Research Progress on Baduanjin Qigong for Depression Prevention and Treatment in the Last Decade

The literature for this study was primarily drawn from PubMed and the China National Knowledge Infrastructure, which are widely recognized for their comprehensive coverage of international and Chinese research in the field of health and wellness, particularly related to traditional medicine.

To ensure both breadth and precision, PubMed and the China National Knowledge Infrastructure were searched using Chinese and English terms for “Baduanjin,” “depression,” “efficacy,” “safety,” and “intervention,” combined with Boolean operators (AND, OR). The search period was restricted to 2015–2024 to capture the most recent evidence. Using the above strategies, literature related to the application of Baduanjin in the prevention and treatment of depression was screened, and the selected studies were further filtered (Figure 2).

Figure 2:

Flowchart of Literature Selection for the Prevention and Treatment of Depression with Baduanjin

The inclusion criteria for this study are as follows: the research involves the application of Baduanjin as an intervention in the prevention and treatment of depression; the study clearly evaluates the efficacy and/or safety of Baduanjin; the study design is a randomized controlled trial (RCT); the study was published in Chinese or English journals between 2015 and 2024.

The exclusion criteria are as follows: the study involves non-clinical samples or animal experiments; the study does not involve Baduanjin intervention or fails to assess its efficacy and safety; the study design is not an RCT; the study was not published between 2015 and 2024; the study is published in a language other than Chinese or English. In the end, 16 articles meeting the inclusion criteria were selected.

To ensure standardized and efficient reference management, Zotero was used throughout the screening process to build a dedicated database. This database contained every article that satisfied the inclusion criteria, with detailed records of each study’s key information. It also stored the DOI, journal details, and PDF links, ensuring full traceability and completeness. All reference data were entered and updated in a uniform format to maintain consistency and integrity.

This study employs a qualitative analysis approach to systematically evaluate the literature. First, all studies meeting the inclusion criteria were reviewed and organized, assessing the similarities and differences in methods and efficacy of Baduanjin interventions for depressive symptoms. Second, efficacy data from the literature were primarily summarized using descriptive statistics. All analysis results were based mainly on the data and conclusions provided in the original studies (Table 1)

This research did not require IRB approval because it is a literature review, which involves the synthesis and analysis of existing published data and does not involve human subjects, animal experiments, or the collection of new primary data.

In experimental studies on the prevention and treatment of depression, Baduanjin is often employed as a stand-alone intervention. Evidence from intervention trials across diverse populations has demonstrated that, even without the integration of other therapeutic modalities, Baduanjin can produce significant improvements in psychological well-being.

For instance, Li et al. (2022) conducted a 16-week Baduanjin intervention among postmenopausal women with osteoporosis and found a significant reduction in depressive symptoms, with the Self-Rating Depression Scale (SDS) scores decreasing from 50.03 ± 1.85 to 47.06 ± 1.81 (p < 0.05), indicating that depression was effectively alleviated through Baduanjin alone. Similarly, Lv et al. (2022) confirmed the efficacy of Baduanjin, reporting that after six weeks of intervention, participants with depression exhibited significantly lower Hamilton Depression Scale (HAMD) scores compared to the control group (p < 0.01)

Furthermore, Tan and Tan (2020) implemented a year-long Baduanjin intervention among university students and demonstrated that it effectively reduced mild to moderate depressive symptoms, with a significant decline in SDS scores (p < 0.01). Finally, research by Wei et al. (2024) revealed that even a low-frequency protocol, consisting of a 90-minute session once per week, led to a significant reduction in Patient Health Questionnaire-9 (PHQ-9) scores among university students, further supporting the positive impact of Baduanjin as an independent intervention.

Collectively, these findings indicate that Baduanjin, when applied as a stand-alone modality, can significantly alleviate depressive symptoms across diverse populations. This not only confirms its therapeutic efficacy but also highlights its preventive potential, extending beyond clinical groups to broader healthy populations (Table 2).

Although Baduanjin, when used as a stand-alone intervention, can alleviate depressive symptoms, its therapeutic efficacy remains limited in patients with severe depression or those presenting with comorbid conditions. In such cases, combining Baduanjin with pharmacotherapy can significantly enhance overall treatment outcomes and provide a more comprehensive therapeutic approach. Within the context of Western medicine, Baduanjin often serves as an adjunct modality. For example, Zhang et al. (2017) demonstrated that the combination of paroxetine with Baduanjin exercise yielded superior outcomes compared to pharmacotherapy alone in patients with depression.

Moreover, integrating Baduanjin with medication not only reduces depressive symptoms but also improves overall health status. Yang et al. (2021) reported that, in the treatment of depression accompanied by insomnia, the combination of Baduanjin with agomelatine produced favorable results, with the combined group showing significantly greater improvements in sleep quality compared to the control group (P < 0.05). In addition, therapeutic strategies combining Baduanjin with TCM have also shown promising efficacy. Among perimenopausal or postmenopausal women with depression, the herbal formula Jieyu Fang combined with Baduanjin yielded significant clinical benefits, including positive effects on bone mineral density and lower-limb balance (Suo and Yu, 2016). Furthermore, in cases of chronic heart failure accompanied by depression, patients treated with Baduanjin in conjunction with Guipi Tang exhibited significantly lower HAMD scores compared to those receiving medication alone (P < 0.05), further confirming the effectiveness of integrating Baduanjin with TCM across different populations (Xiao et al, 2024).

In summary, whether combined with Western medication or traditional Chinese herbal therapy, Baduanjin demonstrates superior therapeutic outcomes for depression compared to either modality used in isolation (Table 3).

Beyond its application as a stand-alone intervention or in combination with pharmacotherapy, the integration of Baduanjin with psychological interventions offers dual benefits by simultaneously promoting physical regulation and psychological support. This combined approach has been shown to significantly enhance treatment efficacy and improve overall mental health in patients with depression, with minimal adverse effects.

Jing et al. (2018), in their investigation of Baduanjin combined with cognitive-behavioral therapy (CBT) among home-dwelling older adults, found that the combined intervention group demonstrated superior outcomes in depressive symptoms, quality of life, and physical functioning compared to groups receiving CBT or Baduanjin alone. Given the high prevalence of negative emotions among patients with chronic illness, Li and Luo (2024) reported that, after a two-month intervention in patients with chronic cor pulmonale, the combination of Baduanjin and traditional Chinese emotional care not only effectively addressed cardiopulmonary conditions but also prevented the onset of anxiety and depression.Furthermore, Yang et al. (2024) revealed that, among patients in the recovery phase of schizophrenia, an intervention combining Baduanjin with MBSR significantly reduced SDS scores, indicating notable improvements in depressive symptoms.

Collectively, these findings underscore that Baduanjin combined with psychological interventions yields substantial benefits in alleviating depressive symptoms and enhancing overall health, warranting broader integration into clinical practice (Table 4).

In addition to the aforementioned intervention modalities, Baduanjin has also been integrated with medical nursing, music therapy, and other forms of physical exercise in the treatment of depression. In studies involving patients with COVID-19, Ma et al. (2023) combined routine nursing care with Baduanjin and reported a significant reduction in PHQ-9 scores, with the intervention group showing markedly greater improvement than the control group (P < 0.01). Similarly, Wang et al. (2021) and Wang et al. (2023) implemented a combined intervention consisting of routine care, Baduanjin, and Five-Element Music Therapy, and observed significant decreases in both HAMD and PHQ-9 scores, with the observation groups outperforming the control groups.Furthermore, Yan et al. (2024) explored the effects of integrating Baduanjin with relaxation exercises in individuals with moderate depression. Their findings indicated a significant reduction in HAMD scores among patients receiving the combined intervention of routine care, Baduanjin, and relaxation training. Ye and Wang (2024) further validated the effectiveness of Baduanjin combined with routine nursing in patients with depression. After a 12-week intervention, HAMD scores significantly decreased from 1.28 ± 0.99 to 1.19 ± 0.11 (P < 0.001), demonstrating the clinical efficacy of this integrative approach.

Collectively, these studies indicate that combining Baduanjin with other therapeutic modalities not only enhances treatment outcomes but also highlights its broad applicability. Baduanjin can be effectively integrated with diverse treatment strategies, offering a versatile and complementary option for the prevention and management of depressive symptoms (Table 5).

In summary, findings from sixteen studies consistently demonstrate the significant efficacy of Baduanjin in the prevention and treatment of depression. Whether applied as a standalone intervention or in combination with Western pharmacotherapy, TCM, or psychological therapies, Baduanjin has been shown to markedly alleviate depressive symptoms, enhance emotional well-being, and improve overall health status. A substantial body of evidence further indicates that Baduanjin is not only effective among patients with comorbid conditions such as insomnia, cancer, or renal transplantation, but also beneficial for individuals experiencing physical frailty, contributing to improvements in muscle strength and functional capacity. Moreover, it plays a positive role in the prevention of depression and the promotion of mental health in broader populations. Therefore, the effectiveness of Baduanjin in the management of depressive disorders is unequivocal.

In managing depression, ensuring safety is as crucial as confirming therapeutic efficacy. Due to its low intensity, minimal risk, and notable adaptability, Baduanjin has emerged as an increasingly favorable and safe intervention option for depressive disorders.

As a form of traditional Chinese mind–body exercise characterized by low intensity and minimal risk, Baduanjin involves slow, gentle movements with moderate amplitude and steady rhythm, resulting in relatively low physiological load. It is not only physically safe but also psychologically stabilizing, as its emphasis on breath regulation and mindful concentration fosters mental relaxation and reduces anxiety and tension. Patients with depression often present with comorbid conditions such as cardiovascular disease, diabetes, or chronic pain, which may limit their ability to engage in high-intensity physical activity. In contrast, Baduanjin consists of simple, easy-to-learn movements that can be flexibly adapted to individual physical capacities, thereby avoiding excessive strain on the cardiopulmonary or musculoskeletal systems.

Accordingly, the concept of “objective safety” in this context refers to the integrated safety profile of Baduanjin across exercise modality, physiological load, and psychological regulation. Its movement design inherently ensures low intensity and controllability, while the coordinated interaction of body and mind during practice promotes emotional balance—constituting a structurally embedded form of safety supported by both physical and psychological mechanisms. Moreover, Baduanjin practice is minimally constrained by time, space, or environmental conditions, further enhancing its feasibility and safety for widespread daily implementation (Ying, 2024).

Across the 16 studies reviewed, the safety of Baduanjin as an intervention for depression has been extensively recognized and empirically validated. The majority of studies reported no serious adverse events, and multiple studies actively monitored physiological parameters such as complete blood counts and hepatic and renal functions, confirming that Baduanjin did not introduce significant physical stress while effectively alleviating depressive symptoms. For instance, studies conducted by Jing et al. (2018) and Suo & Yu (2016) have shown improvements in participants' quality of life and psychological well-being without notable adverse effects. Collectively, current evidence substantiates the favorable safety profile of Baduanjin, supporting its suitability for sustained use in depression management.

At the psychological level, Lv, et al. (2022) reported that no psychological or physiological discomfort occurred among participants in the experimental group during the six-week intervention. Patients experienced an “enhanced sense of relaxation and reduced anxiety” throughout the training process, suggesting that Baduanjin is psychologically safe, stable, and capable of regulating emotional states. Similarly, Wei et al. (2024) noted the absence of adverse psychological reactions or dropout events during Baduanjin practice, with students commonly reporting “improved mood and relief from anxiety” following each session.

Taken together, these findings indicate that Baduanjin demonstrates excellent safety across both physical and psychological dimensions, making it particularly suitable for long-term use as a therapeutic approach for individuals with depression.

Based on the studies reviewed, Baduanjin is suitable for the prevention and treatment of depression in various patient populations, particularly demonstrating good operability and safety in individuals with chronic diseases. Additionally, Baduanjin can be adapted to individuals with different health conditions, allowing for self-regulation of intensity to meet individual needs and reduce exercise-related risks.Thus, Baduanjin serves as a versatile, low-risk therapeutic modality that can be safely and effectively utilized by both healthy individuals and patients with specific health considerations, provided they receive appropriate guidance and practice self-regulation. Therefore, as a flexible and low-risk exercise intervention, Baduanjin is suitable for a wide range of populations. Whether applied to healthy individuals or those with special clinical needs, it can effectively reduce depressive symptoms when practiced under appropriate guidance and individualized adjustment.

The study holds significant practical value for society: Baduanjin exercise, which requires no equipment and can be performed in any open space, is a low-cost, easily accessible form of exercise. It provides a safe, convenient, non-pharmacological intervention option for individuals with depression. The review findings indicate that whether practiced alone or combined with medication, psychotherapy, or other exercises, its significant efficacy and safety allow people of different ages and health conditions to engage in it. This method is particularly suitable for regions with limited medical resources or populations reluctant to rely on drugs.

This study aims to address two major social challenges: first, the growing population with depression has increased pressure on global medical resources, and this low-cost intervention can alleviate the strain on treatment resources; second, as some patients worry about drug side effects, Baduanjin can be regarded as a more acceptable alternative.

Understanding the current academic progress in Baduanjin intervention for depressive symptoms can provide a more scientific basis and options for the treatment of more people with such symptoms. For global mental health, this study enriches the diversity of global mental health interventions and offers a Chinese practical example for non-pharmacological treatment of depression, contributing to the construction of a more inclusive and diverse global mental health system.