Depression in adolescents: BRIDGES plans to test support for engaging in physical activity

Support centered on autonomy

According to the authors, physical activity interventions for adolescents with depression may lack developmental appropriateness, support for autonomy and feasibility in their everyday settings. BRIDGES seeks to address these barriers rather than simply offer an exercise program.

The intervention was co-designed and draws notably on self-determination theory and motivational interviewing. The aim is to support autonomous engagement and a sense of competence. This rationale forms the basis of the intervention, not proof of its efficacy.

A pilot trial planned for 60 young people

The protocol plans to recruit 60 physically inactive adolescents aged 12 to 19 with depression from an outpatient mental health service in Brussels. They will be randomly assigned, taking into account factors including age, gender, physical activity level and baseline depression severity.

The support consists of 18 individualized counseling sessions delivered by a physiotherapist over 12 weeks. Additional support is intended to facilitate the transition to community-based physical activities. These are therefore support sessions, not necessarily 18 exercise sessions.

The abstract provided does not specify what the comparator group will receive. This information is missing, making it unclear exactly what the intervention will be compared with.

Feasibility before clinical conclusions

The study will primarily seek to determine whether the approach is feasible, acceptable and can be integrated into care. Quantitative measures and interviews with adolescents, the people supporting them and local partners are intended to document these aspects.

The researchers also plan to estimate changes in physical activity using the Physical Activity Vital Sign and assess depressive symptoms using the PHQ-A, a version of the PHQ-9 questionnaire adapted for adolescents. Social support, exercise self-efficacy and cardiorespiratory fitness are also among the secondary outcomes.

These preliminary estimates are intended to inform a larger trial. Even if this pilot produces encouraging signals, its purpose and sample size will limit the conclusions that can be drawn about clinical efficacy.

What we can take away

BRIDGES proposes to test how to make physical activity more accessible and acceptable for adolescents with depression receiving outpatient care. At this stage, the new development is the study design, not a demonstrated benefit for depression.