Exercise Interventions for Mental Health: A Quantitative and Qualitative Review

Clinical Psychology Science and Practice (Impact Factor: 2.92). 05/2006; 13(2):179 - 193. DOI: 10.1111/j.1468-2850.2006.00021.x

ABSTRACT Associations between exercise and mental well-being have been documented repeatedly over the last two decades. More recently, there has been application of exercise interventions to clinical populations diagnosed with depression, anxiety, and eating disorders with evidence of substantial benefit. Nonetheless, attention to the efficacy of exercise interventions in clinical settings has been notably absent in the psychosocial treatment literature, as have been calls for the integration of these methods within the clinical practice of psychologists. In this article, we provide a quantitative and qualitative review of these efficacy studies in clinical samples and discuss the potential mechanism of action of exercise interventions, with attention to both biological and psychosocial processes. The meta-analysis of 11 treatment outcome studies of individuals with depression yielded a very large combined effect size for the advantage of exercise over control conditions: g = 1.39 (95% CI: .89–1.88), corresponding to a d = 1.42 (95% CI: .92–1.93). Based on these findings, we encourage clinicians to consider the role of adjunctive exercise interventions in their clinical practice and we discuss issues concerning this integration.

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Available from: Mark B Powers, Feb 21, 2014
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    • "These models focus not only on individual trips, where time savings alone are important, but seek to better understand how time is allocated across all trips and activities, allowing the impact on wellbeing of various interrelated factors such as travel patterns, urban form, and time use to be examined concurrently (Abou-Zeid and Ben-Akiva, 2012; Bhat and Koppelman, 1999; Bowman and Ben-Akiva, 2001; McFadden et al., 1977; Pinjari et al., 2011; Sallis et al., 2004). Studies that examine the impact on wellbeing of active travel for recreational purposes, such as visiting friends (Hamer et al., 2009; Humphreys et al., 2013; Mutrie and Faulkner, 2004; Ravulaparthy et al., 2013; Teychenne et al., 2008), or as an intervention in clinical settings (Gusi et al., 2008; Stathopoulou et al., 2006), are more common than those that examine more routine active commuting. However, behaviour change in these non-work domains may be impractical for large numbers of working-aged people for whom the opportunity cost of physical activity outside of work hours is relatively high (House of Commons Health Committee, 2004; Martin et al., 2012; Popham and Mitchell, 2006). "
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    ABSTRACT: Objective To explore the relationship between active travel and psychological wellbeing. Method This study used data on 17,985 adult commuters in eighteen waves of the British Household Panel Survey (1991/2-2008/9). Fixed effects regression models were used to investigate how (i.) travel mode choice, (ii.) commuting time, and (iii.) switching to active travel impacted on overall psychological wellbeing and how (iv.) travel mode choice impacted on specific psychological symptoms included in the General Health Questionnaire (GHQ12). Results After accounting for changes in individual-level socioeconomic characteristics and potential confounding variables relating to work, residence and health, significant associations were observed between the 36-point GHQ12 wellbeing scale and (i.) active travel (0.185, 95% CI: 0.048-0.321) and public transport (0.195, 95% CI: 0.035-0.355) when compared to car travel, (ii.) time spent (per ten minute change) walking (0.083, 95% CI: 0.003-0.163) and driving (− 0.033, 95% CI: − 0.064 – -0.001), and (iii.) switching from car travel to active travel (0.479, 95% CI: 0.199-0.758). Active travel was also associated with reductions in the odds of experiencing two specific psychological symptoms when compared to car travel. Conclusion The positive psychological wellbeing effects identified in this study should be considered in cost-benefit assessments of interventions seeking to promote active travel.
    Preventive Medicine 12/2014; 69. DOI:10.1016/j.ypmed.2014.08.023 · 2.93 Impact Factor
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    • "Physical activity reduces the risk of many chronic diseases (Blair et al., 2001), including cardiovascular disease (Lee and Skerrett, 2001), depression and anxiety (Biddle et al., 2000; Stathopoulou et al., 2006), diabetes (Williams, 2007), musculoskeletal conditions (Oida et al., 2003), obesity (Foresight, 2007) and some cancers (Wolin et al., 2007). However, most adults do not achieve recommended levels of physical activity (Chief Medical Officer, 2004). "
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    ABSTRACT: Background and objectives: Referring clinicians’ experiences of exercise referral schemes (ERS) can provide valuable insights into their uptake. However, most qualitative studies focus on patient views only. This paper explores health professionals’ perceptions of their role in promoting physical activity and experiences of a National Exercise Referral Scheme (NERS) in Wales.
    Health Education Journal 11/2014; DOI:10.1177/0017896914559785 · 0.73 Impact Factor
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    • "Indeed, several meta-analyses have revealed that exercise has at least a moderate effect on symptom reduction in major depression, serving as a useful strategy for depression of different severities and presenting few side effects (Cooney et al., 2013; Craft and Landers, 1998; Rethorst et al., 2009; Stathopoulou et al., 2006). Despite these encouraging results, most studies have evaluated the effects of exercise on moderately depressed outpatients (Cooney et al., 2013; Craft and Landers, 1998; Rethorst et al., 2009; Stathopoulou et al., 2006) and only two evaluated in samples that were also composed by severely depressed inpatients. The studies, however, were not exclusively composed by severely depressed inpatients (one had bipolar patients and the other did not used any criterion excluding bipolar depressed inpatients (Knubben et al., 2007; Martinsen et al., 1985). "
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    ABSTRACT: Exercise is a potential treatment for depression. However, few studies have evaluated the role of adjunct exercise in the treatment of severely major depressed inpatients. The goal of this study was to evaluate the effects of add-on exercise on the usual treatment of severely depressed inpatients.Methods Fifty participants were randomized to an exercise (exercise + usual treatment) or a control (usual treatment) group. Twenty-five patients were randomly allocated to each group. The participants in the exercise group performed three sessions per week throughout the hospitalization period, with a goal dose of 16.5 kcal/kg/week plus the usual pharmacological treatment. Depressive symptoms and the Quality of Life (QoL) of the participants were assessed at the baseline, the second week, and discharge.ResultsA significant group x time interaction was found for depressive symptoms and the physical and psychological domains of QoL. Differences between groups occurred at the second week and discharge with respect to depressive symptoms and the physical and psychological domains of QoL. There was no difference in the remission rate at discharge (48% and 32% for the exercise and control group, respectively). An NNT of 6.25 was found. No significant baseline characteristics predict remission at discharge.Conclusion Add-on exercise is an efficacious treatment for severely depressed inpatients, improving their depressive symptoms and QoL. Initial acceptance of exercise remains a challenge.
    Journal of Psychiatric Research 11/2014; 61. DOI:10.1016/j.jpsychires.2014.11.005 · 4.09 Impact Factor
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