A Systematic Literature Review: Is Exercise Effective for Treating Clinical Depression in Young Adults (19-26years) in the UK who take only Standard/Pharmacological Treatment? (Research Proposal Sample)

A Systematic Literature Review: Is Exercise Effective for Treating Clinical Depression in Young Adults (19-26years) in the UK who take only Standard/Pharmacological Treatment?
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A Systematic Literature Review: Is Exercise Effective for Treating Clinical Depression in Young Adults (19-26years) in the UK who take only Standard/Pharmacological Treatment?
Background of the Study
Context and Rationale for the Study
The study will involve conducting a systematic review on literature discussing the relationship between physical exercises and treating depression. The quasi-systematic review will encompass a search string based on the keywords retrieved from the PICO question, source selection to choose the libraries where primary studies will be obtained, studies selection to define the selection process for relevant studies based on inclusion or quality criteria, data extraction to extract and define which data should be obtained from the selected articles to answer the research question and result summarisation to analyse and categorise studies to effectively answer the research question. Thus, the study revolves around a research question which includes the PICO formulation.
Nature and Extent of the Problem/Issue
Mental health is a public health problem affecting European young people. Castelpietra et al. (2022) report that mental health issues remain unmanaged and undetected for a long time. Most European nations depict a high heterogeneity in resource allocation for young people seeking mental health services. Also, only 70 percent of the European nations have put in place the mental health policy for young people. Thus, most countries in Europe, including the UK have not escalated efforts to address mental health issues.
Depressive disorders are the leading mental health diseases reported globally, disproportionately affecting developing nations. Depression contributes to a number of adverse outcomes, including early mortality and disability while also interacting bi-directionally and synergistically with other chronic illnesses, such as hypertension, diabetes and cardiovascular conditions, exacerbating their negative impacts (Agudelo-Botero et al., 2021). Depression is also associated with other illnesses such as addiction, suicide and anxiety, which adversely impact on communities, families and individuals. Thus, depression is a global public health issue that presents adverse outcomes requiring prompt interventions.
The COVID-19 pandemic saw increased levels of mental health issues with the UK reporting escalation of these pre-existing trends. Young adults reported increase in the mental health issues during the first wave of COVID-19 pandemic in 2020 (Gagne et al. 2022). Friedrich (2017) estimates that 322 million people, accounting for 4.4 percent of world’s population, live with depression globally. The prevalence rate for mental disorders is projected to increase, especially in low and middle-income nations, with the populations experiencing anxiety and depression conditions simultaneously.
A Brief Summary of Previous Relevant Research
A strong correlation exists between physical and mental health. Ohrnberger, Fichera, and Sutton (2017) establish strong cross-effects between mental and physical health after controlling for confounders. On the one hand, changing lifestyle behaviours in high income nations avoids 55 percent of the disease burden, including mental health. On the other hand, lifestyle factors account for up to 70 percent of disease burden. Physical activity is one of the leading lifestyle factors that account for the disease burden in developed countries.
The social distancing measures enforced to curb the spread of COVID-19 pandemic limited physical activities and personal contact with family, friends and colleagues, leading to increased cases of mental health problems. The World Health Organisation (WHO) reported that social distancing measures may make people become more agitated, stressed, anxious and withdrawn (Jacob et al. 2020). Research studies showed that mental health problems increased during the COVID-19 era. For instance, one study showed that 36.8 percent of 932 UK adults reported having mental health issues due to COVID-19 social distancing measures. Thus, social distancing, which limited physical activities, contributed to increase in mental health problems.
Physical exercises is fundamental in maintaining or improving mental and physical health and improving quality of life post-COVID-19 era. According to Ai et al. (2021), various psychological and physiological mechanisms explain the positive impact of physical activity. Physiologically, physical activity may enhance the levels of brain-derived neurotrophic factor (BDNF), endorphins and hormones, making people less stressed and feeling happy. Psychologically, physical exercises help people avoid the stressors and enhance self-efficacy to competently handle difficulties they encounter. Thus, engaging in physical activities help people avoid the underlying causes of mental health issues.
Public Health Significance
The outcome of the quasi-systematic review of literature is critical in addressing mental health issues post-COVID-19 era. Clearly, mental health issues increased during the COVID-19 pandemic, and establishing low-cost interventions is essential in addressing poor mental health among young adults. The target populations are productive in the society and can be actively engaged in physical activities to reduce anxiety and other depressive disorders. These non-conventional interventions have little or no cost and suitable for young adults.
Research Question
Is physical exercise effective for treating clinical depression in young adults (19-44 years) in the UK who take only pharmacological/standard treatment?
The researcher will use the PICO approach to guide in the proposed quasi-systemic review as summarised in the Table 1 below:
Population

Young adults between 19 and 44 years old with clinical depression in the UK

Intervention

Physical exercise (integrating physical exercise in the treatment intervention)

Comparison

Examine exercise efficacy in treating depression in young adults compared to pharmacological/standard therapies alone

Outcome

Decrease in depressive symptoms, improved quality of life

Table 1: PICO description
Study Design and Methods
Study Design
A systematic literature review entails a means of determining, examining and interpreting all available information and relevant area, element, research or topic. Silva et al. (2017) note that systematic review is a secondary study as opposed to experiments, case studies and surveys which are characterised as primary studies (p. 352). Quasi-systematic reviews commence with conceiving a well-formulated research question which is informed by the description of a population, the intervention and the expected outcome. The protocol for a quasi-systematic review should encompass formulation of research question, determination of the need to undertake the review, comprehensive search incorporating primary studies, quality assessment, and data extraction, summary of study outcomes, results interpretation and written report.
Search Strategy
Search strategy explicitly defines the survey scope, including the terms used to develop search strings. The definitions of the terms are based on the population, intervention and projected outcomes, which were included in the research question. The scope of the search entails searching electronic databases for conference proceedings and journals. The online databases to be used include CINHAL, British Nursing Database, Cochrane Library, PubMed, PsycInfo, Social Service Abstracts and Health Research Premium Collection, among others. The terms used during the search include: physical exercises, physical activities, depression, depressive disorders, anxiety, stress, young people, quality of life, pharmacological and standard therapies, COVID-19 pandemic and post-COVID-19 era.
The search string should be defined based on the keywords originating from PICO. While the population is the young people aged between 19 and 44 years, the intervention is using physical exercises or activities. The key words that the researcher may use in the search string include standard/pharmacological therapies as compared to enhanced quality of life and depressive symptoms for the outcome of the study. Thus, these keywords from PICO should inform the development of search strings.
The combination of key terms using BOOLEAN operators will help in generating the search string. For instance, the string used in searching the database may be defined as: (Physical activities) OR (Physical exercises) AND (Mental Health) OR (Depression) OR (Depressive Disorder). The search string may help the researcher to retrieve articles relating to the correlation between mental health and physical activities or exercises. Further, the researcher may define the search string as follows: (Physical activity) OR (Physical exercises) AND (Mental Health) AND (Pharmacological Therapy) OR (Standard Therapy). The search string may assist the researcher in selecting articles that focus on the effectiveness of physical exercises in addressing mental health issues as opposed to pharmacological or standard therapies. Table 2 below summarises search strings that will be used based on PICO.
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