July, 2021. It is my pleasure to congratulate Ivan D Escobar-Roldan, MD, a psychiatry resident at Duke, for his role as first author of the winning submission in the 2020 Resident Paper Competition of the Journal, entitled “Exercise Prescription Practices to Improve Mental Health,” published in this issue of JPP. The value of physical exercise to enhance and improve one’s overall health is well known and important. For many of us, however, it’s in the category of “easier said than done.” Just knowing about good health habits such as exercise, a healthy diet, not smoking, avoiding excessive alcohol, regular preventive medical checkups, regular and adequate sleep, and many more, is one thing. It’s quite another to incorporate these habits into one’s busy life and then stick with them!
What has become steadily clearer in recent years is the importance of these healthy habits in enhancing one’s mental as well as physical health. The protective and therapeutic value of good habits such as exercise for those of us at risk for, or suffering with, a mental illness such as depression, anxiety, and even cognitive impairment is no longer disputed. A recent study, for example, from the Royal College of Surgeons of Ireland, examined treatments for depression in patients with coronary artery disease. The researchers looked at the benefits of antidepressants, psychotherapy, and exercise in their patients. Although all interventions showed some benefit, the authors of the study concluded that “exercise is likely to be the best treatment for depression following coronary artery disease.”1
Escobar-Roldan’s paper is a welcome addition to this growing literature, but it is one with a novel focus: to examine the patterns of exercise prescribing by healthcare providers—in effect, how well do we practice what we preach, not just in our personal habits, but in our advice to our patients? Survey responses from 185 health care providers were evaluated. Respondents were asked how often they recommended exercise to their patients, and how often they actually specified, prescription-style, exercise programs. Read the paper—you’ll find it interesting. Suffice it to say, we’ve got some work to do! Also in this issue of the Journal, Masand and colleagues emphasize the importance of exercise for maintaining well-being during the devastating COVID-19 pandemic.
I was intrigued to review how often we’ve published papers on this topic in the history of the Journal. I did a search just entering the words “physical exercise” and found over 100 articles in the archives (6 issues/year×25 y=150 issues). A fair number of these should be excluded since they weren’t on point, but clearly the importance of physical activity and exercise in the field of mental health is increasingly being recognized. A sampling of these references is shown below.2–11
John M. Oldham, MD
1. Doyle F, Freedland KE, Carney Robert M, et al. Hybrid systematic review and network meta-analysis of randomized controlled trials of interventions for depressive symptoms in patients with coronary artery disease. Psychosom Med. 2021;83:423–431.
2. Giles A, Nasstasia Y, Baker A, et al. Exercise as treatment for youth with major depression: the Healthy Body Healthy Mind Feasibility Study. J Psychiatr Pract. 2020;26:444–460.
3. Sylvia LG, Janos JA, Pegg SL, et al. Feasibility and acceptability of a lifestyle intervention for individuals with bipolar disorder. J Psychiatr Pract. 2019;25:451–460.
4. Scott TM, Gerbarg PL, Silveri MM, et al. Psychological function, Iyengar yoga, and coherent breathing: a randomized controlled dosing study. J Psychiatr Pract. 2019;25:437–450.
5. Chen MD, Yeh YC, Tsai YJ, et al. Efficacy of Baduanjin exercise and feasibility of mobile text reminders on follow-up participation in people with severe mental illness: an exploratory study. J Psychiatr Pract. 2016;22:241–249.
6. Uebelacker LA, Weinstock LM, Kraines MA. Self-reported benefits and risks of yoga in individuals with bipolar disorder. J Psychiatr Pract. 2014;20:345–352.
7. Rethorst CD, Trivedi MH. Evidence-based recommendations for the prescription of exercise for major depressive disorder. J Psychiatr Pract. 2013;19:204–212.
8. Sylvia LG, Nierenberg AA, Stange JP, et al. Development of an integrated psychosocial treatment to address the medical burden associated with bipolar disorder. J Psychiatr Pract. 2011;17:224–232.
9. Sylvia LG, Kopeski LM, Mulrooney C, et al. Does exercise impact mood? Exercise patterns of patients in a psychiatric partial hospital program. J Psychiatr Pract. 2009;15:70–78.
10. Trivedi MH, Greer TL, Grannemann BD, et al. Exercise as an augmentation strategy for treatment of major depression. J Psychiatr Pract. 2006;12:205–213.
11. Richardson CR, Avripas SA, Neal DL, et al. Increasing lifestyle physical activity in patients with depression or other serious mental illness. J Psychiatr Pract. 2005;11:379–388.