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Summary Physical activity and mental health - part of prof Vancamfort

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  • 15 décembre 2023
  • 54
  • 2022/2023
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Onderdeel 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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