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New Guidelines: Exercise Key Part of Mental Health Treatment

October 15, 2018

New guidelines from the European Psychiatric Association promote exercise as a core part of treatment for severe mental illnesses, including major depressive disorder and schizophrenia. The recommendations follow a review of existing research on the effect of physical activity on mental health disorders.

Findings from the meta-review and the resulting position statement and guidelines were published online in European Psychiatry.

“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, King’s College London, and South London and Maudsley NHS Foundation Trust, London, United Kingdom.

Prescribing Exercise as an Intervention for Depression

“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.”

According to the analysis, moderate-intensity aerobic exercise 2 to 3 times a week, for a total of 150 minutes, eases symptoms of depression and schizophrenia. In people with schizophrenia spectrum disorders, such physical activity also improves cognition and cardiorespiratory health. Combining aerobic with resistance exercise, according to evidence, may also improve outcomes in people with major depression and schizophrenia spectrum disorders.

To better support the treatment of patients with severe mental illness, new association guidelines advocate for structural changes to mental health facilities to include exercise facilities and exercise specialists, as well as updated insurance reimbursement guidelines that support the recommended physical activity interventions.

Trivia: How Much Exercise Is Needed to Prevent Depression?

“Our systematic review of top-tier evidence has convincingly demonstrated that exercise training, delivered by physical activity professionals, does indeed provide an effective add-on treatment for improving both physical and mental health outcomes in people with mental illness,” Dr. Stubbs said.

The International Organization of Physical Therapists in Mental Health also endorsed the guidelines.

—Jolynn Tumolo


Stubbs B, Vancampfort D, Hallgren M, et al. EPA guidance on physical activity as a treatment for severe mental illness: a meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental Health (IOPTMH). European Psychiatry. 2018 October 1;[Epub ahead of print].

European Psychiatric Association (EPA) comprehensive review demonstrates that exercise is an effective treatment for major mental health conditions and should form a core part of treatment [press release]. Philadelphia, Pennsylvania: Elsevier; October 1, 2018.

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