Exercise and physical activity in mental disorders

  • Elisabeth WolffEmail author
  • Katharina Gaudlitz
  • Brigitt-Leila von Lindenberger
  • Jens Plag
  • Andreas Heinz
  • Andreas Ströhle


Exercise (EX) and physical activity (PA) have been shown to prevent or delay the onset of several mental disorders and to have therapeutic effects in different groups of psychiatric disorders. This review focuses on studies investigating EX as therapeutic intervention in anxiety disorders, affective disorders, eating disorders, schizophrenia, and substance use disorders. Despite EX being discussed as a potential therapy for several decades, adequately powered randomized, controlled trials are sparse in most disorder groups. Nevertheless, evidence points toward disorder-specific benefits that can be induced by EX/PA. Mechanisms of the therapeutic effects of EX/PA are summarized, including metabolic and physiological as well as psychological aspects. Finally, implications for research and therapeutic practice are illustrated.


Exercise Physical activity Mental disorders Psychiatric disorders Therapy Review 


Conflict of interest

The authors declare that they have no conflict of interest.

This supplement was not sponsored by outside commercial interests. It was funded by the German Association for Psychiatry and Psychotherapy (DGPPN).


  1. 1.
    Goodwin RD (2003) Association between physical activity and mental disorders among adults in the United States. Prev Med 36(6):698–703PubMedCrossRefGoogle Scholar
  2. 2.
    Strohle A, Hofler M, Pfister H, Muller AG, Hoyer J, Wittchen HU, Lieb R (2007) Physical activity and prevalence and incidence of mental disorders in adolescents and young adults. Psychol Med 37(11):1657–1666PubMedCrossRefGoogle Scholar
  3. 3.
    Schmitz N, Kruse J, Kugler J (2004) The association between physical exercises and health-related quality of life in subjects with mental disorders: results from a cross-sectional survey. Prev Med 39(6):1200–1207PubMedCrossRefGoogle Scholar
  4. 4.
    Strohle A (2008) Physical activity, exercise, depression and anxiety disorders. J Neural TransmGoogle Scholar
  5. 5.
    Helmich I, Latini A, Sigwalt A, Carta MG, Machado S, Velasques B, Ribeiro P, Budde H (2010) Draft for clinical practice and epidemiology in mental health neurobiological alterations induced by exercise and their impact on depressive disorders. Clin Pract Epidemiol Ment Health 6:115–125PubMedCrossRefGoogle Scholar
  6. 6.
    Stathopoulou G, Powers MB, Berry AC, Smits JAJ, Otto MW (2006) Exercise interventions for mental health: a quantitative and qualitative review. Clin Psychol-Sci Pr 13(2):179–193CrossRefGoogle Scholar
  7. 7.
    Wipfli BM, Rethorst CD, Landers DM (2008) The anxiolytic effects of exercise: a meta-analysis of randomized trials and dose-response analysis. J Sport Exerc Psychol 30(4):392–410PubMedGoogle Scholar
  8. 8.
    Sexton H, Maere A, Dahl NH (1989) Exercise intensity and reduction in neurotic symptoms. A controlled follow-up study. Acta Psychiatr Scand 80(3):231–235PubMedCrossRefGoogle Scholar
  9. 9.
    Broocks A, Bandelow B, Pekrun G, George A, Meyer T, Bartmann U, Hillmer-Vogel U, Ruther E (1998) Comparison of aerobic exercise, clomipramine, and placebo in the treatment of panic disorder. Am J Psychiatry 155(5):603–609PubMedGoogle Scholar
  10. 10.
    Wedekind D, Broocks A, Weiss N, Engel K, Neubert K, Bandelow B (2010) A randomized, controlled trial of aerobic exercise in combination with paroxetine in the treatment of panic disorder. World J Biol Psychiatry 11(7):904–913PubMedCrossRefGoogle Scholar
  11. 11.
    Esquivel G, Diaz-Galvis J, Schruers K, Berlanga C, Lara-Munoz C, Griez E (2008) Acute exercise reduces the effects of a 35% CO2 challenge in patients with panic disorder. J Affect Disord 107(1–3):217–220PubMedCrossRefGoogle Scholar
  12. 12.
    Strohle A, Graetz B, Scheel M, Wittmann A, Feller C, Heinz A, Dimeo F (2009) The acute antipanic and anxiolytic activity of aerobic exercise in patients with panic disorder and healthy control subjects. J Psychiatr ResGoogle Scholar
  13. 13.
    Newman CL, Motta RW (2007) The effects of aerobic exercise on childhood PTSD, anxiety, and depression. Int J Emerg Ment Health 9(2):133–158PubMedGoogle Scholar
  14. 14.
    Diaz AB, Motta R (2008) The effects of an aerobic exercise program on posttraumatic stress disorder symptom severity in adolescents. Int J Emerg Ment Health 10(1):49–59PubMedGoogle Scholar
  15. 15.
    Manger TA, Motta RW (2005) The impact of an exercise program on posttraumatic stress disorder, anxiety, and depression. Int J Emerg Ment Health 7(1):49–57PubMedGoogle Scholar
  16. 16.
    Oeland AM, Laessoe U, Olesen AV, Munk-Jorgensen P (2010) Impact of exercise on patients with depression and anxiety. Nord J Psychiatry 64(3):210–217PubMedCrossRefGoogle Scholar
  17. 17.
    Merom D, Phongsavan P, Wagner R, Chey T, Marnane C, Steel Z, Silove D, Bauman A (2008) Promoting walking as an adjunct intervention to group cognitive behavioral therapy for anxiety disorders–a pilot group randomized trial. J Anxiety Disord 22(6):959–968PubMedCrossRefGoogle Scholar
  18. 18.
    Knapen J, Sommerijns E, Vancampfort D, Sienaert P, Pieters G, Haake P, Probst M, Peuskens J (2009) State anxiety and subjective well-being responses to acute bouts of aerobic exercise in patients with depressive and anxiety disorders. Br J Sports Med 43(10):756–759PubMedCrossRefGoogle Scholar
  19. 19.
    Smits JA, Berry AC, Rosenfield D, Powers MB, Behar E, Otto MW (2008) Reducing anxiety sensitivity with exercise. Depress Anxiety 25(8):689–699PubMedCrossRefGoogle Scholar
  20. 20.
    Lancer R, Motta R, Lancer D (2007) The effect of aerobic exercise on obsessive-compulsive disorder, anxiety, and depression: a preliminary investigation. The Behavior Therapist 30(3):53–62Google Scholar
  21. 21.
    Brown RA, Abrantes AM, Strong DR, Mancebo MC, Menard J, Rasmussen SA, Greenberg BD (2007) A pilot study of moderate-intensity aerobic exercise for obsessive compulsive disorder. J Nerv Ment Dis 195(6):514–520PubMedCrossRefGoogle Scholar
  22. 22.
    Abrantes AM, Strong DR, Cohn A, Cameron AY, Greenberg BD, Mancebo MC, Brown RA (2009) Acute changes in obsessions and compulsions following moderate-intensity aerobic exercise among patients with obsessive-compulsive disorder. J Anxiety Disord 23(7):923–927PubMedCrossRefGoogle Scholar
  23. 23.
    Mead GE, Morley W, Campbell P, Greig CA, McMurdo M, Lawlor DA (2009) Exercise for depression. Cochrane Database Syst Rev (3): CD004366Google Scholar
  24. 24.
    Babyak M, Blumenthal JA, Herman S, Khatri P, Doraiswamy M, Moore K, Craighead WE, Baldewicz TT, Krishnan KR (2000) Exercise treatment for major depression: maintenance of therapeutic benefit at 10 months. Psychosom Med 62(5):633–638PubMedGoogle Scholar
  25. 25.
    Hoffman BM, Babyak MA, Craighead WE, Sherwood A, Doraiswamy PM, Coons MJ, Blumenthal JA (2011) Exercise and pharmacotherapy in patients with major depression: one-year follow-up of the SMILE study. Psychosom Med 73(2):127–133PubMedCrossRefGoogle Scholar
  26. 26.
    Hoffman BM, Blumenthal JA, Babyak MA, Smith PJ, Rogers SD, Doraiswamy PM, Sherwood A (2008) Exercise fails to improve neurocognition in depressed middle-aged and older adults. Med Sci Sports Exerc 40(7):1344–1352PubMedCrossRefGoogle Scholar
  27. 27.
    Laske C, Banschbach S, Stransky E, Bosch S, Straten G, Machann J, Fritsche A, Hipp A, Niess A, Eschweiler GW (2010) Exercise-induced normalization of decreased BDNF serum concentration in elderly women with remitted major depression. Int J Neuropsychopharmacol 13(5):595–602PubMedCrossRefGoogle Scholar
  28. 28.
    Bodin T, Martinsen EW (2004) Mood and self-efficacy during acute exercise in clinical depression. A randomized, controlled study. J Sport Exercise Psy 26(4):623–633Google Scholar
  29. 29.
    Daley A, Jolly K, MacArthur C (2009) The effectiveness of exercise in the management of post-natal depression: systematic review and meta-analysis. Fam Pract 26(2):154–162PubMedCrossRefGoogle Scholar
  30. 30.
    Shah A, Alshaher M, Dawn B, Siddiqui T, Longaker RA, Stoddard MF, El-Mallakh R (2007) Exercise tolerance is reduced in bipolar illness. J Affect Disord 104(1–3):191–195PubMedCrossRefGoogle Scholar
  31. 31.
    Wright KA, Everson-Hock ES, Taylor AH (2009) The effects of physical activity on physical and mental health among individuals with bipolar disorder: a systematic review. Ment Health Phys Act 2:86–94CrossRefGoogle Scholar
  32. 32.
    Hays AE, Goss F, Aaron D, Abt K, Friedman E, Gallagher M, et al. (2008) Hormonal and perceptual changes in bipolar subjects after acute aerobic exercise. Med Sci Sports Exerc 40(17)Google Scholar
  33. 33.
    Alsuwaidan MT, Kucyi A, Law CW, McIntyre RS (2009) Exercise and bipolar disorder: a review of neurobiological mediators. Neuromolecular Med 11(4):328–336PubMedCrossRefGoogle Scholar
  34. 34.
    Sylvia LG, Ametrano RM, Nierenberg AA (2010) Exercise treatment for bipolar disorder: potential mechanisms of action mediated through increased neurogenesis and decreased allostatic load. Psychother Psychosom 79(2):87–96PubMedCrossRefGoogle Scholar
  35. 35.
    Kucyi A, Alsuwaidan MT, Liauw SS, McIntyre RS (2010) Aerobic physical exercise as a possible treatment for neurocognitive dysfunction in bipolar disorder. Postgrad Med 122(6):107–116PubMedCrossRefGoogle Scholar
  36. 36.
    Hrabosky JI, White MA, Masheb RM, Grilo CM (2007) Physical activity and its correlates in treatment-seeking obese patients with binge eating disorder. Int J Eat Disord 40(1):72–76PubMedCrossRefGoogle Scholar
  37. 37.
    Levine MD, Marcus MD, Moulton P (1996) Exercise in the treatment of binge eating disorder. Int J Eat Disord 19(2):171–177PubMedCrossRefGoogle Scholar
  38. 38.
    Pendleton VR, Goodrick GK, Poston WS, Reeves RS, Foreyt JP (2002) Exercise augments the effects of cognitive-behavioral therapy in the treatment of binge eating. Int J Eat Disord 31(2):172–184PubMedCrossRefGoogle Scholar
  39. 39.
    Plante TG (1999) Could the perception of fitness account for many of the mental and physical health benefits of exercise? Adv Mind Body Med 15(4):291–295PubMedGoogle Scholar
  40. 40.
    Sundgot-Borgen J, Rosenvinge JH, Bahr R, Schneider LS (2002) The effect of exercise, cognitive therapy, and nutritional counseling in treating bulimia nervosa. Med Sci Sports Exerc 34(2):190–195PubMedCrossRefGoogle Scholar
  41. 41.
    Zunker C, Mitchell JE, Wonderlich SA (2010) Exercise interventions for women with anorexia nervosa: A review of the literature. Int J Eat DisordGoogle Scholar
  42. 42.
    del Valle MF, Perez M, Santana-Sosa E, Fiuza-Luces C, Bustamante-Ara N, Gallardo C, Villasenor A, Graell M, Morande G, Romo GR, Lopez-Mojares LM, Ruiz JR, Lucia A (2010) Does resistance training improve the functional capacity and well being of very young anorexic patients? A randomized controlled trial. J Adolesc Health 46(4):352–358PubMedCrossRefGoogle Scholar
  43. 43.
    Ussher MH, Taylor A, Faulkner G (2008) Exercise interventions for smoking cessation. Cochrane Database Syst Rev (4): CD002295Google Scholar
  44. 44.
    Frankel A, Murphy J (1974) Physical fitness and personality in alcoholism. Canonical analysis of measures before and after treatment. Q J Stud Alcohol 35(4 Pt A): 1272-1278Google Scholar
  45. 45.
    Sinyor D, Brown T, Rostant L, Seraganian P (1982) The role of a physical fitness program in the treatment of alcoholism. J Stud Alcohol 43(3):380–386PubMedGoogle Scholar
  46. 46.
    Ermalinski R, Hanson PG, Lubin B, Thornby JI, Nahormek PA (1997) Impact of a body-mind treatment component on alcoholic inpatients. J Psychosoc Nurs Ment Health Serv 35(7):39–45PubMedGoogle Scholar
  47. 47.
    Brown RA, Abrantes AM, Read JP, Marcus BH, Jakicic J, Strong DR, Oakley JR, Ramsey SE, Kahler CW, Stuart G, Dubreuil ME, Gordon AA (2008) Aerobic exercise for alcohol recovery: rationale, program description, and preliminary findings. Behav ModifGoogle Scholar
  48. 48.
    Collingwood TR, Reynolds R, Kohl HW, Smith W, Sloan S (1991) Physical fitness effects on substance abuse risk factors and use patterns. J Drug Educ 21(1):73–84PubMedCrossRefGoogle Scholar
  49. 49.
    Williams DJ (2000) Exercise and substance abuse treatment: predicting programme completion. Correct Compendium 25(25):4–7Google Scholar
  50. 50.
    Roessler KK (2010) Exercise treatment for drug abuse–a Danish pilot study. Scand J Public Health 38(6):664–669PubMedCrossRefGoogle Scholar
  51. 51.
    Brown RA, Abrantes AM, Read JP, Marcus BH, Jakicic J, Strong DR, Oakley JR, Ramsey SE, Kahler CW, Stuart GG, Dubreuil ME, Gordon AA (2010) A pilot study of aerobic exercise as an adjunctive treatment for drug dependence. Ment Health Phys Act 3(1):27–34PubMedCrossRefGoogle Scholar
  52. 52.
    Buchowski MS, Meade NN, Charboneau E, Park S, Dietrich MS, Cowan RL, Martin PR (2011) Aerobic exercise training reduces cannabis craving and use in non-treatment seeking cannabis-dependent adults. PLoS One 6(3):e17465PubMedCrossRefGoogle Scholar
  53. 53.
    Gary V, Guthrie D (1972) The effect of jogging on physical fitness and self-concept in hospitalized alcoholics. Q J Stud Alcohol 33(4):1073–1078PubMedGoogle Scholar
  54. 54.
    Palmer J, Vacc N, Epstein J (1988) Adult inpatient alcoholics: physical exercise as a treatment intervention. J Stud Alcohol 49(5):418–421PubMedGoogle Scholar
  55. 55.
    Burling TA, Seidner AL, Robbins-Sisco D, Krinsky A, Hanser SB (1992) Batter up! Relapse prevention for homeless veteran substance abusers via softball team participation. J Subst Abuse 4(4):407–413PubMedCrossRefGoogle Scholar
  56. 56.
    Li M, Chen K, Mo Z (2002) Use of qigong therapy in the detoxification of heroin addicts. Altern Ther Health Med 8(1):50-54–56-59PubMedGoogle Scholar
  57. 57.
    Murphy TJ, Pagano RR, Marlatt GA (1986) Lifestyle modification with heavy alcohol drinkers: effects of aerobic exercise and meditation. Addict Behav 11(2):175–186PubMedCrossRefGoogle Scholar
  58. 58.
    Weber A (1984) Laufen als Behandlungsmethode—eine experimentelle Untersuchung an Alkoholabhängigen in der Klinik. Suchtgefahren 30:160–167Google Scholar
  59. 59.
    Donaghy ME (1997) The investigation of exercise as an adjunct to the treatment and rehabilitation of the problem drinker. Doctoral dissertation, University of Glasgow, GlasgowGoogle Scholar
  60. 60.
    Palmer JA, Palmer LK, Michiels K, Thigpen B (1995) Effects of type of exercise on depression in recovering substance abusers. Percept Mot Skills 80(2):523–530PubMedCrossRefGoogle Scholar
  61. 61.
    Gorczynski P, Faulkner G (2010) Exercise therapy for schizophrenia. Schizophr Bull 36(4):665–666PubMedCrossRefGoogle Scholar
  62. 62.
    Beebe LH, Tian L, Morris N, Goodwin A, Allen SS, Kuldau J (2005) Effects of exercise on mental and physical health parameters of persons with schizophrenia. Issues Ment Health Nurs 26(6):661–676PubMedCrossRefGoogle Scholar
  63. 63.
    Marzolini S, Jensen B, Melvielle P (2009) Feasibility and effects of a group based resistance and aerobic exercise program for individuals with schizophrenia: a multidisciplinary approach. Ment Health Phys Act 2(1):29–36CrossRefGoogle Scholar
  64. 64.
    Duraiswamy G, Thirthalli J, Nagendra HR, Gangadhar BN (2007) Yoga therapy as an add-on treatment in the management of patients with schizophrenia–a randomized controlled trial. Acta Psychiatr Scand 116(3):226–232PubMedCrossRefGoogle Scholar
  65. 65.
    Acil AA, Dogan S, Dogan O (2008) The effects of physical exercises to mental state and quality of life in patients with schizophrenia. J Psychiatr Ment Health Nurs 15(10):808–815PubMedCrossRefGoogle Scholar
  66. 66.
    Pajonk FG, Wobrock T, Gruber O, Scherk H, Berner D, Kaizl I, Kierer A, Muller S, Oest M, Meyer T, Backens M, Schneider-Axmann T, Thornton AE, Honer WG, Falkai P (2010) Hippocampal plasticity in response to exercise in schizophrenia. Arch Gen Psychiatry 67(2):133–143PubMedCrossRefGoogle Scholar
  67. 67.
    Hoffman MD, Hoffman DR (2008) Exercisers achieve greater acute exercise-induced mood enhancement than non-exercisers. Arch Phys Med Rehabil 89(2):358–363PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Elisabeth Wolff
    • 1
    Email author
  • Katharina Gaudlitz
    • 1
  • Brigitt-Leila von Lindenberger
    • 1
  • Jens Plag
    • 1
  • Andreas Heinz
    • 1
  • Andreas Ströhle
    • 1
  1. 1.Klinik für Psychiatrie und PsychotherapieCharité—Universitätsmedizin BerlinBerlinGermany

Personalised recommendations