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Objective: The purpose of this study was to compare the therapeutic effect of exercise for patients with panic disorder to a drug treatment of proven efficacy and to placebo., Method: Forty-six outpatients suffering from moderate to severe panic disorder with or without agoraphobia (DSM-III-R criteria) were randomly assigned to a 10-week treatment protocol of regular aerobic exercise (running), clomipramine (112.5 mg/day), or placebo pills., Results: The dropout rate was 31% for the exercise group, 27% for the placebo group, and 0% for the clomipramine group. In comparison with placebo, both exercise and clomipramine led to a significant decrease in symptoms according to all main efficacy measures (analysis of variance, last-observation-carried-forward method and completer analysis). A direct comparison of exercise and clomipramine revealed that the drug treatment improved anxiety symptoms significantly earlier and more effectively. Depressive symptoms were also significantly improved by exercise and clomipramine treatment., Conclusions: These results suggest that regular aerobic exercise alone, in comparison with placebo, is associated with significant clinical improvement in patients suffering from panic disorder, but that it is less effective than treatment with clomipramine.

Several studies in healthy volunteers have shown a positive effect of endurance training on anxiety, depressive symptoms, self-esteem, concentration and stress tolerance. There are only a few controlled studies examining the therapeutic potential of exercise in psychiatric disorders. However, there is good evidence that exercise is effective in mild to moderate depression and in anxiety disorders. The therapeutic effect did not correlate with changes in cardiopulmonary fitness in the majority of studies. Therefore, other neurobiological and psychological mechanisms are discussed which might explain the effectiveness of regular physical training. The authors offer a variety of suggestions, how exercise could be integrated and evaluated in the treatment of psychiatric disorders.

Questionnaires assessing interpersonal problems may be of relevance in the field of psychotherapy not only to determine therapeutic goals but also for predicting the quality of the therapeutic alliance. Our study on the clinical validity of the Inventory of Interpersonal Problems-IIP (Horowitz) focussed on patients with affective disorders. According to the literature we hypothesized two subgroups with different areas of problems: one with high interpersonal dependency, one with an overly autonomous stance. Our sample comprises 169 patients of a psychotherapeutic outpatient clinic for students with the diagnosis of an affective disorder according to ICD 10 and a partly (age, sex, subject) comparison group of 119 students. The IIP was able to replicate the aforementioned groups. The instrument therefore may be applied to measure change in depressive psychopathology. It also might offer help for differential indication in psychotherapy.