There is a general belief that physical activity and exercise have positive effects on mood and anxiety and a great number of studies describe an association of physical activity and general ...well-being, mood and anxiety. In line, intervention studies describe an anxiolytic and antidepressive activity of exercise in healthy subjects and patients. However, the majority of published studies have substantial methodological shortcomings. The aim of this paper is to critically review the currently available literature with respect to (1) the association of physical activity, exercise and the prevalence and incidence of depression and anxiety disorders and (2) the potential therapeutic activity of exercise training in patients with depression or anxiety disorders. Although the association of physical activity and the prevalence of mental disorders, including depression and anxiety disorders have been repeatedly described, only few studies examined the association of physical activity and mental disorders prospectively. Reduced incidence rates of depression and (some) anxiety disorders in exercising subjects raise the question whether exercise may be used in the prevention of some mental disorders. Besides case series and small uncontrolled studies, recent well controlled studies suggest that exercise training may be clinically effective, at least in major depression and panic disorder. Although, the evidence for positive effects of exercise and exercise training on depression and anxiety is growing, the clinical use, at least as an adjunct to established treatment approaches like psychotherapy or pharmacotherapy, is still at the beginning. Further studies on the clinical effects of exercise, interaction with standard treatment approaches and details on the optimal type, intensity, frequency and duration may further support the clinical administration in patients. Furthermore, there is a lack of knowledge on how to best deal with depression and anxiety related symptoms which hinder patients to participate and benefit from exercise training.
In context of the current COVID-19 pandemic the consumption of pandemic-related media coverage may be an important factor that is associated with anxiety and psychological distress. Aim of the study ...was to examine those associations in the general population in Germany. 6233 participants took part in an online-survey (March 27th–April 6th, 2020), which included demographic information and media exploitation in terms of duration, frequency and types of media. Symptoms of depression, unspecific anxiety and COVID-19 related anxiety were ascertained with standardized questionnaires. Frequency, duration and diversity of media exposure were positively associated with more symptoms of depression and unspecific and COVID-19 specific anxiety. We obtained the critical threshold of seven times per day and 2.5 h of media exposure to mark the difference between mild and moderate symptoms of (un)specific anxiety and depression. Particularly the usage of social media was associated with more pronounced psychological strain. Participants with pre-existing fears seem to be particularly vulnerable for mental distress related to more immoderate media consumption. Our findings provide some evidence for problematical associations of COVID-19 related media exposure with psychological strain and could serve as an orientation for recommendations—especially with regard to the thresholds of critical media usage.
Background
The COVID‐19 pandemic is related to multiple stressors and therefore may be associated with psychological distress. The aim of this study was to longitudinally assess symptoms of ...(un‐)specific anxiety and depression along different stages of the pandemic to generate knowledge about the progress of psychological consequences of the pandemic and to test the role of potential risk and resilience factors that were derived from cross‐sectional studies and official recommendations.
Methods
The present study uses a longitudinal observational design with four waves of online data collection (from March 27 to June 15, 2020) in a convenience sample of the general population in Germany. A total of N = 2376 participants that completed at least two waves of the survey were included in the analyses.
Findings
Specific COVID‐19‐related anxiety and the average daily amount of preoccupation with the pandemic decreased continuously over the four waves. Unspecific worrying and depressive symptoms decreased on average but not on median level. Self‐efficacy, normalization, maintaining social contacts, and knowledge, where to get medical support, were associated with fewer symptoms relative to baseline. Suppression, unhealthy habits, and a longer average daily time of thinking about the pandemic were correlated with a relative increase of symptoms.
Interpretation
Our findings provide insight into the longitudinal changes of symptoms of psychological distress along the first three months of the COVID‐19 pandemic in Germany. Furthermore, we were able to reaffirm the anticipated protective and risk factors that were extracted from previous studies and recommendations.
Longitudinal assessments revealed that symptoms of anxiety and psychological distress related to the COVID‐19 pandemic decreased on average continuously across the first three months of the pandemic in Germany. Self‐efficacy, normalization, maintaining social contacts, and knowledge, where to get medical support, were longitudinally associated with better mental health outcomes. In contrast, suppression, unhealthy habits, and ruminating about the pandemic were correlated with a higher symptom severity.
•Multilevel analyses revealed changes in COVID-19-related fear, anxiety, and depressive symptoms.•Symptoms were higher with vs. without anxiety, depressive and other mental disorders.•All symptoms ...decreased on average across the first months of the pandemic.•This decrease was stronger in individuals with vs. without anxiety disorders.•A driving factor were initially high symptoms in generalized anxiety disorders.
Especially individuals with mental disorders might experience an escalation of psychopathological symptoms during the COVID-19 pandemic. Therefore, we investigated the role of anxiety, depressive, and other mental disorders for levels and longitudinal changes of COVID-19-related fear, anxiety and depressive symptoms during the first months of the COVID-19 pandemic in Germany. In a longitudinal observational design with four assessment waves from March, 27th until June, 15th 2020, a total of 6,551 adults from Germany was assessed. 4,175 individuals participated in one, 1,070 in two, 803 in three, and 503 in all four waves of data collection. Multilevel analyses revealed that across all assessment waves, COVID-19-related fear, anxiety, and depressive symptoms were significantly higher in individuals with vs. without anxiety, depressive, and other mental disorders. All symptoms decreased on average over time, and this decrease was significantly stronger in individuals with vs. without anxiety disorders, and particularly driven by individuals with generalized anxiety disorder. Our findings suggest that individuals with mental disorders, especially anxiety disorders – and in particular those with a generalized anxiety disorder – seem to be vulnerable to experience psychological strain in the context of the pandemic, might likely overestimate potential threat, and should be targeted by preventive and therapeutic interventions.
The dynamic COVID-19 pandemic has been associated with mental strain. However, most studies focused primarily on the beginning of the pandemic and rarely took into account the long-term course. The ...aim of this prospective-longitudinal study was to investigate levels and changes of pandemic-related fears, unspecific anxiety, depressive symptoms, and psychosocial-behavioral factors over the first 1.5 years of the pandemic.
We conducted a nine-wave longitudinal online-survey from March 2020 to October 2021 with a total of 8148 participants of the adult general population in Germany. Descriptive examination and multilevel analysis were carried out to assess psychological burden, risk-bearing and protective psychosocial-behavioral factors, and associations with sociodemographics and the pandemic's duration and severity over the course of the pandemic.
Symptoms of mental strain fluctuated across the pandemic and displayed a relative maximum at the pandemic's early beginning and during the second and third COVID-19 waves. Most participants (approximately 67.4 %–82.1 %) reported mild and transient symptoms, but a substantial portion (approximately 17.9 %–32.6 %) experienced pronounced mental health problems during the pandemic. Symptom severity was negatively associated with the duration of the pandemic and positively associated with the rate of new infections.
The observational study design, non-probability-sampling methods, and online self-report assessments limit the generalizability of our results.
The fluctuating course of psychological burden during the pandemic emphasizes the relevance of continuous monitoring during this challenging time. Particularly individuals with pronounced subclinical symptoms or manifesting mental disorders should be targeted with adequate prevention and early intervention programs.
•Mental strain fluctuated across the COVID-19 pandemic (9 longitudinal assessments).•Symptom severity was negatively associated with the duration of the pandemic.•Symptom severity was positively associated with the rate of new infections.•The probability of getting infected was particularly overestimated at the beginning.•Risk-bearing and protective psychosocial-behavioral factors seem relatively stable.
Exercise and physical activity are constantly gaining attention as adjuvant treatment for substance use disorders, supplementing classical pharmacological and psychotherapeutic approaches. The ...present work reviews studies addressing the therapeutic effects of exercise in alcohol abuse/dependence, nicotine abuse/dependence, and illicit drug abuse/dependence. In the field of smoking cessation, evidence is strong for exercise as an effective adjuvant treatment, whereas no generalizable and methodologically strong studies have been published for alcohol and drug treatment so far, allowing only preliminary conclusions about the effectiveness of exercise in these disorders. A couple of potential mechanisms are discussed, by which exercise may act as an effective treatment, as well as future directions for studies investigating exercise as a treatment strategy for substance use disorders.
Background
The current COVID‐19 pandemic comes with multiple psychological stressors due to health‐related, social, economic, and individual consequences and may cause psychological distress. The aim ...of this study was to screen the population in Germany for negative impact on mental health in the current COVID‐19 pandemic and to analyze possible risk and protective factors.
Methods
A total of 6,509 people took part in an online survey in Germany from 27 March to 6 April. The questionnaire included demographic information and ascertained psychological distress, anxiety and depressive symptoms, and risk and protective factors.
Results
In our sample, over 50% expressed suffering from anxiety and psychological distress regarding the COVID‐19 pandemic. Participants spent several hours per day thinking about COVID‐19 (M = 4.45). Psychological and social determinants showed stronger associations with anxiety regarding COVID‐19 than experiences with the disease.
Conclusions
The current COVID‐19 pandemic does cause psychological distress, anxiety, and depression for large proportions of the general population. Strategies such as maintaining a healthy lifestyle and social contacts, acceptance of anxiety and negative emotions, fostering self‐efficacy, and information on where to get medical treatment if needed, seem of help, while substance abuse and suppression of anxiety and negative emotions seem to be associated with more psychological burden.
The aim of this study was to screen the population in Germany for negative impact on mental health in the current COVID‐19 pandemic and to analyze possible risk and protective factors. A total of 6,509 people took part in an online survey. Over 50% expressed suffering from anxiety and psychological distress regarding the COVID‐19 pandemic. Participants spent several hours per day thinking about COVID‐19. Psychological and social determinants showed stronger associations with anxiety regarding COVID‐19 than experiences with the disease.
Highlights • We investigate chronic and acute stress-buffering effects of acute exercise. • We use a multi-modal approach with fMRI data, self-report, cortisol and α-amylase. • Acute aerobic exercise ...reduces the neural and cortisol stress response to the MIST. • Exercise-induced mood and endocrine changes correlate with subsequent brain activations.
Demographic changes are increasing the pressure to improve therapeutic strategies against cognitive decline in Alzheimer disease (AD) and mild cognitive impairment (MCI). Besides drug treatment, ...physical activity seems to be a promising intervention target as epidemiological and clinical studies suggest beneficial effects of exercise training on cognition. Using comparable inclusion and exclusion criteria, we analyzed the efficacy of drug therapy (cholinesterase inhibitors, memantine, and Ginkgo biloba) and exercise interventions for improving cognition in AD and MCI populations.
We searched The Cochrane Library, EBSCO, OVID, Web of Science, and U.S Food and Drug Administration data from inception through October 30, 2013. Randomized controlled trials in which at least one treatment arm consisted of an exercise or a pharmacological intervention for AD or MCI patients, and which had either a non-exposed control condition or a control condition that received another intervention. Treatment discontinuation rates and Standardized Mean Change score using Raw score standardization (SMCR) of cognitive performance were calculated.
Discontinuation rates varied substantially and ranged between 0% and 49% with a median of 18%. Significantly increased discontinuation rates were found for galantamine and rivastigmine as compared to placebo in AD studies. Drug treatments resulted in a small pooled effect on cognition (SMCR: 0.23, 95% CI: 0.20 to 0.25) in AD studies (N = 45, 18,434 patients) and no effect in any of the MCI studies (N = 5, 3,693 patients; SMCR: 0.03, 95% CI: 0.00 to 0.005). Exercise interventions had a moderate to strong pooled effect size (SMCR: 0.83, 95% CI: 0.59 to 1.07) in AD studies (N = 4, 119 patients), and a small effect size (SMCR: 0.20, 95% CI: 0.11 to 0.28) in MCI (N = 6, 443 patients).
Drug treatments have a small but significant impact on cognitive functioning in AD and exercise has the potential to improve cognition in AD and MCI. Head-to-head trials with sufficient statistical power are necessary to directly compare efficacy, safety, and acceptability. Combining these two approaches might further increase the efficacy of each individual intervention.
PROSPERO (2013:CRD42013003910).
Several epidemiological studies have shown that exercise (EX) and physical activity (PA) can prevent or delay the onset of different mental disorders, and have therapeutic benefits when used as sole ...or adjunct treatment in mental disorders. This review summarizes studies that used EX interventions in patients with anxiety, affective, eating, and substance use disorders, as well as schizophrenia and dementia/mild cognitive impairment. Despite several decades of clinical evidence with EX interventions, controlled studies are sparse in most disorder groups. Preliminary evidence suggests that PA/EX can induce improvements in physical, subjective and disorder-specific clinical outcomes. Potential mechanisms of action are discussed, as well as implications for psychiatric research and practice.
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