Effect of cognitive-behavioral therapy combined with exercise training in adolescent girls with elevated depression symptoms: a randomized controlled clinical trial

Objective: To investigate the effects of cognitive-behavioral therapy (CBT) combined with regular versus intermittent exercise on depression and quality of sleep-in adolescent girls. Participants and Methods: Sixty adolescent girls aged 12-17 years with mild to moderate depression were equally distributed to three groups, each group 20 patients. Group A received weekly 60-minutes CBT session combined with regular exercise 60 minutes three times per week for 12 weeks; Group B received weekly 60-minutes CBT plus intermittent exercise 60-minutes exercise once per week for 12 weeks and Group C received weekly 60-minute CBT alone for 12 weeks. Participants' depressive symptoms were evaluated before and after the 12-week interventions using the Center for Epidemiologic Studies Depression Scale (CES-D), sleep quality was evaluated before and after 12-week interventions using Pittsburgh Sleep Quality Index (PSQI). Results: After 12-week interventions, group A showed significantly lower reductions in CES-D depressive symptoms scores compared to group B and group C. Sleep quality improved significantly in all three groups, with group A experiencing the greatest increase. The comparison between groups B and C yielded no significant results. The intragroup statistical evaluation showed no significant difference between the groups. Conclusion: Among depressed adolescent girls, regular triweekly exercise combined with CBT led to significantly greater decreases in depressive symptoms and improved quality of sleep than intermittent once weekly exercise plus CBT or CBT alone. These findings indicate that exercise frequency may be key in potentiating the antidepressant benefits of CBT.