New Guidelines Promote Exercise as a Key Additional Treatment for Major Mental Health Disorders

Based on compelling evidence from a meta-review of existing research, the European Psychiatric Association (EPA) has issued new guidelines to promote exercise as a key additional treatment for mental health conditions.

The guideline, published in European Psychiatry, recommends that a regime of structured exercise be added to standard medication and psychotherapy.

Exercise can effectively reduce mental health symptoms, improve cognition, and strengthen cardiovascular fitness among patients with depression and schizophrenia.

“Our comprehensive review provides clear evidence that physical activity has a central role in reducing the burden of mental health symptoms in people with depression and schizophrenia,” said lead investigator Brendon Stubbs, PhD, Institute of Psychiatry, King’s College London, London, United Kingdom. “Our guidelines provide direction for future clinical practice. Specifically, we provide convincing evidence that it is now time for professionally-delivered physical activity interventions to move from the fringes of healthcare and become a core component in the treatment of mental health conditions.”

Their analysis, issued as the EPA’s position statement and guidelines, demonstrates that moderate intensity aerobic exercise -- 2 to 3 times a week for at least 150 minutes -- reduces symptoms of depression and schizophrenia and improves cognition and cardiorespiratory health in schizophrenia spectrum disorders.

Evidence also supports combining aerobic with resistance exercise to improve outcomes for individuals with schizophrenia spectrum disorders and major depression.

Long-term outcomes and full recovery among people with mental illness are often poor, even for those receiving appropriate medications. People with mental illness also experience very poor physical health and drastic physical health inequalities, which lead to this population dying up to twenty years prematurely.

“Signs and symptoms of premature cardiovascular diseases can be identified early in the disease course of mental disorders, when patients are in their thirties to forties,” said senior author Kai G. Kahl, PhD, Hannover Medical School, Hannover, Germany. “Interventions that modify cardiometabolic risks are clearly needed, and should be recommended as early as possible, as an integral part of a multimodal treatment plan.”

The guidance advocates the development of structural changes in hospitals and other institutions concerned with the treatment of mental disorders that establish exercise facilities and physiotherapists or exercise specialists to support the treatment of severe mental illness. It also points to the need to modify insurance reimbursement guidelines to include the recommended treatments.

The EPA guidance was also endorsed by the International Organization of Physical Therapists in Mental Health.


SOURCE: Elsevier
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