Mental disorders have emerged as a significant public health issue, among which depression and anxiety are the most prevalent and one of the primary causes of the global health burden (Santomauro et al., 2021). Indeed, they severely impact mental health, social function activities and quality of life. Depression is typically characterized by persistent low mood, loss of interest, cognitive impairment, sleep disorders, loss of appetite and suicidal tendencies (McCarron et al., 2021). The World Health Organization (WHO) has listed depression as the third leading cause of the global burden of disease (Malhi and Mann, 2018). Moreover, the previous study (Slavich and Irwin, 2014) reported that nearly 25% of women and 16% of men will experience depression, and over 50% of patients with depression will relapse. Anxiety disorders are chiefly manifested as episodic or persistent anxiety, tension or panic and other emotions (Rezaei et al., 2023), accounting for approximately 3% of the global burden of disease (Madonna et al., 2019). In a systematic retrospective study of disease prevalence studies in 44 countries, the global prevalence of anxiety disorders was estimated at 7.3% (Baxter et al., 2013). With the increasing pressure of modern human society, the accelerated pace of life is accompanied by an increase in a variety of various stress factors, leading to an increase in the incidence of depression and anxiety disorders, becoming one of the world’s major concerns.

The pathogenesis of depression and anxiety disorders remains unclear despite considerable research in the field (Malhi and Mann, 2018) involving the regulation of multi-system dysfunction. Through extensive clinical and animal experiments, genetics, biology, and social psychology have been established to participate in the development of diseases (Guilloux et al., 2011; Beesdo-Baum and Knappe, 2012; Fischer et al., 2018; Malhi and Mann, 2018). Drug therapy is a common clinical approach but is associated with side effects. Antidepressants have potential adverse reactions such as gastrointestinal symptoms, respiratory distress, hepatotoxicity, and allergic reactions (Carvalho et al., 2016). On the other hand, anxiolytics can lead to addiction (Offidani et al., 2013), gastrointestinal disorders (Harvey et al., 2000), and sexual dysfunction (Clayton et al., 2002). However, physical activity (PA) is considered a critical health behavior. The term “physical activity intervention” captures a broad range of interventions aimed at increasing energy expenditure above resting levels (Caspersen et al., 1985), encompassing aerobic exercise, resistance exercise, weight training, dance, yoga, tai chi, wuqinxi, baduanjin, and yijinjing (Noone et al., 2018).

In the previous studies, researchers focused on the health benefits of PA and revealed that exercise can mitigate the risk of diseases such as cardiovascular disease (Valenzuela et al., 2023), obesity (Hao et al., 2023) and diabetes (Kazeminasab et al., 2023). Afterward, studies have shifted toward the relationship between exercise and mental health. The 2018 American Sports Guide Advisory Committee report highlighted that PA can alleviate anxiety and depression symptoms (Pate, 2019). Previous evidence-based studies have also established that PA is an effective, safe, low-cost, and convenient method for the treatment of depression and anxiety (Mammen and Faulkner, 2013; Singh et al., 2023). Likewise, Singh et al. (2023) demonstrated that physical activity can significantly relieve symptoms of depression, anxiety and distress across a wide range of adult populations. Kvam et al. (2016) found that physical exercise is an effective intervention for depression. However, the current research progress and future development trends are unclear, impeding further exploration and development of PA interventions for anxiety and depression.

Bibliometrics is a research method commonly adopted to analyze scientific literature and identify research hotspots and emerging trends (Chen et al., 2012). The advantage of bibliometrics analysis lies in the wide range of included studies. Through the intuitive visual display of bibliometrics, the development of a specific field can be more intuitively, comprehensively, and systematically elucidated. Consequently, this research method has been widely applied across various fields (Chen et al., 2012; Dong et al., 2021; Cui et al., 2023). In the previous searches, relevant bibliometrics analysis were identified but were limited in terms of time (You et al., 2021), population (Ai et al., 2023) and disease type (Zhai and Xu, 2023). To the best of our knowledge, there is no comprehensive bibliometric analysis addressing on the current status and trends of PA on anxiety and depression. Therefore, the objective of this study is to present the current research status, hotspots, and trends of PA on anxiety and depression, and to lay a theoretical reference for subsequent research directions and to help clinicians better carry out clinical work.

To date, there are no standardized guidelines for bibliometric analysis. Nevertheless, this study was conducted in accordance with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (Page et al., 2021) (PRISMA 2020) (Appendix 1). Additionally, this study was registered on the Open Science Framework (OSF) with the registration DOI: https://doi.org/10.17605/OSF.IO/7NJUP.Registration after data analysis was selected based on specific circumstances.

Overall, the results of this study revealed the current status and trends in the field of PA on anxiety or depression. The research in this field has consistently expanded, demonstrating ongoing scholarly interest. Notably, the USA and Brazil have emerged as key countries in the field, with the latter depicting the closest and most central cooperation with other nations and the former conducting the highest number of research and the largest number of corresponding authors. Noteworthily, Harvard University remains a prolific contributor to this area of research. Among authors, Stubbs B was identified as the most prominent, with the highest number of published papers and H-index. A network of author cooperation centered on Stubbs B was also noted. Stanton R’s articles, published in 2020 (Stanton et al., 2020), garnered the highest total citations and were associated with the negative impact of Corona Virus Disease 2019 (COVID-19) on mental health in Australia. This finding may be ascribed to the particular attention paid by scholars on COVID-19-related articles. Among references considered in the final included studies, Schuch Fb’s article published in 2016 (Schuch et al., 2016) was the most frequently cited one. Their study determined that previous meta-analyses may underestimate the huge of exercise antidepressants due to publication bias.

According to the keyword frequency analysis (Table 9), meta-analysis (245 times) is a type of research that is of concern in this field. As the highest level of medical evidence, meta-analysis plays a fundamental role in clinical guidance. Josefsson et al. (2014) conducted a meta-analysis and demonstrated a significant overall effect of exercise intervention on depression. Thus, physical exercise is recommended for patients with depressive symptoms. At the same time, Zhang et al. (2023) conducted a network meta-analysis and found that resistance exercise 3–4 times a week for 30–60 min, lasting more than 6 weeks, exerted a substantial effect on the treatment and prevention of depression. Furthermore, Lin and Gao (2023) evaluated on the anxiety symptoms of college students and evinced the positive effect of PA on relieving anxiety, with aerobic exercise being potentially the optimal choice.

According to the keyword clustering map constructed from the research results, clusters #0 and #2 signaled that the field pays close attention to the anxiety and depression levels of students and pregnant women. With rapid economic expansion, the pressure faced by students is becoming increasingly heavy. However, most students grow up under the care and love of their families. As they enter the academic environment and confront the high pressure of learning and peer relationships, their mental health is affected (Slimmen et al., 2022). Therefore, it is vital to monitor students’ mental health and implement the necessary measures. Nonetheless, there are shortcomings in approving drug treatment regimens for young adults due to the unknown long-term risks on their future lives (You et al., 2021). At present, non-pharmacological interventions are preferred over drug therapy. Previous studies have concluded that low-intensity physical exercise can significantly enhance the mental health of college students, which can be attributed to the activation of potential targets in the brain (Zhu et al., 2020). Women experience physical and emotional fluctuations during pregnancy and childbirth. Pregnancy-related anxiety (PrA) is a special anxiety response characterized by fear and worry during pregnancy (Huizink et al., 2004), experienced by up to 14.4% (Poikkeus et al., 2006) of pregnant women. Additionally, postpartum depression is one of the most prevalent complications following childbirth. It comprises any depression women may experience from the beginning of their pregnancy until four weeks after delivery (Poyatos-León et al., 2017). According to a study undertaken by the U.S. Centers for Disease Control and Prevention (Bauman et al., 2020), approximately one in eight women develop postpartum depression. Hence, it is critical to timely identify pregnant and post-partum women with depression or anxiety disorders. Notwithstanding, it can have a devastating impact on mothers and children without timely intervention and, most importantly, exert a negative effect on mother-to-child relationships (Sanger et al., 2015). PA during pregnancy and postpartum is a viable strategy to achieve better mental health (Poyatos-León et al., 2017).

According to cluster #1, generalized anxiety disorder (GAD) is a prominent type of research disease in this field. With a global average lifetime prevalence of around 3.7% (Wittchen et al., 2002), GAD is among the most common types of anxiety disorders. Specifically, its prevalence is higher in women (Luo et al., 2019), who usually experience more severe symptoms of somatic anxiety (Steiner et al., 2005). A clinical study reported that exercise therapy is a feasible, safe, and well-tolerated treatment for GAD and could be a potential adjunctive therapy for sedentary women with GAD (Herring et al., 2012). According to cluster #8, this field focuses on sedentary behavior, which requires the least PA and leads to low energy consumption, similar to resting levels (Pate et al., 2009). It includes sitting for a series of purposes (such as work and travel) and screen-based activities, such as using computers, video games, and watching TV. Existing evidence suggests that sedentary behavior can increase the risk of cardiovascular disease (Katzmarzyk et al., 2009), osteoporosis (Warburton et al., 2006), and diabetes (Hu et al., 2003). Moreover, prior studies have established sedentary behavior as a risk factor for anxiety and depression (Huizink et al., 2004; Teychenne et al., 2010, 2015). In other words, sedentary behavior affects not only physical health but also mental health.

Cluster #5 Adult neurogenesis (AN), the ability to produce new neurons from neural stem cells to adulthood, persists in specific regions of the brain throughout the life cycle of mammals, especially in the subgranular zone of the hippocampal dentate gyrus (DG) and the subventricular zone of the lateral ventricle (Ming and Song, 2011; Gage, 2019). Based on existing research, exercise (Schoenfeld and Swanson, 2021) and study (Gould et al., 1999) can promote adult neurogenesis. Conversely, stress (Hueston et al., 2017), heredity (Jacobs, 2002), senescence (Olariu et al., 2007), and unhealthy diet (Poulose et al., 2017) can inhibit AN (Figure 6A). According to the burst keyword dentate gyrus, we have noticed adult hippocampal neurogenesis (AHN) (Terreros-Roncal et al., 2021), which refers to the process by which neural stem cells synthesize new neurons in the hippocampus. It is universally acknowledged as a fundamental brain function, supporting endogenous regeneration and facilitating structural plasticity that aids the brain in adapting to environmental stressors (Mahar et al., 2014). Moreover, AHN plays a crucial role in learning, memory, and emotion regulation (Hill et al., 2015). To date, sufficient experimental evidence supports its role in governing depression and anxiety (Lim et al., 2021). Luo et al. (2023) claimed that exercise can effectively alleviate mental disorders, including anxiety and depression, and its neural mechanism can be attributed to improvements in AN. Nonetheless, the mechanism underlying PA-induced AN has not been determined so far. However, these important effects of PA in AN seem to be mainly mediated by neurotrophic factors including brain-derived neurotrophic factor (BDNF), insulin-like growth factor 1 (IGF-1), and vascular endothelial growth factor (VEGF) (Cotman et al., 2007). Nevertheless, whether these neurotrophins are the causes or the consequences of PA-induced neurogenesis and the mechanisms by which they mediate PA-induced neurogenesis remain to be determined. BDNF may be a convergent target of PA-induced peripheral factors in the brain (Gao et al., 2023). To begin, numerous peripheral factors are released, among which BDNF shows the most significant increase in the brain. Moreover, BDNF is a positive regulator of mature AN (Liu and Nusslock, 2018). Peripheral BDNF can pass through blood–brain barrier (BBB) (Pan et al., 1998). Finality, PA can up-regulate the expression of cathepsin B in muscles and drive the accumulation of metabolite lactic acid, both of which can cross the BBB and enhance the expression levels of BDNF in the hippocampus (Moon et al., 2016; El Hayek et al., 2019). Furthermore, PA can induce structural and functional changes, including an increase in adult neurogenesis (van Praag et al., 1999), remodeling of dendritic structures (Eadie et al., 2005), and enhancement of synaptic plasticity in the hippocampus (van Praag et al., 1999), suggesting a biological basis for PA in protecting the brain against stress (Figure 6B). A prior study (Li et al., 2019) has suggested that PA may rescue impaired neuronal plasticity by regulating neurotrophic factors and adjusting the adaptive response of the hypothalamic–pituitary–adrenal axis to stress.

According to the results of the burst keywords, recent studies focused on Tai Chi, a traditional Chinese sports that is currently classified as mind–body exercise (MBE, exercise aiming to improve participants’ mind–body coordination and awareness by having them practice a series of controlled movements that focus on interactions among the brain, body, mind, and behavior, such as Tai Chi, yoga, and dance, etc.) (Huang et al., 2022). It has been extensively applied for the prevention and treatment of various diseases, such as cancer (Song et al., 2020), knee osteoarthritis (Zhang et al., 2023), mild cognitive impairment (Zhang et al., 2019), and so on. It is worthwhile emphasizing that a meta-analysis has demonstrated that Tai Chi is more effective than non-mindfulness exercises in reducing anxiety and depression levels and improving general mental health (Yin et al., 2023). Moreover, Tai Chi possesses the advantage of minimal equipment requirements and is not limited by location or facilities.

According to the keywords, students and pregnant women were identified as groups of concern. Similarly, AN was established as a physiological and pathological mechanism of interest. Sedentary behavior was the lifestyle of concern, while GAD is the type of disease of concern. Finally, Tai Chi is the type of PA of interest.

In this study, the bibliometric analysis provided information regarding emerging trends about the field of PA on anxiety or depression. Although this work has some limitations, the results may be useful as a basis for helping patients with anxiety or depression and as a foundation for further research in this field. Based on our results, the field of PA on anxiety or depression demonstrating ongoing scholarly interest. Students and pregnant women, adult neurogenesis, and Tai Chi were the prominent keywords. For clinicians, they can consider to recommend patients to perform mind–body exercise for improving mood, especially for students and pregnant women who use medications with cautions. Additionally, future researchers can explore the mind–body exercise and its impact on anxiety or depression, PA and anxiety or depression in specific populations, and adult neurogenesis of various exercise in anxiety or depression.

The original contributions presented in the study are included in the article, further inquiries can be directed to the corresponding author.

X-YZ: Writing – original draft. FY: Supervision, Writing – review & editing. Z-HY: Supervision, Writing – review & editing. Y-QL: Data curation, Writing – original draft. Q-NB: Data curation, Writing – original draft. M-ZX: Investigation, Writing – original draft. Z-HC: Visualization, Writing – original draft. W-QZ: Visualization, Writing – original draft. K-XW: Investigation, Writing – original draft. JY: Investigation, Writing – original draft. F-RL: Writing – review & editing.