Effects of open-skill and closed-skill exercise on subthreshold depression in female adolescents: A randomized controlled trial

Background: Subthreshold depression (SD) affects a significant proportion of adolescent females, posing a risk of major depression in later life. This study examines the effects of open-skill exercise (OSE) and closed-skill exercise (CSE) on SD, executive function (EF), and emotional states in female adolescents. Methods: A double-blind randomized controlled trial involved 95 female adolescents (mean age = 16.73 +/- 0.42 years) with SD symptoms. Participants were assigned to OSE, CSE, or control (CON) groups and underwent an 8week exercise program. Primary outcomes were assessed using the Beck Depression Inventory (BDI-13) and the Center for Epidemiological Studies Depression Scale (CES-D), with secondary outcomes including EF tasks and emotional assessments. Differences were examined using generalized linear mixed models with intention-to-treat and multiple imputation. Results: Both OSE and CSE significantly reduced depressive symptoms, with CSE showing greater improvement. EF assessments showed enhanced cognitive flexibility and working memory in both exercise groups at 4 weeks, and superior inhibitory control and cognitive flexibility in the CSE group at 8 weeks. Emotional assessments indicated a notable reduction in negative emotions in the CSE group after 8 weeks. Conclusions: Both OSE and CSE reduce SD symptoms in female adolescents, with CSE providing more sustained benefits for EF and emotional states. Further research on exercise interventions for mental health is warranted. Trial registration number: ChiCTR2400081139