[Physical training in the treatment of depressive disorders]

Therapeutic exercise programs have become an obligatory component in the modern treatment of many internal and orthopaedic conditions. In the field of psychiatry, the interaction of physical fitness and mental well-being has been increasingly recognized. In the meanwhile, solid evidence has emerged that regular exercise is associated with therapeutic effects in psychiatric patients suffering from depressive and possibly other psychiatric disorders. The present article reviews the relevant literature and summarizes neurobiological effects of exercise which might play a role in the effectiveness of therapeutic exercise. For instance, there is experimental evidence, that regular exercise induces a downregulation of central 5-HT(2C) receptors which play an important role in the pathogenesis of anxiety and depression. The production of brain-derived neurotrophic factor (BDNF)is stimulated in several brain regions. In conclusion, practical aspects and motivational factors have to be regarded in order to successfully establish exercise programs in the treatment of psychiatric disorders.