Exercise may reduce feelings of hopelessness in suicide crisis patients, pilot study finds

Exercise may reduce feelings of hopelessness in suicide crisis patients, pilot study finds

A new study published in the Psychiatric Research Journal found preliminary evidence that exercise can alleviate distress in patients in suicide crisis. Patients hospitalized in a short-stay psychiatric unit reported a decrease in their sense of hopelessness after participating in two days of 30 minutes of physical activity.

Short-stay psychiatric units (SSU) provide emergency care to people in mental health crisis. Offered in many developed countries, this brief hospitalization typically covers up to 72 hours of care with the goal of managing the patient’s suicidal behaviors, stabilizing their symptoms, and connecting them to a treatment plan. As psychiatric SSUs have increased in number, studies have emerged examining their safety and effectiveness.

Researchers Fabien D. Legrand and his team wanted to test the effects of exercise as an adjunct treatment for patients in a suicidal crisis in an SSU. Numerous studies have suggested that physical activity interventions can improve symptoms of distress in people with severe mental illness. But few controlled trials have explored the effects of exercise on suicidality, and no trials have been conducted in patients at high risk for USS.

“Overall, my field of scientific research concerns the evaluation of the effectiveness and safety of physical activity as an adjunct to medication and/or psychotherapy in people with mental health problems,” explained Legrand, lecturer in psychology at the University of Reims Champagne. Ardennes.

“The main reason for the research is that I have already read articles establishing the association between physical activity and reduced risk of hopelessness, depression and suicidal behavior (e.g. Taliaferro et al., 2010) . However, the association between two variables simply implies that knowledge of the value of one variable provides information about the value of the other. This does not necessarily imply that one causes the other.

“Establishing that physical activity has causal protective effects against hopelessness requires randomized experiments,” Legrand said. “We focused on hopelessness, as previous studies have identified it as the strongest predictor of suicide death (e.g., Ribeiro et al., 2018)”,

For their pilot study, Legrand and his colleagues conducted a randomized controlled trial with a sample of patients from a psychiatric SSU in the North-East of France. The patients were 12 women aged 18 to 65 who had recently attempted suicide and had suicidal thoughts or plans.

During an intake visit, participants completed self-report questionnaires measuring hopelessness – a strong predictor of suicide death, and optimism – a protective factor against suicide plans. Subjects were then randomly assigned to participate in two exercise sessions or two sedentary activity sessions over two days, as an add-on treatment to their usual therapy.

Patients in the exercise group participated in two 30-minute sessions of brisk walking/jogging in the park of the short-stay unit. Patients in the sedentary group engaged in two 30-minute sessions of alone time in their hospital room, where they participated in sedentary activities such as reading or playing games. After the intervention, participants again completed measures of hopelessness and optimism, then completed the Subjective Treatment Satisfaction Survey (STSS) to assess how satisfied they were with the intervention and the have found effective.

The results revealed that the patients who participated in the exercise sessions showed significant improvements in hopelessness after the intervention, unlike those who participated in the sedentary activities. Patients in both groups showed relatively stable optimism scores throughout the study.

The results provide evidence that “adding daily sessions (30 min) of moderate-intensity physical activity (brisk walking/jogging with heart rate maintained at 65% – 80% of age-predicted maximum heart rate ) to usual care in hospitalized suicidal patients may reduce hopelessness (and therefore suicide risk),” Legrand told PsyPost.

Notably, participants seemed generally satisfied with the program. Overall treatment satisfaction ratings were high and no serious adverse events were reported. The program also seemed feasible, with an eligibility rate of 74.5%, a retention rate of 75% and an enrollment rate of 80%.

“Perhaps our biggest surprise was how enthusiastic patients were about their daily exercise routine,” Legrand said.

The authors discuss several reasons why exercise sessions may have reduced patients’ hopelessness. First, the exercise intervention may have facilitated feelings of competence and autonomy, which may have helped improve patients’ symptoms. Alternatively, exercise may have served as endurance training, which has been shown to inspire physiological changes that may enhance the effects of medical treatments. Another possibility is that exercise sessions reduce fatigue and lack of energy, common symptoms of psychiatric sedatives.

Legrand and colleagues note that their study did not control for several confounding factors that may have affected the results. For example, patients who participated in the exercise sessions spent time off the unit and in a park. The presence of nature was found to provide psychological benefits, which may have played a role in improving symptoms among the exercise group. The researchers also stress that their results are only preliminary and that further studies will be needed to confirm their findings using a well-powered sample.

“This study should be considered a randomized pilot experiment; it is necessary to replicate the results of our study before a definitive conclusion can be drawn,” said Legrand.

The study, “Physical activity can reduce despair in women admitted to a psychiatric short-stay unit following a suicidal crisis”, was written by Fabien D. Legrand, Dany Lallement and Souhela Kasmi.

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