The Biopsychosocial Impact of Exercise on an Outpatient Psychiatric Population

Sarah J Parker


Presentation for MPA 2004 Conference - Psi Chi Regional Award Session

Abstract

The physical and psychological health benefits of regular exercise are well documented in both healthy and clinical populations (Mutrie, 1997). Concomitantly, a sizeable body of research has focused on the ameliorating effects of exercise on individuals with clinical depression and anxiety disorder (Dunn et al., 2001). While a small subset of research is concerned with exercise among individuals diagnosed with serious and persistent mental illness, most has focused exclusively on inpatient populations. Note that outpatient populations may face daily challenges that are very different from their inpatient peers, thereby precluding the generalization of results from the inpatient to the outpatient experience. As such, the purpose of the current study was to investigate the psychological and physiological effects of exercise on a community dwelling population of individuals with severe and persistent mental illness.

Individuals volunteered to participate in either an exercise group or a control group. Those in the exercise group (N=16) agreed to participate in physical activity a minimum of 2 times each week for a duration of 20 weeks. Those in the control group (N=14) agreed to maintain their current level of daily activity. All exercise was supervised, and completed in the fitness room of a day-time psychosocial rehabilitation center. Psychological (i.e., depression, anxiety, quality of life, self-esteem, mood) and physical (i.e., resting heart rate, resting blood pressure, weight, body composition, hip to waist ratio) data were collected before and after the 20-week exercise intervention. Analysis of variance (ANOVA) and t-test statistics were calculated to investigate group differences and changes across time. Effect size calculations were used to examine the magnitude of the exercise intervention on changes in psychological and physical measures.

No significant time differences were found between groups or within the control group on any of the psychological or physical measures. Among exercisers, Bonferroni adjusted t-tests indicate a significant reduction in depression (t[16]=3.45, p=003) and improvements approaching significance for other psychological variables. Effect size calculations provide further support for the benefits of the exercise intervention (see Table 1). While no significant changes were reported in physical measures, individuals in the exercise group recorded increases in both the duration and intensity of exercise over the 20-week program.

Despite a highly detrained population, results suggest that exercise may be a useful adjunct to traditional psychotherapeutic and pharmacological treatment approaches. Implications for future research and professional practice will be discussed.

References:

Mutrie, N. (1997). The therapeutic effects of exercise on the self. In Kenneth R. Fox (Ed.), The Physical Self: From Motivation to Well-Being Champaign IL:Human Kinetics;287-314.

Dunn, A.L., Trivedi, M.H., & O'Neal, H.A. (2001). Physical activity dose-response effects on outcomes of depression and anxiety. Medicine & Science in Sports & Exercise, 33, (suppl.6), S587-S597

Table 1: Effect Size of Exercise on Psychological Score Change

Measure Mean(pre) Mean(post) Cohen's d
BDI 16.6(+14.7) 8.9(+11.0) 0.86
STAI 43.5(+13.8) 34.6(+10.3) 0.67
QoL 71.5(+16.7) 79.2(+15.8) -0.5
SE 6.4(+ 2.9) 7.5(+ 2.0) -0.379
POMS:
tension 36.9(+6.3) 34.5(+5.3) 0.38
depression 38.2(+3.2) 36.6(+3.5) 0.49
anger 42.2(+4.1) 40.5(+3.7) 0.36
vigor 50.3(+9.3) 52.9(+8.7) 0.21
fatigue 42.9(+5.6) 41.5(+7.7) 0.2
confusion 40.2(+5.9) 40(+6.7) 0.02

Psychsoc Lab Home