In Reply

Letters to the Editor regarding the article Resistance Training in Depression by Noah Augustin, M. Sc., Dr. rer. medic. Antonia Bendau, Selina Heuer, M. Sc., Jan Kaminski, M. Sc., and Prof. Dr. med. Andreas Ströhle in issue 45/2023

We thank Prof. Freund and Prof. Gehring for their correspondence. In our clinical practice we certainly experience the challenge of persuading severely ill patients to access exercise therapy on a daily basis. We already count on a a search+motivate therapeutic approach: brief introductory chats, a collection service from the inpatient setting, transition services from the inpatient into the outpatient setting, and the common start using individual appointments. During inpatient equivalent treatment, exercise therapy has become firmly established and now, as a result of “searching” measures, it has become effectively implemented in the living environment of severely ill persons. We recently studied the great variability in the provision and utilization of exercise and sports therapy in German university hospitals (1). It transpired that the utilization of exercise and sports therapies strongly depends on what is on offer. Activities at different levels are needed in order to make more use of the therapeutic options of exercise and sports therapy in the treatment of mental disorders. Short programs to promote motivation and volition, for example, are effective even in patients with mental disorders (2). Routine capture and documentation of each activity in the sense of “duration of moderate to intensive physical activity per week” (recommended is a minimum of 150 min/week) in routine clinical practice (3) explains the need, enables simple change measurements, and can contribute to increasing the activity.

Treating physicians, affected persons, but also society struggle to leave behind the traditional medical concept of primarily pharmacological treatment. We therefore welcome and support the decision of the G-BA, but we do also see the risk that resources may again be unevenly distributed.

DOI: 10.3238/arztebl.m2024.0023

On behalf of the authors

Prof. Dr. med. Andreas Ströhle

Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte

Charité – Universitätsmedizin Berlin

Conflict of interest statement

The authors of both contributions declare that no conflict of interest exists.

References

1. Brehm K, Dallmann P, Freyer T, et al.: [Implementation of exercise therapy in daily clinical practice in psychiatric clinics in Germany]. Nervenarzt 2020; 91: 642–50

2. Petzold MB, Mumm JLM, Bischoff S, et al.: Increasing physical activity and healthy diet in outpatients with mental disorders: a randomized-controlled evaluation of two psychological interventions. Eur Arch Psychiatry Clin Neurosci 2019; 269: 529–42

3. Roempler J, Petzold MB, Bendau A, Plag J, Ströhle A: Tracking changes in physical activity during inpatient treatment in a psychiatric clinic in Germany by asking two simple questions. Eur Arch Psychiatry Clin Neurosci 2023; 273: 983–94

4. Augustin N, Bendau A, Heuer S, Kaminski J, Ströhle A: Resistance training in depression. Dtsch Arztebl Int 2023; 120: 757–62.