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Kreppke JN, Cody R, Beck J, Brand S, Donath L, Eckert A, Faude O, Hatzinger M, Imboden C, Lang UE, Ludyga S, Mans S, Mikoteit T, Oswald A, Schweinfurth-Keck N, Holsboer-Trachsler E, Zahner L, Gerber M. Long-term outcomes of physical activity counseling in in-patients with major depressive disorder: results from the PACINPAT randomized controlled trial. Transl Psychiatry 2024; 14:160. [PMID: 38521772 PMCID: PMC10960795 DOI: 10.1038/s41398-024-02885-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 03/25/2024] Open
Abstract
Major depressive disorder (MDD) is an increasingly common psychiatric illness associated with a high risk of insufficient physical activity, which in turn is associated with negative mental and physical health outcomes. Theory-based, individually tailored, in-person and remote physical activity counseling has the potential to increase physical activity levels in various populations. Given this, the present study investigated the effect of such a physical activity intervention on the physical activity behavior of in-patients with MDD. This was a multi-center, two-arm randomized controlled trial including initially insufficiently physically active adult in-patients with MDD from four study sites in Switzerland. The sample consisted of 220 participants (Mage = 41 ± 12.6 years, 52% women), 113 of whom were randomized to the intervention group and 107 to the control group. The main outcome, moderate-to-vigorous physical activity (MVPA), was assessed at three time points via hip-worn accelerometer. According to accelerometer measures, there was no significant difference in minutes spent in MVPA over a 12-month intervention period when comparing the intervention with the control group (β = -1.02, 95% CI = -10.68 to 8.64). Higher baseline physical activity significantly predicted physical activity at post and follow-up. This study showed that it is feasible to deliver an individually tailored, theory-based physical activity counseling intervention to in-patients with MDD, however yielding no significant effects on accelerometer-based MVPA levels. Further efforts are warranted to identify efficacious approaches.Trial registration: ISRCTN, ISRCTN10469580, registered on 3rd September 2018, https://www.isrctn.com/ISRCTN10469580 .
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Affiliation(s)
- Jan-Niklas Kreppke
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland.
| | - Robyn Cody
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Serge Brand
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, 6719851115, Iran
- Substance Use Prevention Research Center and Sleep Disorder Research Center, Kermanshah, University of Medical Sciences (KUMS), Kermanshah, 6715847141, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Lars Donath
- German Sport University Cologne, Department of Intervention Research in Exercise Training, Cologne, Germany
| | - Anne Eckert
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Oliver Faude
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Martin Hatzinger
- Psychiatric Services, Solothurn, and Medical Faculty, University of Basel, Basel, Switzerland
| | - Christian Imboden
- Private Clinic Wyss, Muenchenbuchsee, Switzerland
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Undine E Lang
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Sebastian Ludyga
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Sarah Mans
- Private Clinic Wyss, Muenchenbuchsee, Switzerland
| | - Thorsten Mikoteit
- Psychiatric Services, Solothurn, and Medical Faculty, University of Basel, Basel, Switzerland
| | - Anja Oswald
- Psychiatric Clinic Sonnenhalde, Riehen, Switzerland
| | | | | | - Lukas Zahner
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Epiney F, Wieber F, Loosli D, Znoj H, Kiselev N. Voluntary sports programs for individuals with mental health disorders: The trainer's view. PLoS One 2023; 18:e0290404. [PMID: 37883507 PMCID: PMC10602351 DOI: 10.1371/journal.pone.0290404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/07/2023] [Indexed: 10/28/2023] Open
Abstract
There is strong evidence that physical activities (PAs) are an important factor in increasing and maintaining mental health as well as in preventing relapse after mental health disorders. Physical activity is an important part of the treatment program in psychiatric hospitals. However, when individuals with mental health disorders (IMHD) leave the hospitals in Switzerland (CH), there are few possibilities to do physical activity in a given setting. One of them are voluntary sports groups for individuals with mental health disorders (SGPSY), which have been growing continuously in CH since 2016. Yet, little is known about these groups and their training settings. Therefore, the present study explores challenges, barriers, and enablers for participation in SGPSY from the point of view of the trainers of these groups. Additionally, as the sustainable implementation of SGPSY relies on the trainer, the study aims to identify reasons/motivations as well as the personality characteristics of the SGPSY trainers. Semi-structured interviews were conducted with 15 trainers of SGPSY in CH during spring 2022. Interviews were audiotaped, transcribed, and analyzed using thematic analysis in nVivo. Participants identified several intrapersonal (lack of motivation and fitness, mood problems, etc.), interpersonal (conflicts between participants), and structural barriers (time/location) that hinder IMHD from participating in SGPSY. The participating trainer reported that trainer might be helpful in overcoming the barriers by supporting IMHD as enablers. They rate social skills to be essential for the successful management and organization of SGPSY, as well as the ability to set boundaries to protect one's private life and sports skills expertise. The reasons for their engagement as trainers of SGPSY were the satisfaction of doing sports with IMHD and to improve the physical activities habits of IMHD. The findings of the study highlight the need to upskill the trainers of SGPSY in order to improve recruitment of the future trainers of SGPSY by focusing on the assessment of appropriate personality characteristics of trainers and their motives. Additionally, these findings should be integrated in the educational materials of Swiss disabled sports systems. Further research should validate the results from SGPSY participants' point of view.
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Affiliation(s)
- Florence Epiney
- PluSport Bern Gruppen, Bern, Switzerland
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Frank Wieber
- School of Health Professions, Institute of Health Science, Zurich University of Applied Sciences ZHAW, Winterthur, Switzerland
| | | | - Hansjörg Znoj
- Department of Psychology, University of Bern, Bern, Switzerland
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Nikolai Kiselev
- Swiss Research Institute for Public Health and Addiction (ISGF), University of Zürich, Zurich, Switzerland
- PluSport, Umbrella Organization of Swiss Disabled Sports, Volketswil, Switzerland
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Tous-Espelosin M, Fernandez-Lasa U, Romaratezabala E. "Out-of-Hospital and with Qualified Exercise Professionals": Keys to the CORTEX-SP Physical Exercise Program According to the Experience of the Participants. Eur J Investig Health Psychol Educ 2023; 13:1728-1737. [PMID: 37754464 PMCID: PMC10529622 DOI: 10.3390/ejihpe13090125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/22/2023] [Accepted: 09/03/2023] [Indexed: 09/28/2023] Open
Abstract
Physical exercise programs are useful and necessary for the treatment of schizophrenia. The aim of this study was to assess the experiences of participants with schizophrenia in an out-of-hospital exercise program designed and supervised by qualified exercise professionals. Thirty-five individuals with schizophrenia from the intervention group of the CORTEX-SP study were interviewed. The interviews were transcribed verbatim and content analysis was performed using inductive coding. Two main categories emerged: the importance of the program being conducted out-of-hospital, and the individuals responsible for the program being qualified exercise professionals. The participants highlighted the importance of conducting the program outside the psychiatric center since it gave them greater satisfaction. They perceived greater seriousness and a greater number of resources and felt encouraged to repeat the program or prolong it. The success of the program, in addition to the space, was due to the personnel in charge of the program, i.e., the qualified exercise professionals, and the fact that the activities were designed and supervised. Participants emphasized the qualifications of the exercise professionals, key for this type of program, their social skills and the level of involvement with participants and their follow-up.
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Affiliation(s)
- Mikel Tous-Espelosin
- GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), 01007 Vitoria-Gasteiz, Spain; (U.F.-L.); (E.R.)
- Physical Activity, Exercise, and Health Group, Bioaraba Health Research Institute, 01007 Vitoria-Gasteiz, Spain
| | - Uxue Fernandez-Lasa
- GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), 01007 Vitoria-Gasteiz, Spain; (U.F.-L.); (E.R.)
| | - Estibaliz Romaratezabala
- GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), 01007 Vitoria-Gasteiz, Spain; (U.F.-L.); (E.R.)
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Richter D, Riedel-Heller S, Breilmann J, Hasan A, Falkai P, Kilian R, Allgoewer A, Ajayi K, Baumgaertner J, Brieger P, Frasch K, Heres S, Jäger M, Küthmann A, Putzhammer A, Schneeweiß B, Schwarz M, Becker T, Kösters M, Gühne U. [Patient Preferences for Exercise Therapy in People with Severe Mental Illness in Germany]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2023; 91:191-198. [PMID: 35961322 DOI: 10.1055/a-1854-5174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
PURPOSE Assessing the experience with and the attitudes towards exercise therapy in persons with severe mental illness (SMI). Furthermore, potential variables of high preference towards exercise therapy are investigated. METHODS Cross-sectional observational study of SMI patients aged between 18 and 65 years (n=385). Patients were interviewed by trained staff using standardised instruments. Potential variables were analysed using a hierarchic binary logistic regression model. RESULTS 84,4% of SMI patients had a high preference for exercise therapy; of these, 44,1% exercised regularly. Among patients with severe mental illness especially a higher value in the GAF-assessment (p=0,041) and living in a metropolitan area (p=0,011) predict a high preference for exercise therapy. CONCLUSION Most of the patients with severe mental illness interviewed in this study place a surprisingly high value on sports and exercise therapy. Due to the increasing evidence with regard to positive effects of these therapies, it may be an excellent starting point to expand sports and exercise therapy as part of a comprehensive treatment plan. At the same time, strategies for everyday transfer need to be implemented more rigorously.
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Affiliation(s)
- Daniel Richter
- Institut für Qualitätssicherung und Transparenz im Gesundheitswesen, Berlin, Germany
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Medizinische Fakultät, Leipzig, Germany
| | - Steffi Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Medizinische Fakultät, Leipzig, Germany
| | - Johanna Breilmann
- Klinik für Psychiatrie und Psychotherapie II am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg, Germany
| | - Alkomiet Hasan
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik der Universität Augsburg, Medizinische Fakultät, Universität Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany
| | - Peter Falkai
- Klinik für Psychiatrie und Psychotherapie am Klinikum der Universität München, Germany
| | - Reinhold Kilian
- Klinik für Psychiatrie und Psychotherapie II am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg, Germany
| | - Andreas Allgoewer
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Germany
| | | | - Jessica Baumgaertner
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik der Universität Augsburg, Medizinische Fakultät, Universität Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany
| | | | - Karel Frasch
- Klinik für Psychiatrie und Psychotherapie II am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg, Germany
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Bezirkskrankenhaus Donauwörth, Germany
| | | | - Markus Jäger
- Klinik für Psychiatrie und Psychotherapie II am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg, Germany
- Fachkrankenhaus für Psychiatrie, Psychotherapie und Psychosomatik, Bezirkskrankenhaus Kempten, Germany
| | - Andreas Küthmann
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Bezirkskrankenhaus Memmingen, Germany
| | - Albert Putzhammer
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Bezirkskrankenhaus Kaufbeuren, Germany
| | | | | | - Thomas Becker
- Klinik für Psychiatrie und Psychotherapie der Universität Leipzig, Medizinische Fakultät, Universität Leipzig, Germany
| | - Markus Kösters
- Klinik für Psychiatrie und Psychotherapie II am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg, Germany
| | - Uta Gühne
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Medizinische Fakultät, Leipzig, Germany
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Cody R, Beck J, Brand S, Donath L, Faude O, Hatzinger M, Imboden C, Kreppke JN, Lang UE, Ludyga S, Mans S, Mikoteit T, Oswald A, Schweinfurth N, Zahner L, Gerber M. Short-term outcomes of physical activity counseling in in-patients with Major Depressive Disorder: Results from the PACINPAT randomized controlled trial. Front Psychiatry 2023; 13:1045158. [PMID: 36741581 PMCID: PMC9889670 DOI: 10.3389/fpsyt.2022.1045158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction A physical activity counseling intervention based on a motivation-volition model was developed and delivered to in-patients with Major Depressive Disorders with the aim of increasing lifestyle physical activity. The aim of this study is to evaluate the short-term outcomes of this intervention. Methods A multi-center randomized controlled trial was conducted in four Swiss psychiatric clinics. Adults who were initially insufficiently physically active and were diagnosed with Major Depressive Disorder according to ICD-10 were recruited. The sample consisted of 113 participants in the intervention group (M age = 42 years, 56% women) and 107 in the control group (M age = 40 years, 49% women). Motivation and volition determinants of physical activity were assessed with questionnaires. Implicit attitudes were assessed with an Implicit Association Test. Physical activity was self-reported and measured with hip-worn accelerometers over 7 consecutive days starting on the day following the data collection. Results According to accelerometer measures, step count decreased on average 1,323 steps less per day (95% CI = -2,215 to -431, p < 0.01) over time in the intervention group compared to the control group. A trend was recognized indicating that moderate-to-vigorous physical activity decreased on average 8.37 min less per day (95% CI = -16.98 to 0.23, p < 0.06) over time in the intervention group compared to the control group. The initial phase of the intervention does not seem to have affected motivational and volitional determinants of and implicit attitudes toward physical activity. Conclusion Physical activity counseling may be considered an important factor in the transition from in-patient treatment. Methods to optimize the intervention during this period could be further explored to fulfill the potential of this opportunity. Clinical trial registration https://www.isrctn.com/ISRCTN10469580, identifier ISRCTN10469580.
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Affiliation(s)
- Robyn Cody
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Serge Brand
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Adult Psychiatric Clinics Universitäre Psychiatrische Klinik für Erwachsene (UPKE), University of Basel, Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
- Substance Use Prevention Research Center and Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | | | - Jan-Niklas Kreppke
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Undine E. Lang
- Adult Psychiatric Clinics Universitäre Psychiatrische Klinik für Erwachsene (UPKE), University of Basel, Basel, Switzerland
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Sarah Mans
- Private Clinic Wyss, Münchenbuchsee, Switzerland
| | | | - Anja Oswald
- Psychiatric Clinic Sonnenhalde, Riehen, Switzerland
| | - Nina Schweinfurth
- Adult Psychiatric Clinics Universitäre Psychiatrische Klinik für Erwachsene (UPKE), University of Basel, Basel, Switzerland
| | - Lukas Zahner
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Metri NJ, Ee C, Wardle J, Ng CH, Siskind D, Brakoulias V, Ho FYY, Wong VWH, Naidoo U, Eaton M, Firth J, Sarris J. Assessing dietary, exercise, and non-pharmacological modalities within psychiatric hospitals. Gen Hosp Psychiatry 2022; 76:31-35. [PMID: 35358900 DOI: 10.1016/j.genhosppsych.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Najwa-Joelle Metri
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
| | - Chee H Ng
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Richmond, Victoria, Australia
| | - Dan Siskind
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Vlasios Brakoulias
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia; Western Sydney Local Health District Mental Health Services, Sydney, NSW, Australia
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong
| | | | - Uma Naidoo
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Melissa Eaton
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia; School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia; Division of Psychology & Mental Health, The University of Manchester, Manchester, UK
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia; Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Richmond, Victoria, Australia; Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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7
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Imboden C, Claussen MC, Seifritz E, Gerber M. [The Importance of Physical Activity for Mental Health]. PRAXIS 2022; 110:186-191. [PMID: 35291871 DOI: 10.1024/1661-8157/a003831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The Importance of Physical Activity for Mental Health Abstract. Due to the worldwide high prevalence of psychiatric disorders and its association with sedentary behavior and comorbid physical diseases, increasing physical activity in psychiatric populations is of high importance. Regular physical activity is associated with increased mental wellbeing and has shown to have preventive effects on depression, anxiety disorders and probably sleep disorders. Additionally, positive effects on comorbid chronic physical diseases have been found. Exercise as treatment for several weeks has shown to have an antidepressant effect. Similar positive effects on symptoms have been found in anxiety disorders and schizophrenia. Therefore, assessing and promoting physical activity is advisable in clinical psychiatric practice. Patients should be coached to reach at least a weekly average of 150 minutes of moderate and/or 75 minutes of vigorous physical activity. Establishing physical activity and exercise groups is of utmost importance for psychiatric outpatients.
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Affiliation(s)
| | - Malte Christian Claussen
- Privatklinik Wyss AG, Münchenbuchsee
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Psychiatrische Universitätsklinik Zürich, Universität Zürich, Zürich
- Erwachsenenpsychiatrie, Psychiatrische Dienste Graubünden, Chur
| | - Erich Seifritz
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Psychiatrische Universitätsklinik Zürich, Universität Zürich, Zürich
| | - Markus Gerber
- Departement für Sport, Bewegung und Gesundheit, Universität Basel, Basel
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8
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Imboden C, Claussen MC, Seifritz E, Gerber M. The Importance of Physical Activityfor Mental Health. PRAXIS 2022; 110:e186-e190. [PMID: 35291869 DOI: 10.1024/1661-8157/a003820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Due to the worldwide high prevalence of psychiatric disorders and its association with sedentary behavior and comorbid physical diseases, increasing physical activity in psychiatric populations is of high importance. Regular physical activity is associated with increased mental wellbeing and has shown to have preventive effects on depression, anxiety disorders and probably sleep disorders. Additionally, positive effects on comorbid chronic physical diseases have been found. Exercise as treatment for several weeks has shown to have an antidepressant effect. Similar positive effects on symptoms have been found in anxiety disorders and schizophrenia. Therefore, assessing and promoting physical activity is advisable in clinical psychiatric practice. Patients should be coached to reach at least a weekly average of 150 minutes of moderate and/or 75 minutes of vigorous physical activity. Establishing physical activity and exercise groups is of utmost importance for psychiatric outpatients.
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Affiliation(s)
| | - Malte Christian Claussen
- Private Clinic Wyss, Münchenbuchsee, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
- Department of Adult Psychiatry, Psychiatric Services Grisons, Chur, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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9
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Kreppke JN, Cody R, Faude O, Gerber M. [Enjoying Sports and Movement in Mental Illness]. PRAXIS 2022; 110:200-204. [PMID: 35291865 DOI: 10.1024/1661-8157/a003830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Enjoying Sports and Movement in Mental Illness Abstract. Sports and exercise therapy is an effective complemant in the treatment of major depression. The recommendations of at least 150 minutes of moderate or 75 minutes of intensive physical activity per week should be met to achieve positive effects of physical activity. In addition, individual needs and the physical health conditions must be considered in the planning and implementation, so that exercise will be enjoyed in the long term.
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Affiliation(s)
- Jan-Niklas Kreppke
- Abteilung Bewegungs- und Trainingswissenschaften, Departement für Sport, Bewegung und Gesundheit, Universität Basel, Basel
| | - Robyn Cody
- Abteilung Sport und psychische Gesundheit, Departement für Sport, Bewegung und Gesundheit, Universität Basel, Basel
| | - Oliver Faude
- Abteilung Bewegungs- und Trainingswissenschaften, Departement für Sport, Bewegung und Gesundheit, Universität Basel, Basel
| | - Markus Gerber
- Abteilung Sport und psychische Gesundheit, Departement für Sport, Bewegung und Gesundheit, Universität Basel, Basel
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10
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[Implementation of exercise therapy in daily clinical practice in psychiatric clinics in Germany]. DER NERVENARZT 2020; 91:642-650. [PMID: 31463534 DOI: 10.1007/s00115-019-0782-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Exercise therapy has proven to be effective in the treatment of multiple mental illnesses. As mental disorders result in tremendous costs for the healthcare system as well as a huge burden for the affected individuals, improving treatment strategies according to latest scientific evidence should be of highest priority. In 2016 a first study provided indications that only a minority of patients are treated with exercise therapy during their stay in hospital. Hence, the aim of this study was to assess the actual extent of exercise therapy usage in psychiatric inpatients in Germany, thereby giving a scientific foundation to the call for a better standard of care. To achieve this, a retrospective analysis was performed on pre-existing data from 2693 patients who were treated in 1 of 4 participating university hospitals. Only 23% of these patients participated in exercise therapy with a mean training duration of 36 min per week. Patients with the diagnosis of schizophrenia or patients with multiple comorbidities were even less likely to participate in exercise therapy. With these findings it becomes evident that the healthcare situation concerning exercise therapy is insufficient. Solid evidence for the effectiveness of exercise therapy, the current treatment guidelines as well as the positive side effects, especially when compared to side effects of pharmacotherapy (i.e. weight gain) should motivate healthcare officials to make an effort to improve this situation.
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11
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Gerber M, Imboden C, Beck J, Brand S, Colledge F, Eckert A, Holsboer-Trachsler E, Pühse U, Hatzinger M. Effects of Aerobic Exercise on Cortisol Stress Reactivity in Response to the Trier Social Stress Test in Inpatients with Major Depressive Disorders: A Randomized Controlled Trial. J Clin Med 2020; 9:E1419. [PMID: 32403243 PMCID: PMC7291068 DOI: 10.3390/jcm9051419] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/30/2020] [Accepted: 05/05/2020] [Indexed: 12/01/2022] Open
Abstract
Physical activity is associated with a favourable (blunted) cortisol stress reactivity in healthy people. However, evidence from experimental study and with psychiatric patients is missing. This study examines whether exercise training impacts on cortisol stress reactivity in inpatients with major depressive disorder (MDD). These new insights are important because the stress reactivity of healthy people and patients with severe symptoms of depression might differ. Methods: The study was designed as a randomized controlled trial (trial registration number: NCT02679053). In total, 25 patients (13 women, 12 men, mean age: 38.1 12.0 years) completed a laboratory stressor task before and after a six-week intervention period. Nine samples of salivary free cortisol were taken before and after the Trier social stress test (TSST). Fourteen participants took part in six weeks of aerobic exercise training, while 11 patients were allocated to the control condition. While the primary outcome of the study was depressive symptom severity, the focus of this paper is on one of the secondary outcomes (cortisol reactivity during the TSST). The impact of aerobic exercise training was examined with a repeated-measures analysis of variance. We also examined the association between change in depression and cortisol response via correlational analysis. Cortisol reactivity did not change from baseline to post-intervention, either in the intervention or the control group. Participation in six weeks of aerobic exercise training was not associated with participants' cortisol reactivity. Moreover, depressive symptom change was not associated with change in cortisol response. Aerobic exercise training was not associated with patients' stress reactivity in this study. Because many patients initially showed a relatively flat/blunted cortisol response curve, efforts might be needed to find out which treatments are most efficient to promote a normalization of HPA axis reactivity.
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Affiliation(s)
- Markus Gerber
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, CH-4052 Basel, Switzerland; (S.B.); (F.C.); (U.P.)
| | - Christian Imboden
- Psychiatric Services Solothurn, 4503 Solothurn, Switzerland; (C.I.); (M.H.)
- Private Clinic Wyss, 3053 Muenchenbuchsee, Switzerland
| | | | - Serge Brand
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, CH-4052 Basel, Switzerland; (S.B.); (F.C.); (U.P.)
- University Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders, University of Basel, 4002 Basel, Switzerland;
- Substance Abuse Prevention Research Center and Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Flora Colledge
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, CH-4052 Basel, Switzerland; (S.B.); (F.C.); (U.P.)
| | - Anne Eckert
- University Psychiatric Clinics (UPK), Neurobiology Laboratory for Brain Aging and Mental Health, University of Basel, 4002 Basel, Switzerland;
| | - Edith Holsboer-Trachsler
- University Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders, University of Basel, 4002 Basel, Switzerland;
| | - Uwe Pühse
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, CH-4052 Basel, Switzerland; (S.B.); (F.C.); (U.P.)
| | - Martin Hatzinger
- Psychiatric Services Solothurn, 4503 Solothurn, Switzerland; (C.I.); (M.H.)
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12
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Ströhle A. Sports psychiatry: mental health and mental disorders in athletes and exercise treatment of mental disorders. Eur Arch Psychiatry Clin Neurosci 2019; 269:485-498. [PMID: 29564546 DOI: 10.1007/s00406-018-0891-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 03/19/2018] [Indexed: 12/11/2022]
Abstract
Sports psychiatry has developed for the past 3 decades as an emerging field within psychiatry and sports medicine. An International society has been established in 1994 and also national interest groups were implemented, mostly within the national organizations for psychiatry, some also containing the topic of exercise treatment of mental disorders. Where are we now 30 years later? We systematically but also selectively review the medical literature on exercise, sport, psychiatry, mental health and mental disorders and related topics. The number of publications in the field has increased exponentially. Most topics keep remaining on the agenda, e.g., head trauma and concussion, drug abuse and doping, performance enhancement, overtraining, ADHD or eating disorders. Supported by the growing literature, evidence-based recommendations have become available now in many clinical areas. A relatively new phenomenon is muscle dysmorphia, observed in weightlifters, bodybuilders but also in college students and gym users. Further, sports therapy of mental disorders has been studied by more and more high-quality randomized controlled clinical trials. Mostly as a complementary treatment, however, for some disorders already with a 1a evidence level, e.g., depression, dementia or MCI but also post-traumatic stress disorder. Being grown up and accepted nowadays, sports psychiatry still represents a fast-developing field. The reverse side of the coin, sport therapy of mental disorders has received a scientific basis now. Who else than sports psychiatry could advance sport therapy of mental disorders? We need this enthusiasm for sports and psychiatry for our patients with mental disorders and it is time now for a broadening of the scope. Optimized psychiatric prevention and treatment of athletes and ideal sport-related support for individuals with mental disorders should be our main purpose and goal.
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Affiliation(s)
- Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany.
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13
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Brand S, Colledge F, Ludyga S, Emmenegger R, Kalak N, Sadeghi Bahmani D, Holsboer-Trachsler E, Pühse U, Gerber M. Acute Bouts of Exercising Improved Mood, Rumination and Social Interaction in Inpatients With Mental Disorders. Front Psychol 2018; 9:249. [PMID: 29593592 PMCID: PMC5859016 DOI: 10.3389/fpsyg.2018.00249] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 02/15/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Studies at the macro level (such as longer-term interventions) showed that physical activity impacts positively on cognitive-emotional processes of patients with mental disorders. However, research focusing on the immediate impact of acute bouts of exercise (micro level) are missing. The aim of the present study was therefore to investigate whether and to what extent single bouts of moderately intense exercise can influence dimensions of psychological functioning in inpatients with mental disorders. Method: 129 inpatients (mean age: 38.16 years; 50.4% females) took part and completed a questionnaire both immediately before and immediately after exercising. Thirty inpatients completed the questionnaires a second time in the same week. The questionnaire covered socio-demographic and illness-related information. Further, the questionnaire asked about current psychological states such as mood, rumination, social interactions, and attention, tiredness, and physical strengths as a proxy of physiological states. Results: Psychological states improved from pre- to post-session. Improvements were observed for mood, social interactions, attention, and physical strengths. Likewise, rumination and tiredness decreased. Mood, rumination, and tiredness further improved, when patients completed the questionnaires the second time in the same week. Conclusion: At micro level, single bouts of exercise impacted positively on cognitive-emotional processes such as mood, rumination, attention and social interactions, and physiological states of tiredness and physical strengths among inpatients with mental disorders. In addition, further improvements were observed, if patients participated in physical activities a second time.
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Affiliation(s)
- Serge Brand
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics, University of Basel, Basel, Switzerland
- Substance Abuse Prevention Research Center and Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Flora Colledge
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Sebastian Ludyga
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Raphael Emmenegger
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Nadeem Kalak
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Dena Sadeghi Bahmani
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics, University of Basel, Basel, Switzerland
- Substance Abuse Prevention Research Center and Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Edith Holsboer-Trachsler
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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14
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Ehrbar J, Brand S, Colledge F, Donath L, Egger ST, Hatzinger M, Holsboer-Trachsler E, Imboden C, Schweinfurth N, Vetter S, Gerber M. Psychiatric In-Patients Are More Likely to Meet Recommended Levels of Health-Enhancing Physical Activity If They Engage in Exercise and Sport Therapy Programs. Front Psychiatry 2018; 9:322. [PMID: 30079036 PMCID: PMC6062635 DOI: 10.3389/fpsyt.2018.00322] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 06/29/2018] [Indexed: 11/26/2022] Open
Abstract
Background: People with mental disorders engage in sedentary behaviors more often than their healthy counterparts. In Switzerland, nearly all psychiatric hospitals offer structured exercise and sport therapy as part of their standard therapeutic treatment. However, little is known about the degree to which psychiatric patients make use of these treatment offers. The aim of this study is to examine, in a sample of psychiatric in-patients (a) how many participate in the structured exercise and sport therapy programs offered by the clinic, (b) how many engage in exercise and sport activities on an individual basis, and (c) how many meet recommended levels of health-enhancing physical activity during their stay at the clinic. Furthermore, we examine whether those who engage in exercise and sport activities are more likely to meet internationally accepted physical activity recommendations. Methods: 107 psychiatric in-patients (49% women, Mage = 39.9 years) were recruited at three psychiatric clinics in the German-speaking part of Switzerland. All participants were engaged in treatment and received usual care. Based on accelerometer data, participants were classified as either meeting or not meeting physical activity recommendations (≥150 min of moderate-to-vigorous physical activity per week). Participation in structured and individually performed exercise and sport activities was assessed with the Simple Physical Activity Questionnaire. Results: In total, 57% of all patients met physical activity recommendations. 55% participated in structured exercise and sport therapy activities, whereas only 22% of all patients engaged in exercise and sport activities independently. Psychiatric patients were significantly more likely to meet recommended levels of health-enhancing physical activity if they engaged in at least 60 min per week of structured exercise and sport therapy or in at least 30 min of individually performed exercise and sport activity. Conclusions: Given that prolonged immobilization and sedentary behavior have harmful effects on patients' physical and mental well-being, promoting exercise and sport activities is an important endeavor in psychiatric care. Clinics currently succeed in involving between 50 and 60% of all patients in sufficient physical activity. While this is encouraging, more systematic efforts are needed to ensure that all patients get enough physical activity.
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Affiliation(s)
- Janine Ehrbar
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Serge Brand
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.,Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, Basel, Switzerland.,Substance Abuse Prevention Research Center and Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Flora Colledge
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Lars Donath
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.,Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| | - Stephan T Egger
- Center for Integrative Psychiatry, Psychiatric Clinics of the University of Zürich, Rheinau, Switzerland
| | | | - Edith Holsboer-Trachsler
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, Basel, Switzerland
| | - Christian Imboden
- Psychiatric Services Solothurn, Solothurn, Switzerland.,Private Clinic Wyss, Münchenbuchsee, Switzerland
| | - Nina Schweinfurth
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, Basel, Switzerland
| | - Stefan Vetter
- Center for Integrative Psychiatry, Psychiatric Clinics of the University of Zürich, Rheinau, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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15
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Gerber M, Holsboer-Trachsler E, Pühse U, Brand S. Exercise is medicine for patients with major depressive disorders: but only if the "pill" is taken! Neuropsychiatr Dis Treat 2016; 12:1977-81. [PMID: 27540294 PMCID: PMC4981216 DOI: 10.2147/ndt.s110656] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Major depressive disorders (MDDs) are a widespread and burdensome mental illness associated with a high comorbidity with other conditions and a significantly reduced life expectancy compared to the general population. Therefore, targeted actions are needed to improve physical health in people with MDDs, in addition to ongoing efforts to enhance psychological well-being. Meanwhile, the positive effects of exercise training on the treatment of MDDs are well documented, while compelling evidence exists that exercise interventions can improve cardiorespiratory fitness in clinically meaningful ways. On the flipside, the long-term effects of exercise therapy are still not well documented, and recent studies suggest that initial improvements in MDDs dissipate if regular exercise participation is discontinued after the end of interventions. A recent survey among Swiss psychiatric hospitals further shows that all institutions provide some form of physical activity and exercise program. However, only a limited number of patients participate in these programs, mainly because participation is voluntary and no particular efforts are undertaken to engage patients with the lowest physical activity levels. We argue that more systematic efforts are needed to fully exploit the potential of physical activity and exercise programs in psychiatric care. We also emphasize that initiating and maintaining regular physical activity among psychiatric patients is a major challenge because specific dysfunctional cognitive-emotional processes might interfere with their capacity to self-regulate health-related behaviors. Specifically, we claim that behavioral skill training should be used to support patients with MDDs in overcoming barriers to initiating and maintaining physical activity. Moreover, we suggest that the assessment of physical activity and cardiorespiratory fitness should become routine in psychiatric practice.
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Affiliation(s)
- Markus Gerber
- Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, University of Basel
| | - Edith Holsboer-Trachsler
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel
| | - Uwe Pühse
- Department of Sport, Exercise and Health, Division of Sport and Health Pedagogy, University of Basel, Basel, Switzerland
| | - Serge Brand
- Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, University of Basel; Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel
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