BACKGROUND: Anxiety disorders are commonly treated with antidepressants and psychological treatments. Some patients may prefer alternative approaches such as exercise. OBJECTIVE: To investigate the treatment effects of exercise compared with other treatments for anxiety disorders. DATA SOURCES: Randomised controlled trials (RCTs) of exercise interventions for anxiety disorders were identified by searching six online databases (July 2011). A number of journals were also hand searched. MAIN RESULTS: Eight RCTs were included. For panic disorder: exercise appears to reduce anxiety symptoms but it is less effective than antidepressant medication (1 RCT); exercise combined with antidepressant medication improves the Clinical Global Impression outcomes (1 RCT, p < 0.05); exercise combined with occupational therapy and lifestyle changes reduces Beck Anxiety Inventory outcomes (1 RCT, p = 0.0002). For social phobias, added benefits of exercise when combined with group cognitive behavioural therapy (CBT) were shown (p < 0.05). There was no significant difference between aerobic and anaerobic exercise groups (1 RCT, p > 0.1) with both seeming to reduce anxiety symptoms (1 RCT, p < 0.001). It remains unclear as to which type of exercise; moderate to hard or very light to light, is more effective in anxiety reduction (2 RCTs). CONCLUSIONS: Exercise seems to be effective as an adjunctive treatment for anxiety disorders but it is less effective compared with antidepressant treatment. Both aerobic and non-aerobic exercise seems to reduce anxiety symptoms. Social phobics may benefit from exercise when combined with group CBT. Further well-conducted RCTs are needed.
Reproduced with permission from the BMJ Publishing Group.

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