[Is Physical Activity a Treatment Option for ADHD?]

Is Physical Activity a Treatment Option for ADHD? Abstract: Physical activity as an option for the prevention and treatment of psychiatric disorders is increasingly becoming the focus of research. In particular, because of improvements in cognitive functioning, attentional performance, impulsivity, and hyperactivity, physical exercise could be a promising treatment option for attention deficit hyperactivity disorder (ADHD). In this narrative review, we present and evaluate the current state of research on exercise effects in children and adolescents as well as in adults with ADHD. While studies of the short-term effects of a single bout of physical activity indicate robust effects on attention and inhibitory control, results on the impact on further symptoms of ADHD as well as in adults are mixed. Randomized controlled trials of longer-term physical activity are scarce and show high heterogeneity. Nevertheless, they are encouraging for further research in this area.

[Movement as a Neuromodulator: How Physical Activity Influences the Physiology of Adolescent Depression]

Movement as a Neuromodulator: How Physical Activity Influences the Physiology of Adolescent Depression Abstract: In the context of adolescent depression, physical activity is becoming increasingly recognized for its positive effects on neuropathology. Current scientific findings indicate that physical training affects the biological effects of depression during adolescence. Yet the pathophysiology of adolescent depression is not yet fully understood. Besides psychosocial and genetic influences, various neurobiological factors are being discussed. One explanation model describes a dysfunction of the hypothalamus-pituitary-adrenal axis (HPA axis) with a sustained elevation in cortisol concentration. Recent studies highlight neuroimmunological processes and a reduced concentration of growth factors as causative factors. These changes appear to lead to a dysregulation of the excitation and inhibition balance of the cerebral cortex as well as to cerebral morphological alterations. Regular physical training can potentially counteract the dysregulation of the HPA axis and normalize cortisol levels. The release of proinflammatory cytokines is inhibited, and the expression of growth factors involved in adult neurogenesis is stimulated. One should ensure the synergistic interaction of biological and psychosocial factors when designing the exercise schedule (endurance or strength training, group or individual sports, frequency, duration, and intensity). Addressing these open questions is essential when integrating physical activity into the guidelines for treating depressive disorders in children and adolescents.

[Physical Activity in the Prevention and Treatment of Eating Disorders]

Physical Activity in the Prevention and Treatment of Eating Disorders Abstract. On the one hand, excessive or insufficient physical activity is a phenomenological feature and an important etiological factor in eating disorders. On the other hand, healthy and adaptive physical activity has the potential to support the effectiveness of preventive and therapeutic interventions for eating disorders. Research findings confirm the usefulness of interventions focusing on physical activity as an add-on to psychotherapy. Professionally planned and accompanied interventions of this kind are not counterproductive or dangerous but can have a positive effect on the treatment outcome. The current state of research allows a preliminary formulation of guidelines to embed physical activity interventions into evidence-based treatment approaches. The focus of such interventions lies on the reduction of unhealthy, excessive physical activity and the promotion of flexible physical activity.

COVID-19: Effects of Pandemic Related Restrictions on Physical Activity, Screen Time, and Mental Well-being in German adolescents

Objective: To describe the impact of the COVID-19 pandemic-related restrictions (PR) in April and May 2020 on physical activity (PA), sedentary screen time (SST), and mental well-being (MWB) in German adolescents, and to analyze associations between these variables. Methods: The Münster District Government invited all secondary school students (aged 11-17) in the region to take part in the online survey that assessed PA, SST, and MWB. For data analysis, we calculated descriptive statistics and ran linear regression analysis. Results: 1,038 students (627 [60.4%] female; 14.18 [± 1.97] years) were included in the analysis. During the PR, a marked decline in overall PA (p < .001) and a significant increase (p < .001) in SST were observed. One-third of the students reported worrying more and being less satisfied with their lives since PR. A decrease in life satisfaction (ß = -.524, p < .001) as well as an increase in general worrying (ß = -.336, p = .015) were associated with a decrease in PA during PR. Conclusion: The results show that the restrictions led to a decrease in physical activity, which may have detrimental effects on the students' mental and physical health.

[Enjoying Sports and Movement in Mental Illness]

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.

Age-Dependency of Cardiometabolic Risk and Protective Factors in Females Living in a Countryside Area of Switzerland

We investigated the effect of age on cardiometabolic risk and protective factors in females living in a countryside area of Switzerland. For this cross-sectional analysis, data from 268 female adults, who live in two neighboring countryside villages in Italian-speaking Switzerland were retained. 89 study participants were premenopausal, 82 climacteric and 97 postmenopausal. Television viewing time, short duration of sleep, overweight, blood pressure, levels of atherogenic lipids and glycated hemoglobin significantly increased with age. Walking time also significantly increased with age. Tobacco smoking was more common among premenopausal women. It is concluded that in these countryside villages climacteric and postmenopausal women generally have an unfavorable cardiometabolic risk profile. On the other side, low physical activity and smoking are, compared to premenopausal and climacteric women, less prevalent in postmenopausal women.

[Risk-taking Behaviour and Aspects on Adolescents' Participation in High-risk Sports]

Risk-taking Behaviour and Aspects on Adolescents' Participation in High-risk Sports The age of adolescence represents an enhanced reward sensitivity which is often linked to increased risk-taking behaviour. Peers enhance risk-taking behaviour which is shown through delinquency and substance use. Whereas most research on adolescent risk-taking has been directed towards negative risk-taking, this narrative review tries to highlight adventure and high-risk sport participation as a prosocial form of risk-taking and its potential influence on adolescents' behaviour. Adventure/high-risk sports such as mountainbiking, freeride ski and snowboarding and climbing have grown exponentially in the last years with a high popularity among adolescents. Besides the inherent risk of severe injury in case of a mismanaged accident, which should be minimized by preventive steps such as educative risk-management and protective gear, those sports bear the potential for multiple psychological benefits such as enhanced mood, autonomy, resilience and self-efficacy. Adventure/high-risk sports seem to have the possibility to satisfy the need for rewards, prestige and risk-taking in a socially accepted way. Few research projects have already successfully integrated adventure sport interventions in clinical settings in mental health treatment. The idea of testing adventure/high-risk sport interventions as an addition to the treatment in child and adolescent psychiatry and psychotherapy could be promising and an impulse for future research projects.

[Sleep and Psychological Functioning of Children and Adolescents - a Narrative Review]

Sleep and Psychological Functioning of Children and Adolescents - a Narrative Review Children and adolescents need sufficient and restoring sleep to improve their cognitive, emotional, social and behavioral performance. The present narrative review describes the associations between children's and adolescents' sleep patterns and a broad variety of topics; these topics were chosen at the authors' discretion and does not claim to be exhaustive. After a short introduction, we describe the associations between (adolescent) children's sleep in tight relation to the family functioning. Specifically, (adolescent) children's sleep and psychological functioning appears to be related to mothers' sleep and psychological functioning. Findings from longitudinal studies are reported, which underline that poor sleep at childhood increases the risk of poor sleep and somatic and psychological health issues later in life. Excessive screen time in the evening increases the risk of shorter sleep duration and increased daytime sleepiness; on the flip side, it also appears the excessive screen time might be a coping strategy to deal with symptoms of anxiety; further, using social media in the evening seems to be associated with the adolescents' need to stay in touch with their peers. While physical inactivity and sedentary behavior is a serious health concern, in children and adolescents, regular physical activity is associated with improved subjective and objective sleep and a broad variety of psychological health outcomes. Further selective topics are: While children and adolescents with repaired cleft did not show disadvantages in their sleep and psychological functioning compared to their counterparts without clefts, at the age of seven to nine years, very preterm children show unfavorable sleep patterns and psychological functioning, compared to typically developing children.

Physical Activity Is an Opportunity for the Health of Nations: What Should We Do Next?

Physical activity provides huge opportunities for the health of nations. Understanding this, the World Health Organization has published a Global Action Plan which aims to provide member states with a framework for action, namely to create active societies, people, environments and systems. The target is set at a 15 % reduction in physical inactivity levels by 2030. We explore in this paper some of the challenges and opportunities that come with it, and give the practitioner some real-world opportunities for relevant action at the local level, as well as for their patients, staying true to the Physician's Pledge (Declaration of Geneva): "I will attend to my own health, well-being, and abilities in order to provide care of the highest standard."

[Cardiac Rehabilitation 2015]

The goals of cardiac rehabilitation are (re-)conditioning and secondary prevention in patients with heart disease or an elevated cardiovascular risk profile. Rehabilitation is based on motivation through education, on adapted physical activity, instruction of relaxation techniques, psychological support and optimized medication. It is performed preferably in groups either in outpatient or inpatient settings. The Swiss working group on cardiac rehabilitation provides a network of institutions with regular quality auditing. Positive effects of rehabilitation programs on mortality and morbidity have been established by numerous studies. Although a majority of patients after cardiac surgery are being referred to rehabilitation, these services are notoriously underused after catheter procedures.

[Sport, is it really so good for health?]

Physical activity is necessary for life and is one of the greatest opportunities to improve the health of populations, although it is sometimes mixed up with sports which can cause injuries or acute cardiac events. Nevertheless, some sedentaries can present with metabolic adverse responses after initiation of a well-planned, health-enhancing physical activity program. This sort of exercise intolerance has some genetic roots and does not necessarily imply that all physical activity should be stopped, but rather must be considered as a side effect of therapy that needs optimizing. Individualization of exercise prescription will always consider follow-up and has to be dynamic according to observations made with the patient.