Exercise for anxiety disorders: systematic review
- 1Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
- 2Department of Health Sciences, The University of York, York, UK
- 3Department of Liaison Psychiatry, Leeds Partnerships NHS Foundation Trust, Leeds, UK
- Correspondence to Dr Kaushadh Jayakody, Division of Applied Medicine (Psychiatry), University of Aberdeen, Royal Cornhill Hospital, Aberdeen, AB25 2ZH, Scotland;
- Received 6 May 2012
- Revised 17 November 2012
- Accepted 21 November 2012
- Published Online First 7 January 2013
Background Anxiety disorders are commonly treated with antidepressants and psychological treatments. Some patients may prefer alternative approaches such as exercise.
Objective To investigate the treatment effects of exercise compared with other treatments for anxiety disorders.
Data sources Randomised controlled trials (RCTs) of exercise interventions for anxiety disorders were identified by searching six online databases (July 2011). A number of journals were also hand searched.
Main results Eight RCTs were included. For panic disorder: exercise appears to reduce anxiety symptoms but it is less effective than antidepressant medication (1 RCT); exercise combined with antidepressant medication improves the Clinical Global Impression outcomes (1 RCT, p<0.05); exercise combined with occupational therapy and lifestyle changes reduces Beck Anxiety Inventory outcomes (1 RCT, p=0.0002). For social phobias, added benefits of exercise when combined with group cognitive behavioural therapy (CBT) were shown (p<0.05). There was no significant difference between aerobic and anaerobic exercise groups (1 RCT, p>0.1) with both seeming to reduce anxiety symptoms (1 RCT, p<0.001). It remains unclear as to which type of exercise; moderate to hard or very light to light, is more effective in anxiety reduction (2 RCTs).
Conclusions Exercise seems to be effective as an adjunctive treatment for anxiety disorders but it is less effective compared with antidepressant treatment. Both aerobic and non-aerobic exercise seems to reduce anxiety symptoms. Social phobics may benefit from exercise when combined with group CBT. Further well-conducted RCTs are needed.