Bouldering and Climbing as a Treatment for Depression – A Systematic Review and Meta-Analysis

Depression is a prevalent global health concern, with increasing incidents due to the COVID-19 pandemic (Yoch & Sirull, 2021). Bouldering and climbing interventions have gained attention as adjunctive therapies for depression (Kleinstäuber et al., 2017), yet their specific effects on depression and underlying mechanisms remain unclear (Gassner et al., 2022; Hall et al., 2023). This systematic review and meta-analysis aimed to fill this gap by (1) evaluating the effects of these interventions on depressive outcomes and (2) comparing combined interventions with psychotherapy to those focusing solely on climbing and considering the self-determination health behavior model (Ryan et al., 2008) and the satisfaction of basic psychological needs (i.e., autonomy, competence, relatedness). Adhering to PRISMA guidelines (Page et al., 2020), a literature search yielded 2,946 records with 11 eligible studies from databases including PubMed and Scopus. Due to missing and overlapping data, eight studies with 799 participants were finally included. Methodological quality was assessed using the PEDro scale, of which half of the included studies showed a high risk of bias. Results indicated a significant moderate antidepressant effect favoring bouldering and climbing interventions over controls (g = -0.43, 95% CI -0.64, -0.22, p < .01), with no publication bias indicated and non-significant moderate heterogeneity (I2 = 43%). Subgroup analysis showed a positive but non-significant trend favoring combined interventions. These findings suggest bouldering and climbing as effective treatments for depression. Yet further high-quality research is needed to explore underlying mechanisms, for instance, considering the self-determination health model and basic psychological needs.