Download PDF
Psychiatr Prax 2007; 34: S300-S304
DOI: 10.1055/s-2007-970948
Nicht medikamentöse Behandlung
© Georg Thieme Verlag KG Stuttgart · New York

Körperliches Training in der Behandlung depressiver Erkrankungen

Physical Training in the Treatment of Depressive DisordersAndreas  Broocks1 , Uwe  Ahrendt1 , Marcel  Sommer1
  • 1Carl-Friedrich-Flemming-Klinik, HELIOS-Kliniken Schwerin
Further Information

Publication History

Publication Date:
20 November 2007 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Sport und Bewegung bilden bei einer Vielzahl von internistischen und orthopädischen Erkrankungen heute einen unverzichtbaren Bestandteil etablierter Behandlungsprogramme. Im psychiatrisch-psychosomatischen Bereich wurde die Bedeutung der körperlichen Fitness für das psychische Befinden zunehmend erkannt, und insbesondere für depressive Erkrankungen konnte bewiesen werden, dass die Symptomatik über ausreichend intensive körperliche Aktivität signifikant beeinflusst werden kann. Die Mehrzahl der kontrollierten Studien verwendete Ausdauertraining, in einigen Studien zeigte Krafttraining aber vergleichbare Effekte. Neben psychologischen Wirkmechanismen wie Abnahme von Vermeidungsverhalten, Verbesserung von Selbstbewusstsein, Eigeninitiative und die Veränderung von dysfunktionalen Kognitionen spielen auch neurobiologische Adaptationsprozesse eine wichtige Rolle (serotonerge Rezeptoren, neurotrope Faktoren). Individuelle Anleitung und kontinuierliche Motivationsarbeit sind eine entscheidende Voraussetzung für den Erfolg sporttherapeutischer Maßnahmen. Abschließend werden daher Empfehlungen für die praktische Anwendung sporttherapeutischer Maßnahmen gegeben.

Abstract

Therapeutic exercise programs have become an obligatory component in the modern treatment of many internal and orthodpaedic conditions. In the field of psychiatry, the interaction of physical fitness and mental well-being has been increasingly recognized. In the meanwhile, solid evidence has emerged that regular exercise is associated with therapeutic effects in psychiatric patients suffering from depressive and possibly other psychiatric disorders. The present article reviews the relevant literature and summarizes neurobiological effects of exercise which might play a role in the effectiveness of therapeutic exercise. For instance, there is experimental evidence, that regular exercise induces a downregulation of central 5-HT2C receptors which play an important role in the pathogenesis of anxiety and depression. The production of brain-derived neurotrophic factor (BDNF)is stimulated in several brain regions. In conclusion, practical aspects and motivational factors have to be regarded in order to successfully establish exercise programs in the treatment of psychiatric disorders.

Schlüsselwörter

Sport - Depression

Key words

exercise - major depression

Literatur

  • 1 Reimers C, Broocks A. Neurologie, Psychiatrie und Sport. Stuttgart; Thieme 2003
    Google Scholar
  • 2 Farmer M E, Locke B Z, Moscicki E K, Dannenberg A L, Larson D B, Radloff L S. Physical activity and depressive symptoms: the NHANES I epidemiological follow-up study.  Am J Epidemiol. 1988;  128 (6) 1340-1351
    Google Scholar
  • 3 Kirkcaldy B D, Shephard R J, Siefen R G. The relationship between physical activity and self-image and problem behaviour among adolescents.  Soc Psychiatry Psychiatr Epidemiol. 2002;  37 544-550
    Google Scholar
  • 4 Kaiya H, Umekage T, Harada S I, Okazaki Y, Sasaki T. Factors associated with the development of panic attacks and panic disorder: Survey in the Japanese population.  Psychiatry and Clinical Neurosciences. 2005;  59 177-182
    Google Scholar
  • 5 Ruuskanen J M, Ruoppila I. Physical activity and psychological well-being among people aged 65 to 84 years.  Age Ageing. 1995;  24 (4) 292-296
    PubMedGoogle Scholar
  • 6 Netz Y, Jacob T. Exercise and the psychological state of institutionalized elderly: a review.  Percept Mot Skills. 1994;  79 1107-1118
    PubMedGoogle Scholar
  • 7 Steptoe A, Edwards S, Moses J, Mathews A. The effects of exercise training on mood and perceived coping ability in anxious adults from the general population.  J Psychosom Res. 1989;  33 537-547
    CrossrefPubMedGoogle Scholar
  • 8 Pappas G P, Golin S, Meyer D L. Reducing symptoms of depression with exercise.  Psychosom. 1990;  31 112-113
    PubMedGoogle Scholar
  • 9 Greist J H, Klein M H, Eischens R R, Faris J, Gurman A S, Morgan W P. Running as treatment for depression.  Compr Psychiat. 1979;  20 41-54
    CrossrefPubMedGoogle Scholar
  • 10 McCann I L, Holmes D S. Influence of aerobic exercise on depression.  J Personality und Social Psychology. 1984;  46 1142-1147
    PubMedGoogle Scholar
  • 11 Martinsen E W, Medhus A, Sandvik L. Effects of aerobic exercise on depression: a controlled study.  Brit Med J. 1985;  291 109
    Google Scholar
  • 12 Martinsen E W, Hoffart A, Solberg O. Comparing aerobic with anaerobic forms of exercise in the treatment of clinical depression: a randomized trial.  Comprehensive Psychiatry. 1989;  30 (4) 324-331
    Google Scholar
  • 13 Doyne E J, Ossip-Klein D J, Bowman E D, Osborn K M, McDougall-Wilson I B, Neimeyer R A. Running versus weightlifting in the treatment of depression.  J Consult Clin Psychol. 1987;  55 (5) 748-754
    Google Scholar
  • 14 Blumenthal J A, Babyak M A, Moore K A. et al . Effects of exercise training on older patients with major depression.  Arch Intern Med. 1999;  159 (19) 2349-2356
    Google Scholar
  • 15 Babyak M, Blumenthal J, Herman S. Exercise Treatment for major depression: maintenance of therapeutic benefit over 10 months.  Psychosom Med. 2000;  62 (5) 633-638
    Google Scholar
  • 16 Broocks A, Bandelow B, Pekrun G. et al . Comparison of aerobic exercise, clomipramine, and placebo in the treatment of panic disorder.  Am J Psychiatry. 1998;  155 (5) 603-609
    Google Scholar
  • 17 Broocks A, Meyer T, George A. et al . Decreased neuroendocrine responses to meta-chlorophenylpiperazine (m-CPP) but normal responses to ipsapirone in marathon runners.  Neuropsychopharmacology. 1999;  20 150-161
    Google Scholar
  • 18 Fernstrom J D, Wurtman R J. Brain serotonin content: physiological dependence on plasma tryptophan levels.  Science. 1971;  173 149-152
    Google Scholar
  • 19 Wurtman R J, Fernstrom J D. Control of brain neurotransmitter synthesis by precursor availability and nutritional state.  Biochemical Pharmacology. 1976;  25 1691-1696
    Google Scholar
  • 20 Broocks A, Schweiger U, Pirke K M. The influence of semistarvation-induced hyperactivity on hypothalamic serotonin metabolism.  Physiol Behav. 1991;  50 (2) 385-388
    Google Scholar
  • 21 Meeusen R, Thorre K, Chaouloff F. et al . Effects of tryptophan and/or acute running on extracellular 5-HT and 5-HIAA levels in the hippocampus of food-deprived rats.  Brain Res. 1996;  740 (1 - 2) 245-252
    Google Scholar
  • 22 Morris M, Steinberg H, Sykes E A, Salmon P. Effects of temporary withdrawal from regular running.  J Psychosom Res. 1990;  34 (5) 493-500
    Google Scholar
  • 23 van Praag H M, Kempermann G, Gage F. Running increases cell proliferation and neurogenesis in the adult mouse dentate gyrus.  Nature Neuroscience. 1999;  2 266-270
    Google Scholar
  • 24 Paffenbarger R S, Hyde R T, Wing A L, Lee I M, Jung D L, Kampert J B. The association of changes in physical-activity level and other lifestyle characteristics with mortality among men.  N Engl J Med. 1993;  328 (8) 74-576
    PubMedGoogle Scholar
  • 25 Paffenbarger R J, Lee I M. Smoking, physical activity, and active life expectancy.  Clin J Sport Med. 1999;  9 (4) 244
    Google Scholar
  • 26 Miller W R, Rollnick S. Motivierende Gesprächsführung. Ein Konzept zur Beratung von Menschen mit Suchtproblemen. Freiburg; Lambertus 1999
    Google Scholar

Prof. Dr. med. Andreas Broocks

Helios-Kliniken Schwerin, Carl-Friedrich-Flemming-Klinik

Wismarsche Straße 393 - 397

19055 Schwerin

Email: abroocks@schwerin.helios-kliniken.de

      >