group C was lower than that of Group A. MOCA, SCWT scores of patients in each group were higher than those before intervention. Stroop Word and Stroop Color scores were significantly higher in Groups B and C than in Group A. MOCA and Stroop Color-Word scores of patients in Group B were higher than those of Group C. However, scores of Group C were higher than those of Group A. Conclusion: Both aerobic exercises and stretching or resistance training exercises as adjuncts to conventional treatment improved depressive symptoms, sleep quality, and cognitive function in patients with first-episode severe depression. Patterns were consistent with greater improvement in select executive-function measures in the aerobic arm; confirmation with baseline-adjusted analyses is warranted.
Article Publication Date: 03/02/2026
DOI: 10.3389/fpsyt.2026.1650334
