Activity monitoring in patients with depression: A systematic review

Christopher Burton, Brian McKinstry, Aurora Szentagotai Tatar, Antoni Serrano-Blanco, Claudia Pagliari, Maria Wolters

Research output: Contribution to journalArticlepeer-review

160 Citations (Scopus)
5 Downloads (Pure)


BACKGROUND: Altered physical activity is an important feature of depression. It is manifested in psychomotor retardation, agitation and withdrawal from engagement in normal activities. Modern devices for activity monitoring (actigraphs) make it possible to monitor physical activity unobtrusively but the validity of actigraphy as an indicator of mood state is uncertain. We carried out a systematic review of digital actigraphy in patients with depression to investigate the associations between measured physical activity and depression. METHODS: Systematic review and meta-analysis. Studies were identified from Medline, EMBASE and Psycinfo databases and included if they were either case control or longitudinal studies of actigraphy in adults aged between 18 and 65 diagnosed with a depressive disorder. Outcomes were daytime and night-time activity and actigraphic measures of sleep. RESULTS: We identified 19 eligible papers from 16 studies (412 patients). Case control studies showed less daytime activity in patients with depression (standardised mean difference -0.76, 95% confidence intervals -1.05 to -0.47). Longitudinal studies showed moderate increase in daytime activity (0.53, 0.20 to 0.87) and a reduction in night-time activity (-0.36, -0.65 to -0.06) over the course of treatment. LIMITATIONS: All study participants were unblinded. Only seven papers included patients treated in the community. CONCLUSIONS: Actigraphy is a potentially valuable source of additional information about patients with depression. However, there are no clear guidelines for use of actigraphy in studies of patients with depression. Further studies should investigate patients treated in the community. Additional work to develop algorithms for differentiating behaviour patterns is also needed.
Original languageEnglish
Pages (from-to)21-28
Number of pages8
JournalJournal of Affective Disorders
Issue number1
Early online date4 Aug 2012
Publication statusPublished - 15 Feb 2013


  • depressive disorder
  • actigraphy
  • telemonitoring


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