Aims: To assess feasibility and acceptability of exercise in clinically referred adolescents with major depression.

Methods: Outpatients12 to 17 years with mild to moderate persistent depression participated in a supervised, pulse monitored, 14-week aerobic exercise but without control group. Primary outcome was adherence and secondary was clinician-rated Quick Inventory of Depressive Symptomatology – Adolescent (QIDS-A₁₇-C), aerobic capacity, functioning, and well-being.

Results: Twenty-one (66%) of 32 eligible adolescents with major depression with disease duration 2.4 (1.1–5.3) years and comorbid ADHD (71%) and anxiety disorders (62%) consented. Estimated maximum heart rate above 70% was achieved for mean 31.6 minutes, indicating that the intensity and duration of the exercise intervention was well received. Fourteen patients (67%) participated throughout the program and attended a median of 29 (81%, range 20–35) supporting satisfaction with the intervention by most patients. QIDS-A₁₇-C score decreased compared to baseline at 15 weeks (p <.001) and further at 1 year (p <.001). Aerobic capacity improved during the intervention but was not maintained, while functioning improved and after 1 year also well-being.

Conclusion: This 14 week moderate to vigorous aerobic exercise intervention was feasible and well accepted by most adolescents with persistent depression and extensive comorbidities. © The Author(s) 2021.