Previous research has shown positive effects of exercise on depression but studies have mainly focused on the short-term effects; few have examined the long-term effect, especially with regard to differences in intensity. The aim of this study was to examine the long-term effects of prescribed exercise on depression, performed at three intensity levels. People aged 18 to 67 years with mild to moderate depression (Patient Health Questionnaire-9 score of >= 10) participated in a single-blind, parallel randomized control trial lasting 12 weeks (Sweden 2011 to 2013). Four arms were included: Treatment as usual (TAU, n = 310), light (n = 106), moderate (n = 105) and vigorous exercise (n = 99). Severity of depression was measured at baseline, post-treatment and 12-month follow-up using the Montgomery-Asberg Depression Rating Scale (MADRS). Coefficients (beta) and odds ratios were estimated using linear mixed models with time x group interactions. The results showed that at the 12 month follow-up the light exercise group had significantly lower depression severity scores than the TAU (-1.9, 95% CI -3.7 to -0.04) and the moderate exercise group (-2.94 95% CI -5.2 to -0.7). The vigorous exercise group had significantly lower scores than the moderate exercise group only (-2.7, 95% CI -4.9 to -0.4). In conclusion, compared to usual care for depression, only light exercise resulted in significantly lower depression severity at 12-month follow-up. Both light and vigorous exercise was more effective than moderate exercise. TRIAL REGISTRATION: The study was registered with the German Clinical Trial Register (DRKS study ID DRKS00008745).
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