Exercise therapy improves both mental and physical health in patients with major depression

Abstract

Purpose: to present clinical guidelines for exercise therapy in depressed patients derived from recent meta-analyses. Method: four meta-analyses on effects of physical exercise on mental and physical in depression were analysed. Results: For mild to moderate depression the effect of exercise may be comparable to antidepressant medication and psychotherapy; for severe depression exercise seems to be a valuable complementary therapy to the traditional treatments. Depression is associated with a high incidence of co-morbid somatic illnesses, especially cardiovascular diseases, type 2 diabetes and metabolic syndrome. Exercise is extremely powerful in preventing and treating these diseases. Physical exercise is an outstanding opportunity for the treatment of patients who have a mix of mental and physical health problems. Exercise therapy also improves body image, patient s coping strategies with stress, quality of life and independence in activities of daily living in older adults. Conclusions: Physical therapists should be aware, that several characteristics of major depression (e.g. loss of interest, motivation and energy, generalised fatigue, a low self-worth and self-confidence, fear to move, and psychosomatic complaints) and physical health problems interfere with participation in exercise. Therefore, motivational strategies should be incorporated in exercise interventions to enhance the patients' motivation and adherence in exercise programs.

• Implications for Rehabilitation

• For mild to moderate depression, the effect of exercise may be comparable with antidepressant medication and psychotherapy; for severe depression, exercise seems to be a valuable complementary therapy to the traditional treatments.

• Exercise therapy also improves physical health, body image, patient’s coping strategies with stress, quality of life, and independence in activities of daily living in older adults.

• Motivational strategies should be incorporated in exercise interventions to enhance the patients’ motivation.

     

The enduring and contextual effects of physical health and depression on care-dyad mutuality

Mutuality is a protective factor in family care situations, but little is known about changes in care-dyad mutuality. In this study, we examined mutuality in 103 care dyads over 20 months, and the enduring and contextual impact of older adult and family caregiver health on changes in mutuality. Care dyads consisted of frail older adults and their family caregiver. Older adults reported higher levels of mutuality than family caregivers, but their mutuality declined significantly faster over time. Although changes in physical health were more important than mean health for both older adults and family caregivers, mean depression was more important than changes in depression for older adults. This study shows the importance of examining time-varying covariates in the care dyad.     

Perinatal depression and infant mental health

A mother's mental health during pregnancy and the first year postpartum is of the utmost importance to the cognitive, social, and emotional development of her child. Perinatal depression is associated with increased risk for wide-ranging adverse child development effects that can affect infant and early childhood mental health. Although effective treatments for perinatal depression exist, it is currently unclear if treatment of maternal depression alone is sufficient to ameliorate the negative effects of maternal depression on child outcomes. Interventions focused on the mother-infant relationship and dyadic interaction may be required to address the potential effect of maternal depression on the child. This paper provides an overview of maternal perinatal depression, the risk it poses for infant/early-childhood mental health, strategies for intervention that include mitigating depression and decreasing risk to the child, and implications for psychiatric nurses who work with perinatal women. Early identification and treatment of perinatal depression are critical to ensure optimal infant development and the child's future mental health.     

Placing physical activity in mental health care: a leadership role for mental health nurses

The wide-ranging benefits of physical activity for consumers with mental illness are acknowledged within the mental health nursing field; however, this is not commonly translated to practice. The primary aim of this paper is to argue that mental health nurses are well positioned to, and should, provide leadership in promoting physical activity to improve the quality of care for people with mental illness. Topics addressed in this paper include the relationship between physical activity and both physical and mental health, the views and experiences of consumers with physical activity, the efficacy of physical activity interventions, the attitudes of nurses to physical activity as a component of care, barriers to a physical activity focus in care for mental illness, and the role of mental health nurses in promoting physical activity. There is a clear and important relationship between physical activity and mental health. Mental health nurses are well positioned to encourage and assist consumers to engage in physical activity, although they might lack the educational preparation to perform this role effectively.     

The effect of humor on elder mental and physical health

A convenience sample of community-dwelling older people attending senior centers was asked to participate in a quasi-experimental study to examine the impact of a humor therapy workshop on physical and mental health. Participants were assessed at baseline and at six months for physical (general health and health quality of life) and mental (general well-being, anxiety, depression and psychological distress) health. The sample consisted of 92 subjects, 42 in the control group and 50 in the workshop. Compared to controls, subjects in the workshop had significantly lower follow-up levels of anxiety and depression and improved general well-being. No differences were observed for general health, health quality of life, or psychological distress. This humor therapy workshop was associated with a positive effect upon mental health. It is recommended that attendance at humor workshops be encouraged and that further investigations into the efficacy of such programs on mental and physical health be investigated.     

Improving physical health care in a mental health trust

It is a challenge both to general medicine and psychiatry to develop systems that are better equipped to meet the physical health needs of mental health patients and reduce mortality rates (Hansen et al, 1997). Central and North West London Mental Health NHS Trust is establishing a department of physical health care staffed by nurses with general nursing backgrounds to tackle this problem. This nurse-led department is designed to train nurses and doctors in key aspects of physical health assessment and treatment interventions.     

Serious mental illness and physical health problems: a discussion paper

People with serious mental illness have higher morbidity and mortality rates of chronic diseases than the general population. This discussion paper explores the complex reasons for these disparities in health, such as limitations of health services, the effects of having a serious mental illness, health behaviours and the effects of psychotropic medication. Physical health can be enhanced by improved monitoring and lifestyle interventions initiated at the start of treatment. There are opportunities for mental health nurses to play a significant role in improving both the physical and mental health of people with serious mental illness.