Special Issue "Physical Activity and Physical Fitness in Treating Depression and Boosting Mental Health"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: 31 January 2022.

Special Issue Editors

Dr. Eugenia Murawska-Ciałowicz
E-Mail Website
Assistant Guest Editor
Physiology and Biochemistry Department, University School of Physical Education, Wroclaw, Poland
Interests: exercise biochemistry and physiology; exercise and performance; exercise monitoring; physical activity assessment; exercise benefits; physiological adaptation; adipose tissue; BDNF
Special Issues and Collections in MDPI journals
Dr. Diego Gomez-Baya
E-Mail Website
Assistant Guest Editor
Department of Social, Developmental and Educational Psychology, University of Huelva, 21007, Spain
Interests: physical activity; sports; adolescence; youth; healthy lifestyle; gender; psychological wellbeing; resilience

Special Issue Information

Dear Colleagues,

Depression is a mental health problem related to indicators such as depressed mood, poor concentration, loss of interest, sleeping troubles, feelings of guilt, disturbed appetite, and decreased energy. In recent years, depression has been the most prevalent mental disorder. Depression affects relationships with others, education and work opportunities, and quality of life. Unfortunately, it is a transversal problem, affecting people of both sexes at different ages and different educational and socioeconomic backgrounds.

There is evidence that physical activity and physical fitness provide a protective effect against depression and have a positive effect on treatment in nonclinical and clinical populations. The evidence shows that the protective effects of physical activity and physical fitness in depression are independent of sex and age.

We will accept manuscripts from different disciplines. Special attention will be paid to original research, systematic reviews, and meta-analyses involving the following topics for this Special issue in IJERPH:

– Physical activity, physical fitness, and depression in young people.

– Physical activity, physical fitness, and depression in the general population.

– Physical activity, physical fitness, and depression in people with special needs.

– Relationship between depression, physical activity, and physical fitness stratified by sociodemographic characteristics.

– Adherence to physical activity practice in people with depressive symptoms.

– Emotions in physical activity, sports, and exercise.

– Social influences in physical activity, sports, and exercise in people with depressive symptoms.

– Mechanisms that explain the relationship between physical activity, physical fitness, and depression.

– Relationship between depressive symptoms and the decline in physical activity and physical fitness levels.

Studies do not necessarily have to offer positive results (i.e., results confirming previous literature). Rigorous works where the conclusions offer novelties presenting exceptions to previous studies are also welcome.

Dr. Adilson Marques
Dr. Eugenia Murawska-Ciałowicz
Dr. Diego Gomez-Baya
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Mental health
  • Anxiety
  • Feeling low
  • Sport
  • Physical exercise
  • Exercise and neuroplasticity

Published Papers (13 papers)

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Research

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Article
Exploring a Complementary Stress Management and Wellbeing Intervention Model for Teachers: Participant Experience
Int. J. Environ. Res. Public Health 2021, 18(17), 9009; https://doi.org/10.3390/ijerph18179009 - 26 Aug 2021
Viewed by 478
Abstract
Background: work-related stress can have alarming physiological and psychological health impacts, which may permeate into personal and professional contexts. Teachers need to be supported to develop the skills and strategies to effectively identify how stress manifests and how to use simple, practical techniques [...] Read more.
Background: work-related stress can have alarming physiological and psychological health impacts, which may permeate into personal and professional contexts. Teachers need to be supported to develop the skills and strategies to effectively identify how stress manifests and how to use simple, practical techniques to manage and reduce the impact of stress. Complementary interventions (CIs) for educators may provide stress management and assist with supporting wellbeing at the individual level. Methods: the convergent mixed-methods study included participant reflections, self-report measures for perceived stress, mindful attention awareness, and subjective wellbeing and biological measures (salivary cortisol levels). Data analysis: inductive thematic analysis and mixed-methods case study design. Results: the participants shared that they experienced benefits in personal and professional contexts, behavioural changes, increased awareness of the impact of stress, and a decrease in the stress response. The participant reflections provided contextual information surrounding the self-report and biological measures. The inferences generated were reflected in both datasets. The findings supported the proposed model linking the mechanisms present in the techniques from the system of yoga and the dimensions of wellbeing. Conclusions: the findings suggest that a CI for educators may provide strategies for supporting wellbeing and assisting with stress management. Full article
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Article
Influence of Physical Activity and Socio-Economic Status on Depression and Anxiety Symptoms in Patients after Stroke
Int. J. Environ. Res. Public Health 2021, 18(15), 8058; https://doi.org/10.3390/ijerph18158058 - 29 Jul 2021
Viewed by 487
Abstract
Stroke is a high-risk factor for depression. Neurological rehabilitation is greatly difficult and often does not include treatment of depression. The post-stroke depression plays an important role in the progress of treatment, health, and the life of the patient. The appropriate treatment of [...] Read more.
Stroke is a high-risk factor for depression. Neurological rehabilitation is greatly difficult and often does not include treatment of depression. The post-stroke depression plays an important role in the progress of treatment, health, and the life of the patient. The appropriate treatment of depression could improve the quality of life of the patient and their family. The study aimed to evaluate the impact of physical activity and socio-economic status of the patient on the effectiveness of recovery from depression and the severity of the symptoms of depression. The study was conducted with 40 patients after stroke aged 42–82 years, and included 10 women and 30 men who were hospitalized for two weeks. The severity of depression/anxiety (D/A) symptoms were evaluated two times; at admission and after two weeks of physical therapy. The hospital anxiety and depression scale (HADS) questionnaire was used for this purpose. Socio-economic status was evaluated by several simple questions. It was revealed that physical therapy has a positive influence on mental state. The severity of D/A symptoms after stroke is related to the financial status of the patients (χ2 = 11.198, p = 0.024). The state of health (χ2 = 20.57, p = 0.022) and physical fitness (χ2 = 12.95, p = 0.044) changed the severity of symptoms of anxiety and depressive disorders. The kinesiotherapy in the group of patients with post-stroke depression had positive effects; however, economic and health conditions may influence the prognosis of the disease. Full article
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Article
Relationships between Depression, Daily Physical Activity, Physical Fitness, and Daytime Sleepiness among Japanese University Students
Int. J. Environ. Res. Public Health 2021, 18(15), 8036; https://doi.org/10.3390/ijerph18158036 - 29 Jul 2021
Viewed by 429
Abstract
In Japan and other developed countries, the lifestyles of many—particularly the younger generation—have been disrupted in recent years. This disruption may manifest as a decrease in physical activity and deterioration in the quality and quantity of sleep. Depressive tendencies are also increasing among [...] Read more.
In Japan and other developed countries, the lifestyles of many—particularly the younger generation—have been disrupted in recent years. This disruption may manifest as a decrease in physical activity and deterioration in the quality and quantity of sleep. Depressive tendencies are also increasing among university students. This study examined the relationship between mental health, physical activity, physical fitness, and daytime sleepiness. Eighty-five undergraduate students participated in this study (52 men and 33 women, aged 18.9 (±1.4) years). Physical activity levels were measured using an accelerometer (Lifecorder, Kenz, Nagoya, Japan) for two weeks. To evaluate their level of physical fitness, maximal oxygen uptake (V˙O2max) was calculated by an indirect method using a cycle ergometer. Depressive tendencies and daytime sleepiness were evaluated using the Patient Health Questionnaire (PHQ-9). The PHQ-9 score was positively correlated with sleepiness (r = 0.35, p = 0.001) and total steps per day (r = 0.39, p < 0.001). Moreover, the PHQ-9 score was positively correlated with V˙O2max (r = 0.25, p = 0.019). The PHQ-9 score was higher in students with good exercise habits or part-time jobs. An important finding was the positive correlation between depression and variables related to physical activity levels. These results suggest that vigorous physical activity, such as exercise and part-time jobs, might be positively associated with depressive tendencies among university students. Full article
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Article
A Complementary Intervention to Promote Wellbeing and Stress Management for Early Career Teachers
Int. J. Environ. Res. Public Health 2021, 18(12), 6320; https://doi.org/10.3390/ijerph18126320 - 11 Jun 2021
Viewed by 1055
Abstract
The educational climate and culture in our schools present a variety of environmental (contextual) factors that influence teacher wellbeing, job satisfaction, and work-related stress. The magnitude of contextual factors cannot be ignored, and directing attention towards the environment teachers face daily is essential. [...] Read more.
The educational climate and culture in our schools present a variety of environmental (contextual) factors that influence teacher wellbeing, job satisfaction, and work-related stress. The magnitude of contextual factors cannot be ignored, and directing attention towards the environment teachers face daily is essential. Primary (organisational)-level interventions are documented in organisational health and wellbeing literature; however, to provide teachers with stress management strategies for promoting wellbeing, attention must also be directed towards secondary (individual)-level interventions. The present study addressed the issue of stress management techniques for early career teachers (n = 24) and aimed to contribute to the research surrounding complementary interventions (CIs) for educators. The intervention was designed to include strategies that operated through cognitive and physiological mechanisms that regulated the stress response and increased awareness of behaviours, emotions, and reactivity. The self-report measures included perceived stress, attention awareness, subjective wellbeing, burnout, and job-related affective wellbeing. The results indicated a statistically significant decrease in perceived stress and increases in attention awareness and subjective wellbeing. The salivary cortisol levels (waking and resting) decreased from baseline to week 6, and the pre- and post-session salivary cortisol levels indicated an immediate decrease in cortisol for weeks 4 to 6. Full article
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Article
Physical Activity and the Emotional State of Physiotherapy Students Who Finish Their Education
Int. J. Environ. Res. Public Health 2021, 18(9), 4572; https://doi.org/10.3390/ijerph18094572 - 26 Apr 2021
Viewed by 558
Abstract
This study aimed to evaluate the emotional state and the level of the sense of coherence in the context of physical activity among physiotherapy students and investigate how the participating students’ emotional state changed after two years of studying and what factors were [...] Read more.
This study aimed to evaluate the emotional state and the level of the sense of coherence in the context of physical activity among physiotherapy students and investigate how the participating students’ emotional state changed after two years of studying and what factors were associated with the mood disorders. The study group consisted of 110 students—79 female and 31 male. The Back Depression Inventory (BDI), the Sense of Coherence Questionnaire (SOC-29) and the Perceived Stress Questionnaire (PSQ) were used. The results presented an increase in depressive symptoms during the studies of a group of physiotherapy students. Physical activity can play a protective role in the prevention and treatment of mood disorders. The students who regularly engaged in physical activity exhibited better mood, a lower perceived stress level and a higher level of the sense of coherence as compared to the physically inactive students. Full article
Article
Organized Sport Participation, Physical Activity, Sleep and Screen Time in 16-Year-Old Adolescents
Int. J. Environ. Res. Public Health 2021, 18(6), 3162; https://doi.org/10.3390/ijerph18063162 - 18 Mar 2021
Viewed by 950
Abstract
This study aimed to examine the association of different frequencies of organized sport participation (OSP) with physical activity, cardiorespiratory fitness, body composition, sleep, and screen time among adolescents. A cross-sectional study involving 315 16-year-old adolescents was conducted. OSP was self-reported, being categorized as [...] Read more.
This study aimed to examine the association of different frequencies of organized sport participation (OSP) with physical activity, cardiorespiratory fitness, body composition, sleep, and screen time among adolescents. A cross-sectional study involving 315 16-year-old adolescents was conducted. OSP was self-reported, being categorized as 0 times a week, less than three times a week, 4–5 times a week, and 6–7 times a week, on average. Screen time was also self-reported but physical activity and sleep duration were objectively measured. Cardiorespiratory fitness and body composition were measured using a maximal cycle ergometer test and a dual-energy X-ray absorptiometry (DXA) scan, respectively. An analysis of covariance revealed a significant association between OSP and physical activity (F (3, 286) = 14.53, p < 0.01), cardiorespiratory fitness (F (3, 236) = 17.64, p < 0.01), screen time (F (3, 294) = 8.14, p < 0.01), body fat percentage (F (3, 292) = 11.84, p < 0.01), and fat free mass (F (3, 290) = 5.76, p < 0.01. No significant association was found between OSP and sleep duration. Post hoc analyses showed that OSP at least four times a week was beneficial to favorable physical activity levels, cardiorespiratory fitness, screen time, and body composition and may therefore serve as a valuable tool in battling unhealthy lifestyle behaviors among adolescents. Full article
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Article
Analysis of Body Perception, Preworkout Meal Habits and Bone Resorption in Child Gymnasts
Int. J. Environ. Res. Public Health 2021, 18(4), 2184; https://doi.org/10.3390/ijerph18042184 - 23 Feb 2021
Viewed by 1037
Abstract
The beneficial effects of physical activity on body image perception and bone are debated among artistic gymnasts. Gymnasts seem to be at greater risk of developing body dissatisfaction, eating disorders and osteoporosis due to inadequate nutrition and attention to the appearance of the [...] Read more.
The beneficial effects of physical activity on body image perception and bone are debated among artistic gymnasts. Gymnasts seem to be at greater risk of developing body dissatisfaction, eating disorders and osteoporosis due to inadequate nutrition and attention to the appearance of the body. The objective of this work was to investigate the association between the artistic gymnast and a more favorable body image compared to their sedentary peers and if a preworkout high-carbohydrate meal (HCM; 300 kcal, 88% carbohydrates, 9% protein, 3% fat) or high-protein meal (HPM; 300 kcal, 55% carbohydrates, 31% protein, 13% fat) is able to attenuate bone resorption in young rhythmic gymnasts. Twenty-eight preadolescent female gymnasts were examined. Self-esteem tests were used to analyze body image perception. Preworkout eating habits were examined by short food frequency questions (FFQ) validated for children. The biomarker of the bone resorption C-terminal telopeptide region of collagen type 1 (CTX) was measured in the urine (fasting, postmeal and postworkout). Gymnasts reported higher satisfaction with their body appearance compared to sedentary peers. Of the gymnasts, 30% did not have a preworkout meal regularly, and the timing of the consumption was variable. Bone resorption was decreased by the HCM, consumed 90 min before the training, with respect to the HPM. The study suggests that playing artistic gymnastics is associated with a positive body self-perception in a child. The variability in preworkout meal frequency and timing need attention to prevent inadequate eating habits in light of the ability of the HCM to reduce acute bone resorption. Full article
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Article
Let’s Live Healthier: The Relationship between Suicidal Behavior and Physical Activity in an Age-, Gender-, and Body Mass Index-Matched Adults
Int. J. Environ. Res. Public Health 2020, 17(22), 8350; https://doi.org/10.3390/ijerph17228350 - 11 Nov 2020
Cited by 1 | Viewed by 779
Abstract
The purpose of this study was to identify the association between physical activity (PA) and predictors of suicidal behaviors and to investigate whether the different PA measurements influence the association between PA and suicidal behaviors in South Korean adults. This study analyzed data [...] Read more.
The purpose of this study was to identify the association between physical activity (PA) and predictors of suicidal behaviors and to investigate whether the different PA measurements influence the association between PA and suicidal behaviors in South Korean adults. This study analyzed data from the National Health and Nutrition Examination Survey 2014–2015 data. The study selected participants who checked suicide-related questions as “Yes” (n = 99) and checked suicide-related questions as “No” (n = 99) in the questionnaire. The age, gender, and body mass index of participants between the two groups were matched. The moderate to vigorous PA (p = 0.000) and sedentary PA (p = 0.000), measured by accelerometers, were a significant risk factor for suicidal behaviors. Furthermore, the number of steps was a considerable difference between the two groups (healthy group: 61,495.76 steps; suicide group: 40,517.34 steps), and the accelerometer and questionnaire also showed significant differences. The study demonstrated that there were significant associations with physical activity and socioeconomic status and suicidal behaviors in anthropometry (i.e., age, gender, height, weight) matched groups. Additionally, this study highlights the importance of the assessment of PAs, and increasing PA levels could reduce the incidence of suicidal behaviors. Full article
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Article
Longitudinal Association between Sport Participation and Depressive Symptoms after a Two-Year Follow-Up in Mid-Adolescence
Int. J. Environ. Res. Public Health 2020, 17(20), 7469; https://doi.org/10.3390/ijerph17207469 - 14 Oct 2020
Cited by 1 | Viewed by 1025
Abstract
Sport participation has been advocated as a strategy to improve adolescents’ mental health. However, how these variables evolve during the adolescent years is uncertain. The objective of the present work was to examine the longitudinal associations of sports participation and depressive symptoms in [...] Read more.
Sport participation has been advocated as a strategy to improve adolescents’ mental health. However, how these variables evolve during the adolescent years is uncertain. The objective of the present work was to examine the longitudinal associations of sports participation and depressive symptoms in adolescents. Participants were 525 Spanish adolescents (50.3% boys), aged between 12 and 15 years old (M = 13.45, SD = 0.69). They were enrolled in 18 secondary schools located in Andalusia (Spain) in the first two academic years of Compulsory Secondary Education. Data were collected in three waves, separated by one year, by administering self-report measures of depressive symptoms and sport participation. Repeated measures analyses of variance were conducted to examine the change in depressive symptoms and sport participation, and a latent growth curve model was tested to examine the change in depressive symptoms controlling initial sport participation and gender. At each wave, more frequent sport participation was related to lower depressive symptoms. Two years after the first assessment, adolescents became more depressed but not more active. Less active adolescents had more depressive symptoms in each assessment time. At all moments of assessment, girls were less active and reported more depressive symptoms. Moreover, girls had a higher increase in depressive symptoms than boys. Promotion of physical activity (PA) as a mental health strategy needs to consider gender differences as boys and girls have different patterns of presentation of depressive symptoms throughout adolescence. Full article
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Article
The Association of Grip Strength with Depressive Symptoms among Middle-Aged and Older Adults with Different Chronic Diseases
Int. J. Environ. Res. Public Health 2020, 17(19), 6942; https://doi.org/10.3390/ijerph17196942 - 23 Sep 2020
Cited by 3 | Viewed by 865
Abstract
Low grip strength has been associated with an increase in depressive symptoms, independent of age group or gender, although the literature has not investigated this association among different chronic diseases. The present study aims to investigate the association of grip strength and depressive [...] Read more.
Low grip strength has been associated with an increase in depressive symptoms, independent of age group or gender, although the literature has not investigated this association among different chronic diseases. The present study aims to investigate the association of grip strength and depressive symptoms among middle-aged and older adults with different chronic diseases. A cross-section of data from the Survey of Health, Ageing, and Retirement in Europe wave 6 (collected in 2015) was analysed. Grip strength was measured by a handgrip dynamometer, and the European Depression Symptoms 12-item scale (EURO-D) was used to assess depressive symptoms. Multivariable logistic regression analysis was conducted. Those in the high strength tertile had 42% (95% confidence interval: 0.50, 0.71; p < 0.005) and 41% (95% confidence interval: 0.50, 0.70; p < 0.001) lower odds of depressive symptoms in the ‘no disease’ and in the ‘metabolic diseases’ groups of participants, respectively, compared with those in the lower strength tertile. No statistically significant relationship between grip strength and depression was observed in the ‘arthritis diseases’ group of participants. The association of grip strength with depressive symptoms must consider, besides gender and age group, the chronic conditions that an individual could have. Full article

Review

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Review
BDNF Impact on Biological Markers of Depression—Role of Physical Exercise and Training
Int. J. Environ. Res. Public Health 2021, 18(14), 7553; https://doi.org/10.3390/ijerph18147553 - 15 Jul 2021
Viewed by 872
Abstract
Depression is the most common and devastating psychiatric disorder in the world. Its symptoms, especially during the pandemic, are observed in all age groups. Exercise training (ET) is well known as a non-pharmacological strategy to alleviate clinical depression. The brain-derived neurotrophic factor (BDNF) [...] Read more.
Depression is the most common and devastating psychiatric disorder in the world. Its symptoms, especially during the pandemic, are observed in all age groups. Exercise training (ET) is well known as a non-pharmacological strategy to alleviate clinical depression. The brain-derived neurotrophic factor (BDNF) is one of the biological factors whose expression and secretion are intensified in response to ET. BDNF is also secreted by contracted skeletal muscle that likely exerts para-, auto- and endocrine effects, supporting the crosstalk between skeletal muscle and other distant organs/tissues, such as the nervous system. This finding suggests that they communicate and work together to induce improvements on mood, cognition, and learning processes as BDNF is the main player in the neurogenesis, growth, and survival of neurons. Therefore, BDNF has been recognized as a therapeutic factor in clinical depression, especially in response to ET. The underlying mechanisms through which ET impacts depression are varied. The aim of this review was to provide information of the biological markers of depression such as monoamines, tryptophan, endocannabinoids, markers of inflammatory processes (oxidative stress and cytokines) stress and sex hormones and their relationship to BDNF. In addition, we reviewed the effects of ET on BNDF expression and how it impacts depression as well as the potential mechanisms mediating this process, providing a better understanding of underlying ET-related mechanisms in depression. Full article
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Review
The Effects of Exclusively Resistance Training-Based Supervised Programs in People with Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Int. J. Environ. Res. Public Health 2020, 17(18), 6715; https://doi.org/10.3390/ijerph17186715 - 15 Sep 2020
Cited by 1 | Viewed by 2033
Abstract
The purpose of this study was to systematically review the effects of supervised resistance training (RT) programs in people diagnosed with depression or depressive symptoms. The following databases were used to search and retrieve the articles: Cochrane Library, EBSCO, PEDro, PubMed, Scopus and [...] Read more.
The purpose of this study was to systematically review the effects of supervised resistance training (RT) programs in people diagnosed with depression or depressive symptoms. The following databases were used to search and retrieve the articles: Cochrane Library, EBSCO, PEDro, PubMed, Scopus and Web of Science. The search was conducted in late June 2020. Search protocol required the title to contain the words depression or depressive or dysthymia. Furthermore, the title, abstract or keywords had to contain the words or expressions: “randomized controlled trial”; and “strength training” or “resistance training” or “resisted training” or “weight training”. The screening provided 136 results. After the removal of duplicates, 70 records remained. Further screening of titles and abstracts resulted in the elimination of 57 papers. Therefore, 13 records were eligible for further scrutiny. Of the 13 records, nine were excluded, and the final sample consisted of four articles. Results were highly heterogeneous, with half of the studies showing positive effects of resistance training and half showing no effects. In two of the four combinations, the meta-analysis revealed significant benefits of RT in improving depressive symptoms (p ≤ 0.05). However, considering significant differences with moderate (Effect Size = 0.62) and small (ES = 0.53) effects, the heterogeneity was above 50%, thus suggesting a substantial level. To draw meaningful conclusions, future well-designed randomized controlled trials (RCTs) are needed that focus on understudied RT as a treatment for depression. Full article
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Review
The Effect of Muscular Strength on Depression Symptoms in Adults: A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2020, 17(16), 5674; https://doi.org/10.3390/ijerph17165674 - 06 Aug 2020
Cited by 5 | Viewed by 1304
Abstract
The aim was to systematically review the relationship between muscular strength (MS) and depression symptoms (DS) among adults, and conduct a meta-analysis to determine the pooled odds ratio (OR) for the relationship between MS and DS. The strategies employed in this systematic review [...] Read more.
The aim was to systematically review the relationship between muscular strength (MS) and depression symptoms (DS) among adults, and conduct a meta-analysis to determine the pooled odds ratio (OR) for the relationship between MS and DS. The strategies employed in this systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies published up to December 2019 were systematically identified by searching in the PubMed, Scopus, and Web of Science electronic databases. Inclusion criteria were: (1) cross-sectional, longitudinal and intervention studies; (2) outcomes included depression or DS; (3) participants were adults and older adults; and (4) the articles were published in English, French, Portuguese, or Spanish. A total of 21 studies were included in the review, totalling 87,508 adults aged ≥18 years, from 26 countries. The systematic review findings suggest that MS has a positive effect on reducing DS. Meta-analysis findings indicate that MS is inversely and significantly related to DS 0.85 (95% CI: 0.80, 0.89). Interventions aiming to improve MS have the potential to promote mental health and prevent depression. Thus, public health professionals could use MS assessment and improvement as a strategy to promote mental health and prevent depression. Full article
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