Impact of exercise on patients with depression and anxiety

Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Denmark.
Nordic journal of psychiatry (Impact Factor: 1.34). 05/2010; 64(3):210-7. DOI: 10.3109/08039480903511373
Source: PubMed

ABSTRACT Persons with common mental disorders are at risk of lowered physical activity.
To investigate if patients with depressive and/or anxiety disorders can achieve a level of physical activity meeting public health recommendations, increase their physical fitness and quality of life (QoL) through participation in a physical exercise programme.
In a non-blinded controlled study, 48 patients referred by private psychiatric clinics and private general practices were either treated in an intervention (n=27) or a control group (n=21). The intervention group took part in 20 weeks of group exercise consisting of aerobic training and non-aerobic weight-lifting. All participants were interviewed and tested at baseline, week 20 and at week 32.
The intervention group increased in physical activity (120 min/week) and VO(2)max (0.48 ml O(2)/min). The VO(2)max increase was maintained after a 12-week follow-up period. Findings should be conservatively interpreted because of high attrition rate.
Patients with anxiety and/or depressive disorders who participated in a structured, supervised exercise programme achieved in accordance with public health recommendations a higher level of physical activity and VO(2)max.
The clinical implications of the study may be a suggestion of offering physical exercise to milder and moderate severe cases of depression and anxiety.

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    • "after the intervention (Blumenthal et al., 2007; Krogh et al., 2009, 2012; Oeland et al., 2010). Only one study reports on the components of the metabolic syndrome (Krogh et al., 2012). "
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    ABSTRACT: Major depressive disorder (MDD) is associated with decreased physical activity and increased rates of the metabolic syndrome (MetS), a risk factor for the development of type 2 diabetes and cardiovascular disorders. Exercise training has been shown to improve cardiorespiratory fitness and metabolic syndrome factors. Therefore, our study aimed at examining whether patients receiving an exercise program as an adjunct to inpatient treatment will benefit in terms of physiological and psychological factors. Fourty-two inpatients with moderate to severe depression were included. Twenty-two patients were randomized to additional 3x weekly exercise training (EXERCISE) and compared to treatment as usual (TAU). Exercise capacity was assessed as peak oxygen uptake (VO2peak), ventilatory anaerobic threshold (VAT) and workload expressed as Watts (W). Metabolic syndrome was defined according to NCEP ATPIII panel criteria. After 6 weeks of treatment, cardiorespiratory fitness (VO2peak, VAT, Watt), waist circumference and HDL cholesterol were significantly improved in EXERCISE participants. Treatment response expressed as ≥50% MADRS reduction was more frequent in the EXERCISE group. Adjunctive exercise training in depressed inpatients improves physical fitness, MetS factors, and psychological outcome. Given the association of depression with cardiometablic disorders, exercise training is recommended as an adjunct to standard antidepressant treatment. Copyright © 2015 Elsevier B.V. All rights reserved.
    Journal of Affective Disorders 01/2015; 177C:1-6. DOI:10.1016/j.jad.2015.01.006 · 3.38 Impact Factor
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    • "It is well established that there is a substantial association between physical activity and mental state. Recent data suggest that physical exercise may reduce depressive symptoms and have a therapeutic benefit in patients with major depression, (Blumenthal et al., 2007; Carek et al., 2011; Dinas et al., 2011; Legrand and Heuze, 2007; Oeland et al., 2010; Strohle, 2009) although it is not clear which type and intensity of exercise is most effective (Cooney et al., 2013; Krogh et al., 2011; Stanton and Reaburn, 2014). Furthermore, most studies investigating the influence of physical exercise on mood showed a significant positive relationship between levels of physical activity and the absence of mood disorders like anxiety or depression (Galper et al., 2006; Goodwin, 2003; van Gool et al., 2007), but it seems doubtful to conclude causality from these cross-sectional analyses because depression symptoms are also characterized by fatigue and loss of energy which may themselves lead to a decrease in activity. "
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    ABSTRACT: Recent data suggest a substantial association between physical activity and depressive symptoms, but there is a lack of research evaluating the physical activity levels in patients suffering from unipolar depression across different stages of disease in an objective way. The aim of the present pilot study was to objectively examine physical activity levels of this patient group compared to healthy controls. Physical activity performance of 19 patients with major depressive episode and 19 healthy controls was assessed at three different time points using a multisensory armband device (SenseWear® Pro3 Armband) and was reported as total energy expenditure (TEE), active energy expenditure (EE), metabolic equivalents (METs), physical activity (PA) and time of lying down (LD), in each case over 24h. Over all measurements, depressive patients presented a significantly lower mean TEE and EE over 24h. Moreover, the patient group showed significantly shorter duration of PA and lower average MET over 24h. When depressive symptoms abated, physical activity parameters significantly increased in the patient group. Correlation analyses demonstrated a significant relation between depressive status/anhedonia and parameters of physical activity, especially in healthy subjects. Results represented valid data for inpatients only. Acute unipolar depression was associated with a significantly lower level of physical activity and showed a significant increase in parallel to clinical improvement. Electronic monitoring of physical activity may be an additional tool for evaluating and controlling therapeutic effects. Copyright © 2014. Published by Elsevier B.V.
    Journal of Affective Disorders 12/2014; 174C:310-316. DOI:10.1016/j.jad.2014.11.060 · 3.38 Impact Factor
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    • "Two clinical trials [41,42] found that patients suffering from different anxiety disorders achieved higher levels of PA and functional capacity through EX training [42], and that anxiety, depression, and perceived stress declined significantly more strongly in a combined CBT+EX treatment, compared to CBT alone [41]. Patients with social phobia were more likely to benefit from the EX enhancement, compared to patients suffering from other anxiety disorders. "
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    ABSTRACT: 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.
    01/2013; 46 Suppl 1(Suppl 1):S12-21. DOI:10.3961/jpmph.2013.46.S.S12
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