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Summary Physical activity and mental health - part of prof Vancamfort
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7 lessons given by prof Vancamfort, summarized in a nutshell
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InhoudOnderdeel Vancamfort...........................................................................................................................2
LES1: MH vs Mental disorder..............................................................................................................2
What is mental health?...................................................................................................................2
What is mental illnes?.....................................................................................................................3
LES2 : Assessing MH in a PT setting, why?........................................................................................10
Why assessing depression, axienty and self-efficacy levels in your PT practice?..........................10
How assessing depression, axiety and self-efficacy levels?...........................................................10
Why important to consider these MH issues when assessing PA?................................................14
How can we translate assessments of PA into person tailored feedback for regulating mood?. . .16
Why is it important to consider depression, anxiety and self-efficacy when assessing PA? What is
role of MH when doing pyscical fitness testing?...........................................................................17
LES3: What is the evidence for PA in the prevention and treatment of MH problems?....................22
Evidence for PA in prevention and treatment of depression.........................................................22
Evidence for PA in treatment of anxiety and stress-related disorders...........................................23
Evidence for PA in treatment of substance-use disorders.............................................................23
Evidence of PA in treatment of eating disorders...........................................................................24
Evidence for PA in treatment of ASS.............................................................................................24
Evidence for PA in treatment of ADHD..........................................................................................25
Evidence for PA in dementia.........................................................................................................25
LES4: Underlying mechanisms of mental health benefits of PA........................................................27
Psychosocial hypothesis................................................................................................................27
Behavioral hypothesis:..................................................................................................................28
Neurobiological hypothesis..........................................................................................................28
What are associations between MH and Pinactivity?.......................................................................31
LES5: How can we prescribe PA for people with mental health problems?......................................33
PA counseling: why is special attention towards people with MD needed?..................................33
How to provide physical activity counselling for people with mental health problems / mental
illness?..........................................................................................................................................34
LES6: How to prescribe PA for kinesiophobia?..................................................................................41
Kinesiophobia = fear of movement...............................................................................................41
Post-exertional malaise.................................................................................................................45
LES7: PA and eating disorders USE PPT............................................................................................50
1
,Onderdeel Vancamfort
LES1: MH vs Mental disorder
- Self efficacy: confidence you have to be able to complete a task
- Self concept: how you think about yourself
- Self esteem: how you feel about yourself
- Mental ilness when diagnosis, problems in daily functioning
- We all have mental problems, but it becomes a disorder when it interferes with your daily
functioning
- We need to focus on funtioning, much better outcome
- Figure:
o Twe axis that cross eachother:
No symtoms at all – vs very serious mental
ilness
Optimum MH vs – poor MH
o Very serieus mental ilness still can have a good
MH if they can function well: it is not always
constant but it can fluctuate!
o Mental health and mental illness are related, but
distinct dimensions: one continuum indicates the
presence or absence of mental health, the other
the presence or absence of mental illness.
o Mental health is more than just the absence
of a mental illness.
What is mental health?
- Mental health as well-being
o Mental health is described by the World Health Organization (2004) as:
… a state of well-being in which the individual realizes his or her own
abilities, can cope with the normal stresses of life, can work productively and
fruitfully, and is able to make a contribution to his or her community.
o In this positive sense mental health is the foundation for well-being and effective
functioning for an individual and for a community.
o Two traditions of well-being research are currently distinguished
Hedonic well-being
As much pleasure as possible and Avoiding any painful expieriences
Pleasure attainmment and pain avoidance
Spending as much time having fun, and as less time in lijden
Logicall fallacy: flaw in persons reasoning: it doenst necceralily
contribute to a persons well being.
Eudaimonic well-being
Pursuit of personal fulfillment and a realizing of mans potential
deugden: voluntering, well informed, …
We wanted to avoid pain in our patients
o Focussing only on pain avoidement is not efficient anymore.
We focus on eudacimonic
2
, o These aren’t two polar opposites but two sides of a spectrum – a mixed approach.
The pursuit of noting but plaesure while avoiding any type of pain, would get
old and leave the individual feeling empty
Living a live that is pure and virtuous will not satify the innate need for
pleasure of people
o Blended to get to a balanced approach
- Eudaimonic well-being encompasses 6 elements
o Self acceptance: accepting your limitations
o Positive relationships: belongingness..
o Autonomy: psychological freedom to do what you want
o Environmental mastery: be succesfull in what you do
o Porpuse in life: strive towards a value (esp in patients with chronic pain)
o Personal growth
What is mental illnes?
- A mental illness is a disorder diagnosed by a psychiatrist / psychologist.
- The disorder significantly interferes with a person’s cognitive, emotional, social and often also
motor abilities: mental disorders are worldwide the leading cause of years lived with disability
Alcohol and depressions
- They encompass a wide variety of signs, symptoms and experiences.
- They are typically classified according to the Diagnostic and Statistical Manual of Mental
Disorders (DSM-5; American Psychiatric Association) or International Classification of Diseases
( ICD-10, World Health Organization).
- As a PT, We dont need to diagnose, we need to recognize and prevent!
Most prevalent are anxiety and depression
Yearly point prevalence is ong 15%: 1/7 heeft een disorder
Life time prevalence of disorder is 1 out of 4
Of MH problems is 100%
3
, - From a MH problem to a mental illess: different stages
Stage 1: Recognizing symptoms
Difficulties with sleep
Cant stop thinking, rumination
Changes in eating
Isolate themselves
Faster irritable
Stage 2: Becomes worse and more frequent -> second stage: it starts to interfere with life
activities; lack of attention, concentration
Stage 3: serious disruption in life: people will go for treatment: problems to diagnosis
Stage 4: hospitalisation is needed
- Comorbidity
Common risk factors can contribute to both mental illness and substance use
disorders.
Many genes can contribute to the risk of developing both a substance use
disorder and a mental illness.: if relatives have it, more risk to get it.
Environmental factors (e.g., social deprivation, traumatic events) may contribute
to the development of mental illnesses or a substance use disorder.
Mental illnesses can contribute to drug use and substance use disorders.
Research suggests that people with mental illness may use drugs or alcohol as a
form of self-medication.
Although some drugs may help with mental illness symptoms, sometimes this
can also make the symptoms worse.
When a person develops a mental illness, brain changes may enhance the
rewarding effects of substances, predisposing the person to continue using the
substance.
Substance use and addiction can contribute to the development of mental
illness.
Substance use may change the brain in ways that make a person more likely to
develop a mental illness.
4
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