The Weekly Mind Reader: Exercise Versus Sedentary Lifestyle

by Liz Neporent
October 6, 2023 at 10:30 AM UTC

This week features a rare report of phentermine-induced tardive dyskinesia, research on suicide neural markers, and maternal mental health.

A recent paper in The Journal of Clinical Psychiatry’s Clinical and Practical Psychopharmacology column is a detailed retrospective about where the research on the health benefits of exercise and lifestyle stands. Among other things, the paper, written by Chittaranjan Andrade, MD, offers some compelling thoughts on the interplay between physical activity and sedentary behavior.

Exercise Versus Movement  

At first glance, the notion of being both active and sedentary may seem contradictory. Afterall, current Centers for Disease Control (CDC) exercise guidelines call for 150 minutes of moderate-intensity aerobic activity each week and two days of muscle strengthening. Most experts agree that meeting this threshold reaps numerous health benefits. Physically, it leads to improved cardiovascular health, stronger muscles and bones, and better weight management. Mentally, studies show that regular exercise can reduce symptoms of anxiety and depression, improve mood, and enhance cognitive function.

However, the modern lifestyle can chip away at these benefits. It’s entirely possible for someone to meet the recommended guidelines for physical activity, say by walking briskly for 30 minutes a day, yet still fall within the category of a sedentary lifestyle if they spend the majority of their day stuck to a desk, glued to a screen, or rooted to a couch. Evidence indicates that a sedentary lifestyle correlates with poorer health outcomes, irrespective of regular gym sessions. This underscores the limitations of exercise as a one-size-fits-all remedy for well-being.

Andrade’s perspective offered clinical psychiatrists a more complex understanding of how a patient spends their day might have an impact on their overall health. Simply advising them to get a bit of exercise isn’t necessarily sufficient. Clinicians also need to address the inactive habits that often accompany the average lifestyle. 

Providing Recommendations

What can clinicians suggest? For desk jockeys and gamers, recommend incorporating movement into their daily routines. Simple strategies like setting a timer to stand and stretch or walk around every 30 minutes can be effective. Additionally, using a standing desk or an ergonomic chair that encourages good posture can make a difference. Short, frequent movement breaks, such as doing a quick set of push-ups or squats, can also get the heart rate up and muscles engaged. 

The good news is that incremental changes can accumulate. Even just a slight uptick in daily movement can add up to better physical and mental well-being without requiring a significant time commitment.

Encouraging physical activity should be as much a part of medical practice as discouraging sedentary lifestyles. As Andrade writes, this balanced approach to patient care acknowledges the intricate interplay between the mind, body, and lifestyle, allowing for more comprehensive and effective treatment strategies.

IN OTHER PSYCHIATRY AND NEUROLOGY NEWS

  • In Phase 3 trials, the benefit-risk ratios for both lemborexant and daridorexant were favorable as measured by NNT, NNH, and LHH in insomnia disorder.  
  • PREDDICT trial showed improvements in measures of cognition clinically similar to findings of other studies on treatment of cognitive dysfunction with antidepressants, especially vortioxetine. However, there is no evidence the addition of celecoxib offers additional benefits. 
  • A fascinating new case study shed light on the manifestations and management of PANDAS in a teenager with treatment-resistant symptoms. While not a success story, it offered essential clinical guidance. 
  • More than 45 percent of adult patients with neurofibromatosis were diagnosed with at least one psychiatric comorbidity, such as a mood or anxiety disorder. 
  • Researchers identified a threefold increase in autism risk for boys whose mothers consumed the sugar substitute aspartame daily during pregnancy or breastfeeding.
  • Try something new, like following us on Meta Threads, @ClinicalPsychiatrist. Don’t miss any great content from our journals and news teams. 

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Original Research

Association of Suicidal Status, Inflammation Markers, and Resting-State Functional Activity and Connectivity in Patients With Major Depressive Disorder

Resting-state activity of the VLPFC was altered in suicide attempters, possibly contributing to language impairment and poor decision-making and cognitive control.

Emilie Olié and others

Case Report

A Rare Case of Phentermine-Related Tardive Dyskinesia

This report describes a patient prescribed phentermine for low energy and weight control, who subsequently developed tardive dyskinesia a month after starting the medication.

Pooja Prasad and others