Mental disorders account for the third largest source of disease burden in Australia, those with severe mental illness living from 10-32 years less than the general population. This gap has grown in recent decades. It is estimated that two-thirds of these early deaths can be attributed to inadequate access to medical care, poor diets, insufficient exercise, medications that induce weight gain and subsequent lifestyle-related diseases.
So what role can exercise play in managing mental disorders, and closing this life expectancy gap?
Unfortunately there is a limited amount of high quality studies on the linkages of exercise with mental health outcomes. Most of current research pertains to the effects of exercise as a treatment for depression, with recent meta-analyses indicating exercise may have a moderate to large therapeutic effect on those with mild to moderate depression.
Some studies have investigated the effects of exercise on those with anxiety disorders and schizophrenia, but with mixed results. Exercise seems to be effective as an adjunctive treatment for anxiety disorders, but less effective compared with anti-depressant treatment. Research on the effects of exercise in those with schizophrenia seems to indicate that exercise can improve certain aspects such as loss of motivation and cognitive ability, but has little effect on other symptoms such as delusions and hallucinations.
Perhaps one of the most key areas where exercise treatment may be effective in these populations is in the prevention of medication-induced weight gain and subsequent lifestyle related diseases.
Recent research has shown exercise to be effective in significantly attenuating medication-induced weight gain in those experiencing first episode psychosis. Other studies indicate that patients with schizophrenia are twice as likely to develop type 2 diabetes compared to the general population. Exercise may have a significant role to play in the health outcomes in this population, with known benefits being the prevention of the onset of type 2 diabetes and improving glycemic control in those with type 2 diabetes.
Unfortunately, the exact types and amounts of exercise needed to achieve a therapeutic effect are yet to be determined. Based on the limited research, a minimum recommendation of at least 30 minutes three times per week at a moderate to vigorous intensity is recommended. This recommendation is similar to that advised for the maintenance of general health. However, it is important for exercise to be tailored to suit the needs of the individual, taking into account the fitness level, motivation and any co-morbidities that may affect a person’s ability to maintain regular exercise. An Accredited Exercise Physiologist will be able to assist in the implementation of a patient-specific exercise program.