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Physical activity, exercise, depression and anxiety disorders

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Abstract

There is a general belief that physical activity and exercise have positive effects on mood and anxiety and a great number of studies describe an association of physical activity and general well-being, mood and anxiety. In line, intervention studies describe an anxiolytic and antidepressive activity of exercise in healthy subjects and patients. However, the majority of published studies have substantial methodological shortcomings. The aim of this paper is to critically review the currently available literature with respect to (1) the association of physical activity, exercise and the prevalence and incidence of depression and anxiety disorders and (2) the potential therapeutic activity of exercise training in patients with depression or anxiety disorders. Although the association of physical activity and the prevalence of mental disorders, including depression and anxiety disorders have been repeatedly described, only few studies examined the association of physical activity and mental disorders prospectively. Reduced incidence rates of depression and (some) anxiety disorders in exercising subjects raise the question whether exercise may be used in the prevention of some mental disorders. Besides case series and small uncontrolled studies, recent well controlled studies suggest that exercise training may be clinically effective, at least in major depression and panic disorder. Although, the evidence for positive effects of exercise and exercise training on depression and anxiety is growing, the clinical use, at least as an adjunct to established treatment approaches like psychotherapy or pharmacotherapy, is still at the beginning. Further studies on the clinical effects of exercise, interaction with standard treatment approaches and details on the optimal type, intensity, frequency and duration may further support the clinical administration in patients. Furthermore, there is a lack of knowledge on how to best deal with depression and anxiety related symptoms which hinder patients to participate and benefit from exercise training.

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References

  • Abu-Omar K, Rütten A, Lehtinen V (2004a) Mental health and physical activity in the European Union. Soz Praventivmed 49:301–309

    PubMed  Google Scholar 

  • Abu-Omar K, Rütten A, Robine J-M (2004b) Self-rated health and physical activity in the European Union. Soz Praventivmed 49:235–242

    PubMed  Google Scholar 

  • American College of Sports Medicine (1978) The recommended quantity and quality of exercise for developing and maintaining fitness in healthy adults. Med Sci Sports Exerc 10:VII–X

    Google Scholar 

  • American College of Sports Medicine (1990) Position stand: the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Med Sci Sports Exerc 22:265–274

    Google Scholar 

  • Babyak M, Blumenthal JA, Herman S et al (2000) Exercise treatment for major depression: maintenance of therapeutic benefits at 10 months. Psychosom Med 62:633–638

    PubMed  CAS  Google Scholar 

  • Barlow DH, Craske MG (1994) Mastery of your anxiety and panic. Graywind Publications, Albany, NY

    Google Scholar 

  • Bhui K, Fletcher A (2000) Common mood and anxiety states: gender differences in the protective effect of physical activity. Soc Psychiatry Psychiatr Epidemiol 35(1):28–35

    Article  PubMed  CAS  Google Scholar 

  • Blumenthal JA, Emery CF, Madden DJ et al (1989) Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and women. J Gerontol 44:M147–M157

    PubMed  CAS  Google Scholar 

  • Blumenthal JA, Babyak MA, Moore KA et al (1999) Effects of exercise training on patients with major depression. Arch Int Med 159:2349–2356

    Article  CAS  Google Scholar 

  • Blumenthal JA, Michael A, Babyak A et al (2007) Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosom Med 69:587–596

    Article  PubMed  CAS  Google Scholar 

  • Broocks A, Bandelow B, Pekrun G et al (1998) Comparison of aerobic exercise, clomipramine, and placebo in the treatment if panic disorder. Am J Psychiatry 155:603–609

    PubMed  CAS  Google Scholar 

  • Camacho TC, Roberts RE, Lazarus NB, Kaplan GA, Cohen RD (1991) Physical activity and depression: evidence from the Alamada County study. Am J Epidiomiol 134(2):220–231

    CAS  Google Scholar 

  • CDC (1996) Physical activity and health: a report of the surgeon general. US Department of Health and Human Services, National Center for Chronic Disease Prevention and Health Promotion, Atlanta

  • Charney DS (2004) Psychobiological mechanisms of resilience and vulnerability: Implications for successful adaptation to extreme stress. Am J Psychiatry 161:195–216

    Article  PubMed  Google Scholar 

  • Cohen S, Rodriguez R (1995) Pathways linking affective disturbances and physical disorders. Health Psychol 15:374–380

    Article  Google Scholar 

  • Cotman CW, Berchtold NC (2002) Exercise: a behavioral intervention to enhance brain health and plasticity. Trends Neurosci 25(6):295–301

    Article  PubMed  CAS  Google Scholar 

  • Craft LL, Landers DM (1998) The effects of exercise on clinical depression resulting from mental illness: a meta-analysis. J Sport Exerc Psychol 20:339–357

    Google Scholar 

  • Craft LL, Perna FM (2004) The benefits of exercise for the clinically depressed. Prim Care Companion J Clin Psychiatry 6:104–111

    PubMed  Google Scholar 

  • Craig CI, Marshall AL, Sjostrom M, Baumann AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P (2003) International physical activity questionnaire: 12 country reliability and validity. Med Sci Sports Exerc 35:1381–1395

    Article  PubMed  Google Scholar 

  • DiLorenzo TM, Bargman EP, Stucky-Ropp R et al (1999) Long-term effects of aerobic exercise on psychological outcomes. Prev Med 28:75–85

    Article  PubMed  CAS  Google Scholar 

  • Dimeo F, Bauer M, Vahram I, Proest G, Halter U (2001) Benefits from aerobic exercise in patients with major depression: a pilot study. Br J Sports Med 35:114–117

    Article  PubMed  CAS  Google Scholar 

  • Dishman RK, Buckwort J (1996) Increasing physical activity: a quantitative synthesis. Med Sci Sports Exerc 28:706–719

    PubMed  CAS  Google Scholar 

  • Dishman RK, Renner KJ, Youngstedt SD et al (1997) Activity wheel running reduces escape latency and alters brain monoamine levels after footshock. Brain Res Bull 42:399–406

    Article  PubMed  CAS  Google Scholar 

  • Doyne EJ, Ossip-Klein DJ, Bowman ED et al (1987) Running versus weight lifting in the treatment of depression. J Consult Clin Psychol 55:748–754

    Article  PubMed  CAS  Google Scholar 

  • Dractu L (2001) Physical exercise: an adjunctive treatment for panic disorder? Eur Psychiatry 16:372–374

    Article  Google Scholar 

  • Droste SK, Gesing A, Ulbricht S et al (2003) Effects of long-term voluntary exercise on the mouse hypothalamic-pituary-adrenocortical axis. Endocrinology 114(7):3012–3023

    Article  CAS  Google Scholar 

  • Dunn AL, Garcia ME, Marcus BH et al (1998) Six month physical activity and fitness changes in project active, randomized trial. Med Sci Sports Exerc 30:1076–1083

    Article  PubMed  CAS  Google Scholar 

  • Dunn AL, Madhukar H, Trivedi MD et al (2005) Exercise treatment for depression Efficacy and dose response. Am J Prev Med 28(1):1–8

    Article  PubMed  Google Scholar 

  • Dunn AL, Trivedi MH, O’Neal HA (2001) Physical activity dose-response effects on outcome of depression and anxiety. Med Sci Sports Exerc 33:S587–S597

    Article  PubMed  CAS  Google Scholar 

  • Esquivel G, Schruers K, Kuipers H, Griez E (2002) The effects of acute exercise and high lactate levels on 35% CO2 challenge in healthy volunteers. Acta Psychiatr Scand 106:394–397

    Article  PubMed  CAS  Google Scholar 

  • Farmer ME, Locke BZ, Mosciki EK, Dannenberg AL, Larson DB, Radloff LS (1988) Physical activity and depressive symptoms: the NHANES I epidemiologic follow-up study. Am J Epidemiol 128:1340–1351

    PubMed  CAS  Google Scholar 

  • Fremont J, Craighead LW (1987) Aerobic exercise and cognitive therapy in the treatment of dysphoric moods. Cognit Ther Res 11:241–251

    Article  Google Scholar 

  • Goodwin RD (2003) Association between physical activity and mental disorders among adults in the United States. Prev Med 36:698–703

    Article  PubMed  Google Scholar 

  • Greist JH, Klein MH, Eischens RR et al (1979) Running as treatment for depression. Compr Psychiatry 20:41–54

    Article  PubMed  CAS  Google Scholar 

  • Guszkowska M (2004) Effects of exercise on anxiety, depression and mood. Psychiatr Pol 38(4):611–620

    PubMed  Google Scholar 

  • Haarasilta LM, Marttunen MJ, Kapiro JA, Aro HM (2004) Correlates of depression in a representative nationwide sample of adolescents (15–19 years) and young adults (20–24 years). Eur J Pub Health 14:280–285

    Article  Google Scholar 

  • King AC, Haskell WL, Taylor CB, Kraemer HC, DeBusk RF (1991) Group- vs. home-based exercise training in healthy older men and women: a community-based trial. JAMA 266:1535–1542

    Article  PubMed  CAS  Google Scholar 

  • King AC, Taylor CB, Haskell WL (1993) Effects of differing intensities and formats of 12 months of exercise training on psychological outcomes in older adults. Health Psychol 12:292–300

    Article  PubMed  CAS  Google Scholar 

  • Klein MH, Greist JH, Gurman AS, Neiberyer DP (1985) A comparative outcome study of group psychotherapy vs. exercise treatments for depression. Int J Mental Health 13:148–176

    Google Scholar 

  • Knubben K, Reischies FM, Adli M et al (2007) A randomised, controlled study on the effects of a short-term endurance training programme in patients with major depression. Br J Sports Med 41(1):29–33. doi:10.1136/bjsm.2006.030130

    Article  PubMed  CAS  Google Scholar 

  • Kodis J, Smith KM, Arthur HM, Daniels C, Suskin N, McKelvie RS (2001) Changes in exercise capacity and lipids after clinic versus home-based aerobic training in coronary artery bypass graft surgery patients. J Cardiopulm Rehabil 21:31–36

    Article  PubMed  CAS  Google Scholar 

  • Lampinen P, Heikkinen RL, Ruoppila I (2000) Changes in intensity of physical exercise as predictors of depressive symptoms among older adults: an eight year follow-up study. Prev Med 12:113–180

    Google Scholar 

  • Lawlor DA, Hopker SW (2001) The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials. BMJ 322:1–8

    Article  Google Scholar 

  • Long BC, van Stavel R (1995) Effects of exercise training on anxiety: a meta-analysis. J Appl Sport Psychol 7:167–189

    Article  Google Scholar 

  • Manger TA (2000) The effects of a community-based aerobic exercise program on posttraumatic stress disorder-related symptoms and concomitant anxiety and depression (dissertation). Hofstra University, Hempstead, NY

    Google Scholar 

  • Manger TA, Motta RW (2005) The impact of an exercise program on posttraumatic stress disorder, anxiety, and depression. Int J Emerg Ment Health 7:49–57

    PubMed  Google Scholar 

  • Marcus BH, Forsyth LH (1998) Tailoring interventions to promote physically active lifestyles in women. Womens Health Issues 8:104–111

    Article  PubMed  CAS  Google Scholar 

  • Marcus BH, Bock BC, Pinto BM et al (1998) Efficacy of an individualized, motivationally-tailored physical activity intervention. Ann Behav Med 20:174–180

    Article  PubMed  CAS  Google Scholar 

  • Marks I (1999) Treatment of panic disorder. Am J Psychiatry 156:1129–1130

    PubMed  CAS  Google Scholar 

  • Martinsen EW, Medhus A, Sandvik L (1985) Effects of aerobic exercise on depression: a controlled study. BMJ 291:109

    Article  PubMed  CAS  Google Scholar 

  • Martinsen EW, Hoffart A, Solberg O (1989) Comparing aerobic with nonaerobic forms of exercise in the treatment of clinical depression: a randomized trial. Compr Psychiatry 30(4):324–331

    Article  PubMed  CAS  Google Scholar 

  • McEntee DJ, Halgin RP (1999) Cognitive group therapy and aerobic exercise in the treatment of anxiety. J Coll Stud Psychother 13(3):39–58

    Google Scholar 

  • McNeil JK, LeBlanc EM, Joyner M (1991) The effect of exercise on depressive symptoms in the moderately depressed elderly. Psychol Aging 6:487–488

    Article  PubMed  CAS  Google Scholar 

  • Merom D, Phongsavan P, Wagner R et al (2007) Promoting walking as an adjunct intervention to group cognitive behavioral therapy for anxiety disorders: a pilot group randomized trial. J Anxiety Disord 22(6):959–968. doi:101016/j.janxdis.2007.09.010

    Article  PubMed  Google Scholar 

  • Meyer T, Broocks A (2000) Therapeutic impact of exercise on psychiatric diseases. Guidelines for exercise testing and prescription. Sports Med 30:269–279

    Article  PubMed  CAS  Google Scholar 

  • Mobily KE, Rubinstein LM, Lemke JH, O’Hara MW, Wallace RB (1996) Walking and depression in a cohort of older adults: The Iowa 65+ Rural Health Study. JAPA 4:119–135

    Google Scholar 

  • Morris M, Steinberg H, Sykes EA, Salmon P (1990) Effects of temporary withdrawal from regular running. J Psychosomat Res 33:47–61

    Google Scholar 

  • Motl RW, Birnbaum AS, Kubik MY, Dishman RK (2004) Naturally occurring changes in physical activity are inversely related to depressive symptoms during early adolescence. Psychosom Med 66:336–342

    Article  PubMed  Google Scholar 

  • Muller B, Armstrong HE (1975) A further note on the running treatment for anxiety. Psychother Theory Res Pract 12:385–387

    Article  Google Scholar 

  • North TC, McCullagh P, Tran ZV (1990) Effects of exercise on depression. Exerc Sport Sci Rev 18:379–415

    Article  PubMed  CAS  Google Scholar 

  • Orwin A (1974) Treatment of situational phobia—a case for running. Br J Psychiatry 125:95–98

    Article  PubMed  CAS  Google Scholar 

  • Otto MW, Church TS, Craft LL et al (2007) Exercise for mood and anxiety disorders. J Clin Psychiatry 9:287–294

    Google Scholar 

  • Paffenbarger RS, Lee I-M, Leung R (1994) Physical activity and personal characteristics associated with depression and suicide in American college men. Acta Psychiatr Scan Suppl 377:16–22

    Article  Google Scholar 

  • Pate RR, Pratt M, Blair SN et al (1995) Physical activity and public health: a recommendation from the centers for disease control and prevention and the American college of sports medicine. JAMA 273:402–407

    Article  PubMed  CAS  Google Scholar 

  • Petruzzello SJ, Landers AC, Hatfield BD, Kubitz KA, Salazar W (1991) A meta-analysis on the anxiety-reducing effect of acute and chronic exercise: outcomes and mechanisms. Sports Med 11:143–182

    Article  PubMed  CAS  Google Scholar 

  • Ransford CP (1982) A role for amines in the antidepressant effect of exercise: a review. Med Sci Sports Exerc 14:1–10

    Article  PubMed  CAS  Google Scholar 

  • Roth DL, Holmes DS (1987) Influence of aerobic exercise training and relaxation training on physical and psychological health following stressful life events. Psychosom Med 49:355–365

    PubMed  CAS  Google Scholar 

  • Ruuskanen JM, Ruoppila I (1995) Physical activity and psychological well-being among people aged 65–84 years. Age Ageing 24:292–296

    Article  PubMed  CAS  Google Scholar 

  • Segar M, Hankon J, Jayaratne T et al (2002) Fitting fitness into women’s lives: effects of a gender-tailored physical activity intervention. Womens Health Issue 12:338–347

    Article  Google Scholar 

  • Sexton H, Maere Å, Dahl NH (1989) Exercise intensity and reduction in neurotic symptoms. Acta Psychiatr Scand 80:231–235

    Article  PubMed  CAS  Google Scholar 

  • Singh NA, Clements KM, Fiattarone MA (1997) A randomized controlled trial of progressive resistance training in depressed elders. J Gerontol 52:M27–M35

    CAS  Google Scholar 

  • Singh NA, Clements KM, Singh MA (2001) The efficacy of exercise as a long-term antidepressant in elderly subjects: a randomized, controlled trial. J Gerontol A Biol Sci Med Sci 56:M497–M504

    PubMed  CAS  Google Scholar 

  • Singh NA, Stavrinos TM, Scarbek Y, Galambos G, Liber C, Fiatarone Singh MA (2005) A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. J Gerontol A Biol Sci Med Sci 60:768–776

    PubMed  Google Scholar 

  • Smith BJ, Bauman AE, Bull FC et al (2000) Promoting physical activity in general practice: a controlled trial of written advice and information materials. Br J Sports Med 34:262–267

    Article  PubMed  CAS  Google Scholar 

  • Sothman MS, Ismail AH (1984) Relationship between urinary catecholamine metabolites, particularly MHPG, and selected personality and physical fitness characteristics in normal subjects. Psychosom Med 46:523

    Google Scholar 

  • Sothmann MS, Ismail AH (1985) Factor analytic deprivation of the MHPG/NM ratio: implications for studying the link between physical fitness and depression. Biol Psychiatry 20:570–583

    Article  Google Scholar 

  • Stathopoulou G, Powers MB, Berry AC, Smits JAJ, Otto MW (2006) Exercise interventions for mental health: a quantitative and qualitative review. Clin Psychol Sci Pract 13:179–193

    Article  Google Scholar 

  • Stephens T (1988) Physical activity and mental health in the United States and Canada: evidence from four popular surveys. Prev Med 17:35–47

    Article  PubMed  CAS  Google Scholar 

  • Steptoe A, Butler N (1996) Sports participation and emotional well-being in adolescents. Lancet 347:1789–1792

    Article  PubMed  CAS  Google Scholar 

  • Steptoe A, Edwards S, Moses J, Mathews A (1989) The effects of exercise training on mood and perceived coping ability in anxious adults from the general population. J Psychosom Res 33:537–547

    Article  PubMed  CAS  Google Scholar 

  • Steptoe A, Wardle J, Filler R et al (1997) Leisure-time physical exercise: prevalence, attitudinal correlates, and behavioral correlates among young Europeans from 21 countries. Prev Med 26:845–854

    Article  PubMed  CAS  Google Scholar 

  • Stich FA (1998) A meta-analysis of physical exercise as a treatment for symptoms of anxiety adults from the general population. J Psychosom Res 33:537–547

    Google Scholar 

  • Strawbridge WJ, Deleger S, Roberts RE et al (2002) Physical activity reduces the risk of subsequent depression for older adults. Am J Epidemiol 156:328–334

    Article  PubMed  Google Scholar 

  • Strecher V, Wang C, Derry H (2002) Tailored interventions for multiple risk behaviours. Health Educ Res 17:619–626

    Article  PubMed  Google Scholar 

  • Ströhle A, Feller C, Onken M et al (2005) The acute antipanic activity of aerobic exercise. Am J Psychiatry 162:2376–2378

    Article  PubMed  Google Scholar 

  • Ströhle A, Feller C, Strasburger C, Heinz A, Dimeo F (2006) Anxiety modulation by the heart? Aerobic exercise and atrial natriuretic peptide. Psychoneuroendocrinology 31:1127–1130

    Article  PubMed  CAS  Google Scholar 

  • Ströhle A, Höfler M, Pfister H et al (2007) Physical activity and prevalence and incidence of mental disorders in adolescents and young adults. Psychol Med 37(11):1657–1666

    Article  PubMed  Google Scholar 

  • Ströhle A, Holsboer F (2003) Stress responsive neurohormones in depression and anxiety. Pharmacopsychiatry 36(suppl 3):207–214

    Google Scholar 

  • Swinburn BA, Walter LG, Arroll B et al (1998) The green prescription study: a randomised controlled trial of written exercise advice provided by general practitioners. Am J Public Health 88:288–291

    Article  PubMed  CAS  Google Scholar 

  • Thomas S, Reading I, Shephard RJ (1992) Revision of the Physical Activity Readiness Questionnaire (PAR-Q). Can J Sport Sci 17:338–345

    PubMed  CAS  Google Scholar 

  • Thirlaway K, Benton D (1992) Participation in physical activity and cardiovascular fitness have different effects on mental health and mood. J Psychosom Res 36:657–665

    Article  PubMed  CAS  Google Scholar 

  • Veale D, Le Fevre K, Pantelis C et al (1992) Aerobic exercise in the adjunctive treatment of depression: a randomized controlled trial. J R Soc Med 85:541–544

    PubMed  CAS  Google Scholar 

  • Weyerer S (1992) Physical inactivity and depression in the community: evidence from the Upper Bavarian field study. Int J Sports Med 13:492–496

    Article  PubMed  CAS  Google Scholar 

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Ströhle, A. Physical activity, exercise, depression and anxiety disorders. J Neural Transm 116, 777–784 (2009). https://doi.org/10.1007/s00702-008-0092-x

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