Physical Exercise as an Intervention for Depression: Evidence for Efficacy and Mu-Opioid Receptors as a Mechanism of Action.

Physical exercise is often cited as an important part of an intervention for depression, and there is empirical evidence to support this. However, the mechanism of action through which any potential antidepressant effects are produced is not widely understood. Recent evidence points toward the involvement of endogenous opioids, and especially the mu-opioid system, as a partial mediator of these effects. In this chapter, we discuss the current level of empirical support for physical exercise as either an adjunctive or standalone intervention for depression. We then review the extant evidence for involvement of endogenous opioids in the proposed antidepressant effects of exercise, with a focus specifically on evidence for mu-opioid system involvement.

Patient suicide in psychiatry residency programs : a national survey of training and postvention practices.

Patient suicide, which has been shown to have great emotional impact upon trainees, is experienced by as many as one in three psychiatry residents. The authors report the results of a national survey of psychiatry residency training programs (N=166) that asked about 1) current training practices in the area of suicide and 2) required or recommended procedures in the event of suicide by a resident's patient. Results show that programs commonly offer training in the assessment and treatment of suicidal patients, but the question remains as to whether the training is adequate to meet the challenges of working with suicidal individuals. Results also reflect considerable variability in "postvention" practices among programs and training settings, especially in terms of what steps should be taken when a trainee's patient commits suicide. Implications of the survey for residency training programs are discussed.