Exercise Decreases Suicide Attempts in Those With Mental and Physical Illness

Summary: Engaging in an exercise program reduced suicidal thoughts and actions in patients with mental and physical health problems who previously had suicidal ideations.

Source: University of Ottawa

A new study from the University of Ottawa’s Faculty of Medicine found patients with mental or physical illness were able to successfully adhere to exercise regimes despite previous thinking, resulting in decreased suicide attempts.

The findings cast doubt on the misconception that patients suffering from mental or physical illness are not motivated to participate in a physical exercise regime, which has similar efficacy to antidepressants and cognitive behavioural therapy in the treatment of depression. It’s effect on suicidal behaviors, however, was unclear.

This shows two ladies exercising
A new study from the University of Ottawa’s Faculty of Medicine found patients with mental or physical illness were able to successfully adhere to exercise regimes despite previous thinking, resulting in decreased suicide attempts. Image is in the public domain

“This misconception has led to primary care providers under-prescribing exercise, resulting in further deterioration of patients’ mental and physical health,” says Dr. Nicholas Fabiano, a psychiatry resident and lead author of the study with medical student Arnav Gupta.

“The findings of this study “debunk” this belief as exercise was well tolerated in those with mental or physical illness. Therefore, providers should not have apprehension about prescribing exercise to these patients.”

Under the supervision of Dr. Marco Solmi and Dr. Jess Feidorowicz from the Department of Psychiatry, Fabiano and Gupta evaluated 17 randomized control trials with over 1,000 participants to deduct their findings.

About this exercise and mental health research news

Author: Paul Logothetis
Source: University of Ottawa
Contact: Paul Logothetis – University of Ottawa
Image: The image is in the public domain

Original Research: Open access.
The effect of exercise on suicidal behaviors: A systematic review and meta-analysis of randomized controlled trials” by Nicholas Fabiano et al. Journal of Affective Disorders


Abstract

The effect of exercise on suicidal behaviors: A systematic review and meta-analysis of randomized controlled trials

Background

Although exercise may positively impact those with mental or other medical illnesses, there is a lack of understanding on how it influences suicidal ideation or risk.

Methods

We conducted a PRISMA 2020-compliant systematic review searching MEDLINE, EMBASE, Cochrane, and PsycINFO from inception to June 21, 2022. Randomized controlled trials (RCTs) investigating exercise and suicidal ideation in subject with mental or physical conditions were included. Random-effects meta-analysis was conducted. The primary outcome was suicidal ideation. We assessed bias of studies with risk of bias tool 2.

Results

We identified 17 RCTs encompassing 1021 participants. Depression was the most included condition (71 %, k = 12). Mean follow up was 10.0 weeks (SD = 5.2). Post-intervention suicidal ideation (SMD = -1.09, CI -3.08–0.90, p = 0.20, k = 5) was not significantly different between exercise and control groups. Suicide attempts were significantly reduced in participants randomized to exercise interventions as compared to inactive controls (OR = 0.23, CI 0.09–0.67, p= 0.04, k = 2). Fourteen studies (82 %) were at high risk of bias.

Limitations

This meta-analysis is limited by few, and underpowered and heterogenous studies.

Conclusion

Overall, our meta-analysis did not find a significant decrease in suicidal ideation or mortality between exercise and control groups. However, exercise did significantly decrease suicide attempts. Results should be considered preliminary, and more and larger studies assessing suicidality in RCTs testing exercise are needed.

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