Objectives
Both mindfulness intervention and physical activity have been shown to benefit individuals with depression. While it has been suggested that combined mindfulness and physical interventions may induce larger effects than either intervention alone, the existing literature presents mixed results. This meta-analysis aimed to assess the efficacy of combined interventions on depression (primary outcome) and anxiety (secondary outcome) by comparing combined intervention to control condition, mindfulness intervention and physical activity.
Method
Eighteen randomized controlled trials with 1391 participants (mean age, 44.91 years) from over 10 years (2012 to 2023) of research were included in this study; 11 electronic sources were used for the search.
Results
Combined intervention had a generally large and significant positive effect on depression (SMD = − 0.94, p < 0.01) and anxiety (SMD = − 1.64, p < 0.01) compared to the control group (e.g., treatment as usual, waitlist control group, and educational seminar). Compared to physical activity alone, combined intervention produced greater effects on overall effect size in depression (SMD = − 0.52, p < 0.05) and anxiety (SMD = − 0.65, p < 0.05), while no significant differences were found between combined intervention and mindfulness intervention in terms of depression (SMD = 0.11, p > 0.05) and anxiety (SMD = 0.01, p > 0.05). Subgroup analysis showed that effect sizes were affected by country, subject type, duration, and mode of intervention.
Conclusions
The findings suggest that combined intervention demonstrates advantages over control group and physical exercise, while evidence is still lacking for superiority when compared combined intervention to mindfulness intervention.
Preregistration
This review was preregistered on PROSPERO (Ref No: CRD42023442346).