New guidelines from the European Psychiatric Association (EPA) recommend that a regime of structured exercise should be added to standard medication and psychotherapy for the management of severe mental illness (SMI).
The guidance, published in European Psychiatry, advise that physical activity should be used as a treatment for mild-moderate depression to improve symptoms and physical fitness and should also be used to improve physical health in people with SMI. Furthermore, the EPA states, exercise should be utilised as an adjunctive treatment for schizophrenia-spectrum disorders, to improve symptoms, cognition and quality of life. It recommends that people with SMI should be screened for physical activity habits in primary and secondary care.
Based on a review of existing evidence, the EPA supports the use of aerobic exercise of moderate-vigorous intensity at a frequency of two to three times per week, ideally supervised by qualified professionals and achieving 150 minutes of moderate-to-vigorous physical activity (MVPA) per week in order to improve outcomes in people with major depressive disorder and schizophrenia-spectrum disorders.
The review found the evidence for use of exercise in patients with bipolar disorder (BD) is promising but is limited by the paucity of studies. Hence, no specific recommendations are made for patients with BD.