PsychEd Episode 69: Exercise for Depression with Dr. Nicholas Fabiano

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers exercise as a treatment for depression.

Our guest for this episode is Dr. Nicholas Fabiano, a third-year psychiatry resident at the University of Ottawa. His research focuses on the overlap between mental and physical health, particularly lifestyle measures that can be used to improve mental health, including exercise, diet, and sleep.

The learning objectives for this episode are as follows:

1. Understand the evidence supporting the antidepressant effects of exercise 

2. Explore the mechanisms underlying the benefits of exercise

3. Learn how to prescribe exercise as a treatment for depression

4. Identify the risks and caveats of prescribing exercise for depression

   
   

Guest: Dr. Nicholas Fabiano (PGY3)

Hosts: Dr. Wendy MacMillan-Wang (PGY4) and Dr. Angad Singh (PGY1)

Audio Editing: Dr. Angad Singh (PGY1)

Timestamps:

(2:55) Origins of the interest in exercise

(6:22) Evidence of antidepressant effects

(14:05) Considerations in special populations

(18:00) Overlap of mental and physical health

(20:37) Mechanism of action

(26:18) Exercise prescription

(33:10) Exercise as addiction and self-harm

(36:42) Counselling and mitigating harm

(39:30) Combining with other lifestyle interventions

(41:41) Evidence for other mental illnesses

References:

Fabiano N, Gupta A, Fiedorowicz JG, Firth J, Stubbs B, Vancampfort D, Schuch FB, Carr LJ, Solmi M. The effect of exercise on suicidal ideation and behaviors: A systematic review and meta-analysis of randomized controlled trials. Journal of affective disorders. 2023 Jun 1;330:355-66.

Fabiano, N., Puder, D., & Stubbs, B. (2024). The evidence is clear, exercise is not better than antidepressants or therapy: it is crucial to communicate science honestly. Journal of Physical Activity and Health, 1(aop), 1-2.

Heissel, A., Heinen, D., Brokmeier, L. L., Skarabis, N., Kangas, M., Vancampfort, D., ... & Schuch, F. (2023). Exercise as medicine for depressive symptoms? A systematic review and meta-analysis with meta-regression. British journal of sports medicine, 57(16), 1049-1057.

Hird, E. J., Slanina-Davies, A., Lewis, G., Hamer, M., & Roiser, J. P. (2024). From movement to motivation: a proposed framework to understand the antidepressant effect of exercise. Translational Psychiatry, 14(1), 273.

Verhoeven, J. E., Han, L. K., Lever-van Milligen, B. A., Hu, M. X., Révész, D., Hoogendoorn, A. W., ... & Penninx, B. W. (2023). Antidepressants or running therapy: Comparing effects on mental and physical health in patients with depression and anxiety disorders. Journal of affective disorders, 329, 19-29.

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