Exercise and Physical Activity in Mental Disorders: Clinical and Experimental Evidence

Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany.
Journal of preventive medicine and public health = Yebang Ŭihakhoe chi 01/2013; 46 Suppl 1(Suppl 1):S12-21. DOI: 10.3961/jpmph.2013.46.S.S12
Source: PubMed


Several epidemiological studies have shown that exercise (EX) and physical activity (PA) can prevent or delay the onset of different mental disorders, and have therapeutic benefits when used as sole or adjunct treatment in mental disorders. This review summarizes studies that used EX interventions in patients with anxiety, affective, eating, and substance use disorders, as well as schizophrenia and dementia/mild cognitive impairment. Despite several decades of clinical evidence with EX interventions, controlled studies are sparse in most disorder groups. Preliminary evidence suggests that PA/EX can induce improvements in physical, subjective and disorder-specific clinical outcomes. Potential mechanisms of action are discussed, as well as implications for psychiatric research and practice.


Available from: Katharina Gaudlitz, Aug 04, 2014
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    • "Although the benefits of exercise on anxiety, depression, and sleep are well documented, less is known about its impact on PTSD symptoms. Preliminary data, based on small non-controlled studies, have suggested positive benefits of including exercise within PTSD interventions (See Zschucke et al., 2013). Moreover, exercise holds theoretical promise for addressing symptoms of PTSD among those with particularly poor sleep. "
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    ABSTRACT: Introduction Posttraumatic Stress Disorder (PTSD) is prevalent among military veterans and is associated with a number of negative outcomes. Despite available treatments, rates of recovery are poor and many symptoms persist post-treatment. Previous research suggests that exercise functions to reduce symptoms of anxiety and improve sleep quality, though its effects are understudied among those with PTSD. Method We sought to assess the extent to which exercise and sleep interactively impact changes in PTSD severity. Participants were 217 veterans in residential PTSD treatment who were offered the opportunity to participate in a bike-exercise program. Data were collected at treatment intake and discharge. Results Exercise (defined as total volume of cycling completed over the course of treatment) was associated with greater reductions in PTSD hyperarousal symptoms at discharge only among veterans with poor intake sleep quality. Conclusions Overall, exercise may be a beneficial adjunctive treatment for reducing hyperarousal symptoms among individuals with PTSD and poor sleep.
    Mental Health and Physical Activity 03/2015; 8(1):15-20. DOI:10.1016/j.mhpa.2014.12.002
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    • "In the general population, several cross-sectional studies have found significant correlations between physical activities such as exercise training and improvements in mental health disorders including schizophrenia (Zschucke et al., 2013). One study reported that the Total Mental Health Inventory score significantly improved following 12 weeks of combined exercise in patients with schizophrenia, which also correlated with increased functional capacity (Marzolini et al., 2009; Zschucke et al., 2013). "
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    ABSTRACT: Brain-derived neurotrophic factor (BDNF), the most abundant of neurotrophins in the brain, is known to be responsible for maintenance of neurons has been implicated in the pathology of schizophrenia. In the present pilot study, we investigated the effect of a combined exercise program on circulating BDNF expression and the relationship between BDNF and improvements in physical fitness. Twenty-four patients with schizophrenia participated in the exercise intervention, three nonconsecutive days per week for 12 weeks. The resistance exercise program used the elastic band for eight different exercises for 25min, and the aerobic exercise consisted of moderate walking for 25min. After the training program, there were positive improvements in body composition and blood pressure. Also, there was significant improvement in leg strength, cardiovascular fitness, balance, and jump. Serum BDNF values had significantly increased following the combined exercise program. The elevation in serum BDNF concentrations correlated significantly with improvements in cardiovascular fitness and leg strength. These results suggest that exercise induced modulation of BDNF may play an important role in developing non-pharmacological treatment for chronic schizophrenic patients. In addition, these preliminary results serve to generate further hypothesis and facilitate the planning the exercise training program and management of participants. Copyright © 2014. Published by Elsevier Ireland Ltd.
    Psychiatry Research 10/2014; 220(3):792-796. DOI:10.1016/j.psychres.2014.09.020 · 2.47 Impact Factor
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    • "It is well-established that expired gas data obtained during cardiopulmonary exercise testing (CPX) can be used in the diagnosis and prognosis of numerous pathologic conditions [10], [11]. however, there are very limited data on CPX in PD patients [12]. In fact, preliminary evidence suggests that aerobic fitness may be reduced in this clinical condition [13], [14], [15]. "
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    ABSTRACT: Panic disorder (PD) patients often report respiratory symptoms and tend to perform poorly during maximal cardiopulmonary exercise testing (CPX), at least partially, due to phobic anxiety. Thus, we hypothesized that a submaximal exercise variable, minimum VE/VO2 - hereafter named cardiorespiratory optimal point (COP) -, may be useful in their clinical assessment. Data from 2,338 subjects were retrospectively analyzed and 52 (2.2%) patients diagnosed with PD (PDG) (70% women; aged 48±13 years). PD patients were compared with a healthy control group (CG) precisely matched to number of cases, age and gender profiles. PDG was further divided into two subgroups, based on having achieved a maximal or a submaximal CPX (unwilling to continue until exhaustion). We compared COP, VO2 max, maximum heart rate (HR max) between PDG and CG, and also COP between maximal and submaximal PD subgroups. COP was similar between PDG and CG (21.9±0.5 vs. 23.4±0.6; p = 0.07), as well as, for PD subgroups of maximal and submaximal CPX (22.0±0.5 vs. 21.6±1.3; p = 0.746). Additionally, PD patients completing a maximal CPX obtained VO2 max (mL.kg-1.min-1) (32.9±1.57 vs 29.6±1.48; p = 0.145) and HR max (bpm) similar to controls (173±2.0 vs 168±2.7; p = 0.178). No adverse complications occurred during CPX. Although clinically safe, it is sometimes difficult to obtain a true maximal CPX in PD patients. Normalcy of cardiorespiratory interaction at submaximal effort as assessed by COP may contribute to reassure both patients and physicians that there is no physiological substrate for exercise-related respiratory symptoms often reported by PD patients.
    PLoS ONE 08/2014; 9(8):e104932. DOI:10.1371/journal.pone.0104932 · 3.23 Impact Factor
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