Changes In Mental Distress Research Articles

Changes in mental distress among employees during the three years of the COVID-19 pandemic in Germany.

The COVID-19 pandemic changed the future of work sustainably and led to a general increase in mental stress. A study conducted during the second and third pandemic wave with a retrospective survey of the first wave among 1,545 non-healthcare workers confirmed an increase in anxiety and depression symptoms and showed a correlation with the occupational SARS-CoV-2 infection risk. This online follow-up survey aims to examine changes in mental distress as the pandemic progressed in Germany and to identify factors influencing potential changes. Longitudinal data from 260 subjects were available for this analysis. Mental distress related to anxiety and depression symptoms, assessed by the Patient Health Questionnaire-4 (PHQ-4), and occupational risk factors were solicited at the end of 2022 and retrospectively at the fifth wave. Categorized PHQ-4 scores were modelled with mixed ordinal regression models and presented with odds ratios (OR) and 95% confidence intervals (95% CI). A previous diagnosis of a depressive or anxiety disorder was a strong risk factor for severe symptoms (OR 3.49, 95% CI 1.71-7.11). The impact of occupational SARS-CoV-2 infection risk on mental distress was increased, albeit failing to reach the formal level of statistical significance (high risk OR 1.83, 95% CI 0.59-5.63; probable risk OR 1.72, 95% CI 0.93-3.15). Mental distress was more pronounced in those with a previous diagnosis of anxiety and depression. Confirmed occupational risk factors were protective measures against occupational SARS-CoV-2 infection perceived as inadequate, chronic work-related stress, overcommitment, reduced interactions with fellow-workers, and work-privacy conflicts. The pandemic had a negative impact on anxiety and depression symptoms among the studied non-healthcare workers, particularly early in the pandemic, although this effect does not appear to be permanent. There are modifiable risk factors that can protect workers' mental health, including strengthening social interactions among employees and reducing work-privacy conflicts.

Associations Between Cannabis Use and Mental Distress in Young People: A Longitudinal Study

PurposeDespite a large number of studies on the relation between cannabis use and mental distress in adolescence, results are inconclusive regarding the nature of this association. The aim of the present study is to expand this body of research by analyzing the within-person association between changes in cannabis use and changes in mental distress among young people. MethodsWe used longitudinal data from a national sample of young people in Norway. The cohort was assessed in 1992 (T1), 1994 (T2), 1999 (T3), and 2005 (T4). The cumulative response rate was 60%. Respondents who participated in all four waves, aged 11–18 years at T1 (N = 1,988) were analyzed. Within-person association between changes in cannabis use and changes in mental distress in terms of symptoms of depression, anxiety, suicidal ideation, and deliberate self-harm were estimated by applying fixed-effects modeling. ResultsFor males, an increase in cannabis use from no use to more than 10 times/year was significantly associated with increased risk for anxiety (relative risk [RR]: 1.72, p = .009), depressed mood (RR: 1.49, p < .001), and suicidal ideation (RR: 3.43, p = .012). For females, the corresponding increase in cannabis use yielded an increased risk for anxiety (RR: 1.38, p = .023) and suicidal ideation (RR: 2.47, p = .002). DiscussionIncreased cannabis use during adolescence and young adulthood seem to increase the risk for symptoms of mental distress. Although the associations appear to be more pronounced among males, it was only for depression that there was a statistically significant gender difference in the association.

Mental Distress Among Norwegian Adults During the COVID-19 Pandemic: Predictors in Initial Response and Subsequent Trajectories.

Objectives: To identify factors associated with change in mental distress at the onset of the COVID-19 pandemic, relative to pre-pandemic levels, and with changes during the following 1.5years. Methods: The prospective Norwegian Mother, Father and Child Cohort Study collected eight waves of data during the pandemic (March 2020-September 2021) in 105,972 adult participants used for this analyses. A piecewise latent growth model was fitted to identify initial level and longitudinal changes in mental distress. Results: Mental distress peaked at the beginning of the pandemic. Factors associated with initial increases were: medical conditions, living alone, history of psychiatric disorders, lower education, female sex, younger age, and obesity. Being quarantined or infected with SARS-CoV-2 were associated with increasing distress while being vaccinated was associated with reduced mental distress. Conclusion: Having a chronic disease and being quarantined or infected by the SARS-CoV-2 virus were associated with more mental distress during the pandemic. This knowledge is important for planning interventions to support individuals during future pandemics and other societal crises.

Time-course changes in mental distress and their predictors in response to the coronavirus disease 2019 (COVID-19) pandemic: A longitudinal multi-site study of hospital staff.

The coronavirus disease 2019 (COVID-19) pandemic provides a unique opportunity studying individual differences in the trajectory of mental distress to relatively homogeneous stressors by longitudinally examining time-course changes between pandemic waves. For 21 months, we tested the effects of COVID-19 waves on mental health among 545 staffs at 18 hospitals treating COVID-19 patients in Shizuoka Prefecture, Japan. Contrary to increasing new infected cases as waves progressed, initially elevated psychological distress (K6) and fear of COVID-19 (FCV-19S) were decreased among waves (K6: B = -.02, 95% confidence interval [CI] = -.03 to -.01; FCV-19S: B = -.10, 95% CI = -.16 to -.04). This initial increase and subsequent decrease in K6 and FCV-19S were more prominent in individuals with high trait anxiety (K6: B = 1.55, 95% CI = 1.18 to 1.91; FCV-19S: B = 4.27, 95% CI = 2.50 to 6.04) and in occupations other than physicians or nurses. The current study revealed time-course changes in psychological distress and fear regarding COVID-19 in each pandemic wave and across waves, and indicated the usefulness of trait anxiety and occupation as predictors of mental health outcomes.

Perks of the Pandemic?: The Impact of the COVID-19 Pandemic on Socially Withdrawn Emerging Adults

Emerging adults were among those especially affected by the distancing measures and instability brought on by the COVID-19 pandemic. However, not all emerging adults were affected equally. Thus, the purpose of this paper was to determine if different types of socially withdrawn emerging adults (shy, unsocial, avoidant, mixed-withdrawn) were affected differently from one another and from non-withdrawn emerging adults. Pandemic impact was measured in terms of changes in mental distress, life satisfaction, and identity development from before the pandemic to during the pandemic. Participants were 1249 emerging adults from project READY, a nationally representative, longitudinal study of young adults in the United States. Results showed that mixed-withdrawn emerging adults decreased in mental distress from before the pandemic to during the pandemic while non-withdrawn emerging adults increased in mental distress. Additionally, there was a decrease in life satisfaction across groups, and no significant change in identity development across time.

The prevalence of mental distress changes before and during the COVID-19 pandemic: a study on physicians in Turkey

Background The emergence of the COVID-19 pandemic may adversely affect the physicians’ mental health differently.Aims This study aimed to investigate the degree of changes in mental distress in physicians through two cross-sectional studies before and during the COVID-19 pandemic and explore factors associated with the change of mental distress status of participants between two-time periods.Methods This cross-sectional, web-based survey collected demographic data and mental health measurements with the 12-item General Health Questionnaire from 416 and 522 physicians before and during COVID-19, respectively. Mixed-effects ordinal logistic regression analyses were performed to assess the factors associated with the change of mental distress status.Results During the outbreak, a total of 319 of the 522 participants reported a clinically significant level of mental distress compared with 123 of 416 participants before COVID-19. Higher levels of mental distress were observed in all socio-demographic groups during COVID-19 compared with before, with more than two-fold higher prevalence of mental health deterioration in general.ConclusionsThis study suggests a significant deterioration in mental health status after the occurrence of COVID-19 compared with before. The mental health of physicians working in all medical specialty groups, especially those in internal and surgical specialties, may require special attention.

Examining the predictive role of spiritual health and resilience in mental distress of nurses in COVID-19 wards in Iran

ABSTRACT COVID-19 pandemic has triggered serious psychological problems mainly in the front-line healthcare staff. The aim of this study was to examine the predictive role of spiritual health and resilience in mental distress of nurses in COVID-19 wards in Iran. A descriptive cross-sectional study was carried out on 91 nurses working in COVID-19 wards in 2020. The results showed that 23.1% of nurses had mental distress. In addition, the correlation coefficient showed that there was a negative and significant relationship between spiritual health (r = −.22, p < .01) and resilience (r = −.34, p < .01) with mental distress. The regression results indicated that spiritual health and resilience predicted 16% of the variation in mental distress (p < .05). Spiritual health and resilience are important constructs of mental distress in nurses and significantly predict and elaborate parts of changes in mental distress. Thus, mental health in nurses can be improved by improving the spiritual aspect and resilience in nurses.

Covid-19, social restrictions, and mental distress among young people: a UK longitudinal, population-based study.

BackgroundAdolescence is a critical period for social and emotional development. We sought to examine the impacts of Covid‐19 and related social restrictions and school closures on adolescent mental health, particularly among disadvantaged, marginalised, and vulnerable groups.MethodsWe analysed four waves of data – 3 pre‐Covid‐19 (2016–2019) and 1 mid‐Covid‐19 (May–Aug 2020; n, 1074; 12–18 years old, >80% minority ethnic groups, 25% free school meals) from REACH (Resilience, Ethnicity, and AdolesCent Mental Health), an adolescent cohort based in inner‐London, United Kingdom. Mental health was assessed using validated measures at each time point. We estimated temporal trends in mental distress and examined variations in changes in distress, pre‐ to mid‐Covid‐19, by social group, and by pre‐ and mid‐pandemic risks.ResultsWe found no evidence of an overall increase in mental distress midpandemic (15.9%, 95% CI: 13.0, 19.4) compared with prepandemic (around 18%). However, there were variations in changes in mental distress by subgroups. There were modest variations by social group and by pre‐Covid risks (e.g., a small increase in distress among girls (b [unstandardised beta coefficient] 0.42 [−0.19, 1.03]); a small decrease among boys (b − 0.59 [−1.37, 0.19]); p for interaction .007). The most notable variations were by midpandemic risks: that is, broadly, increases in distress among those reporting negative circumstances and impacts (e.g., in finances, housing, social support and relationships, and daily routines) and decreases in distress among those reporting positive impacts.ConclusionsWe found strong evidence that mental distress increased among young people who were most negatively impacted by Covid‐19 and by related social restrictions during the first lockdown in the United Kingdom.

COVID-19 vaccines and mental distress.

The COVID-19 pandemic brought about large increases in mental distress. The uptake of COVID-19 vaccines is expected to significantly reduce health risks, improve economic and social outcomes, with potential benefits to mental health. To examine short-term changes in mental distress following the receipt of the first dose of the COVID-19 vaccine. Participants included 8,003 adults from the address-based sampled, nationally representative Understanding America Study (UAS), surveyed at regular intervals between March 10, 2020, and March 31, 2021 who completed at least two waves of the survey. Respondents answered questions about COVID-19 vaccine status and self-reported mental distress as measured with the four-item Patient Health Questionnaire (PHQ-4). Fixed-effects regression models were used to identify the change in PHQ-4 scores and categorical indicators of mental distress resulting from the application of the first dose of the COVID-19 vaccine. People who were vaccinated between December 2020 and March 2021 reported decreased mental distress levels in the surveys conducted after receiving the first dose. The fixed-effects estimates show an average effect of receiving the vaccine equivalent to 4% of the standard deviation of PHQ-4 scores (p-value<0.01), a reduction in 1 percentage point (4% reduction from the baseline level) in the probability of being at least mildly depressed, and of 0.7 percentage points (15% reduction from the baseline level) in the probability of being severely depressed (p-value = 0.06). Getting the first dose of COVID-19 resulted in significant improvements in mental health, beyond improvements already achieved since mental distress peaked in the spring of 2020.

Longitudinal Distress among Brazilian University Workers during Pandemics.

The present study aimed to examine changes in mental distress in Brazilian university workers during the pandemic. All workers (n ≃ 1850) of an institution were invited to respond to a survey that took place in three stages, with collections in May (n = 407), June/July (n = 258), and August (n = 207) 2020, and included questions on demographic, health, general and psychological support, and psychometric assessment of mental distress (Clinical Outcome Routine Evaluation- CORE-OM) combined with an open question about major concerns. The results of the Multilevel Modeling analysis pointed to the absence of significant differences across the repeated measures of distress. The only variable associated with increased psychological distress over time was a lower level of support for household chores. Qualitative analysis of the reported major concerns was carried out with a sub-sample who showed reliable deterioration in CORE-OM across time (n = 17). The diversity of concerns reported by this group reinforced that work–life imbalance contributes to mental distress of university workers during the pandemic. Low response rate, although not unexpected due to the circumstances, limits the generalization of findings. The present data suggest that in addition to issues related to contagion and specific restricted measures to contain the spread of the disease, the personal reorganization of life required to maintain activities at home and work can be an important contributor to pandemic-related psychological distress.

Embracing resilience in multiple sclerosis: a new perspective from COVID-19 pandemic

ABSTRACT Coronavirus disease 2019 (COVID-19) resulted in several psychological consequences. Past epidemiological experiences already showed the deep albeit heterogeneous psychological repercussions of pandemics. Nevertheless, little is known about COVID-19 outbreak and the possible strategies for boosting resilience in patients with chronic diseases such as Multiple Sclerosis (MS). Therefore, we designed a study aiming to assess the changes in mental distress during COVID-19 outbreak in patients with MS and to identifyfactors contributing to resilience’s development. We enrolled 106 patients (69 relapsing-remitting, 20 secondary-progressive, and 17 primary-progressive) whose neuropsychological assessment before the COVID-19 pandemic (1 January 2019–1 March 2020) was available. It consisted of Brief International Cognitive Assessment for MS (BICAMS), Hospital Anxiety and Depression Scale (HADS) and patient-reported MS Neuropsychological Screening Questionnaire (MSNQ-P). All patients were re-tested during Italian lockdown through an online survey, comprehensive of sociodemographic information, HADS self-rating Scale, MSNQ-P Questionnaire and finally Connor-Davidson Resilience self-rating Scale (CD-RISC 25), in order to evaluate resilience. No significant changes in HADS and MSNQ-P scores were detected during COVID-19 pandemic in our population. Though, pre-existing lower HADS and MSNQ-P scores but not demographic, disease- and treatment-related elements were found significantly (p < 0.0001) and independently associated with a better resilience attitude.

Association between psychological resilience and changes in mental distress during the COVID-19 pandemic

BackgroundPsychological responses to potentially traumatic events tend to be heterogeneous, with some individuals displaying resilience. Longitudinal associations between resilience and mental distress during the COVID-19 pandemic, however, are poorly understood. The objective of this study was to examine the association between resilience and trajectories of mental distress during the COVID-19 pandemic. MethodsParticipants were 6,008 adults from the Understanding America Study, a probability-based Internet-panel representative of the US adult population. Baseline data were collected between March 10 and March 31, 2020, with nine follow-up waves conducted between April 1 and August 4. Mixed-effects logistic regression was used to examine the association between date and mental distress, stratified by resilience level (low, normal, or high). ResultsIn contrast to the high resilience group, participants in the low and normal resilience groups experienced increases in mental distress in the early months of the pandemic (low: OR=2.94, 95% CI=1.93-4.46; normal: OR=1.91, 95% CI=1.55-2.35). Men, middle-aged and older adults, Black adults, and adults with a graduate degree were more likely to report high resilience, whereas adults living below the poverty line were less likely to report high resilience. LimitationsThese associations should not be interpreted as causal, and resilience was measured at only one time-point. ConclusionsTrajectories of mental distress varied markedly by resilience level during the early months of the COVID-19 pandemic, with low-resilience adults reporting the largest increases in mental distress during this crisis. Activities that foster resilience should be included in broader strategies to support mental health throughout the pandemic.

Levels of mental distress over 18 years after entering treatment for substance use disorders: A longitudinal cohort study.

Aims:The aims were to investigate whether baseline characteristics and problematic substance use were related to change in mental distress over time in patients with substance use disorders during an 18-year period.Method:This was a prospective, longitudinal study of patients followed for 18 years after entering specialised treatment for substance use disorders. A sample of 291 patients was recruited in 1997 and 1998. Mental distress was measured using the Hopkins Symptom Checklist 25 at baseline, and at six and 18 years. Lifetime psychiatric disorders and substance use disorders at baseline were measured using the Composite International Diagnostic Interview, while personality disorders were measured using the Millon Clinical Multiaxial Inventory II. At the six- and 18-year follow-ups, substance use was measured using the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test. Linear mixed model was estimated to assess the overall level of mental distress over 18 years for participants with complete data at baseline (n = 232).Results:In an adjusted model, problematic substance use assessed simultaneously with mental distress, having lifetime affective, anxiety and personality disorder at baseline were associated with greater levels of mental distress over the 18-year period. The change in mental distress from baseline to the six-year, but not to the 18-year, follow-up was significantly larger among females than among males.Conclusion:The results suggests a reciprocal relationship over time between substance use and mental health problems. Also, there seems to be an additive effect between ongoing problematic substance use and lifetime mental disorders on greater levels of mental distress. This addresses the importance of integrated treatment for both substance use disorders and mental disorders to improve the long-term course for patients with these comorbid disorders.

Is change in mental distress among adolescents predicted by sedentary behaviour or screen time? Results from the longitudinal population study The Tromsø Study: Fit Futures

ObjectiveThere is growing interest in the relationship between sedentary behaviour and mental distress among adolescents, but the majority of studies to date have relied on self-reported measures with poor validity....

Change in physical activity is not associated with change in mental distress among adolescents: the Troms\xf8 study: Fit Futures

BackgroundPrevious research shows that physical activity has a protective effect on mental distress in adults, but the relationship is less researched and seems more ambiguous for adolescents. Studies in this field have typically been cross-sectional by design and based on self-reported physical activity measures, which are known to be vulnerable to response bias. The aim of this study was to investigate the relationship between change in objectively assessed physical activity as measured by accelerometer and change in mental distress among adolescents using longitudinal data from The Tromsø Study: Fit Futures.MethodThis study was based on data from 676 upper-secondary school students (mean age 16.23 years at baseline, 45.26% boys) from The Tromsø Study: Fit Futures. Physical activity, mental distress and covariates were measured at baseline (T1) and follow-up (T2) 2 years later. Physical activity was objectively measured with an ActiGraph GT3X accelerometer over 7 days. Mental distress was measured with the Hopkins Symptom Checklist-10 (HSCL-10). Change score variables were computed as the difference between T1 and T2 in number of steps, number of minutes of moderate to vigorous physical activity (MVPA) and mental distress between T1 and T2, and analyzed using linear regression analysis.ResultsChanges in steps per day were not associated with changes in mental distress in neither the crude, partially, nor fully adjusted model. Neither was changes in minutes of MVPA per day. Interaction effects between change in both steps per day and minutes of MVPA and gender were also not statistically significant, nor was the interaction effects between baseline levels of mental distress and physical activity.ConclusionThe results of our study indicate that for adolescents in the sample, change in physical activity is unrelated to change in mental distress over a two-year period.

Short-term mental distress in research participants after receiving cardiovascular risk information.

BackgroundUnderstanding of how cardiovascular risk information influence individuals is critical for the practice of risk assessment and the management of patients with cardiovascular disease.ObjectivesThe objective of this study was to investigate change in mental distress among research participants after undergoing a cardiovascular risk assessment and receiving individual test results.MethodsIn 2017, a questionnaire measuring mental distress after taking part in a risk assessment was distributed among 615 participants in the Swedish Cardiopulmonary Bio Image Study in Uppsala, Sweden, aged 50–64 years. Outcome measures were re-assessed after three months (30% were lost to follow-up).ResultsThere were no differences in outcomes after three months for participants with normal test results or for participants who were referred to primary health care. Mental distress increased in participants who were referred to the hospital, and were further explained by the fact that these participants were diagnosed with coronary artery stenosis.ConclusionsCV risk information can be provided to individuals with lower levels of risk without concerns of inducing mental distress. However, in order to prevent unnecessary worry in contexts similar to this study, one should be prepared for different risk outcomes and plan for support for individuals with higher risk. The increased utility of powerful, yet not fully mature, imaging techniques requires careful considerations extending beyond medical risks and benefits; the clinician must also take into account the risk of mental distress and secure support when necessary.

Mental distress following inpatient substance use treatment, modified by substance use; comparing voluntary and compulsory admissions

BackgroundTreatment services to patients with substance use disorders (SUDs), including those mandated to treatment, needs to be evaluated and evidence based. The Norwegian Municipal Health Care Act (NMHCA) calls for compulsory treatment for persons with “severe and life-threatening substance use disorder” if these individuals are not otherwise willing to be voluntarily treated and consequently risk their lives over drug use. Mental distress is known to be high among SUD patients admitted to inpatient treatment. The purpose of this study is to describe changes in mental distress from admission to a 6-month follow-up in patients with SUDs, which underwent either voluntary or compulsory treatment.MethodThis prospective study followed 202 hospitalized patients with SUDs who were admitted voluntarily (VA; n = 137) or compulsorily (CA; n = 65). Levels of mental distress were assessed with SCL-90-R. Of 123 patients followed-up at 6 months, 97 (62 VA and 35 CA) had rated their mental distress at admission, discharge and follow-up. Sociodemographics and substance use severity were recorded with the use of The European Addiction Severity Index (EuropASI). We performed a regression analysis to examine factors associated with changes in psychiatric distress at the 6-month follow-up.ResultsThe VA group exhibited higher mental distress than the CA group at admission, but both groups improved significantly during treatment. At the 6-month follow-up, the VA group continued to show reduced distress, but the CA group showed increases in mental distress to the levels observed before treatment. The deterioration appeared to be associated with higher scores that reflected paranoid ideas, somatization, obsessive-compulsive symptoms, interpersonal sensitivity, and depression. Active substance use during follow-up was significantly associated with increased mental distress.ConclusionIn-patient treatment reduces mental distress for both CA and VA patients. The time after discharge seems critical especially for CA patients regarding active substance use and severe mental distress. A greater focus on continuing care initiatives to assist the CA patients after discharge is needed to maintain the reduction in mental distress during treatment. Continuing-care initiatives after discharge should be intensified to assist patients in maintaining the reduced mental distress achieved with treatment.Trial registrationClinicalTrials.gov NCT 00970372 December 02, 2016.

Co-occurrence between mental distress and poly-drug use: A ten year prospective study of patients from substance abuse treatment

IntroductionLongitudinal research investigating psychiatric trajectories among patients with poly-drug use patterns remains relatively scant, even though this specific population is at elevated risk for multiple negative outcomes. The present study examined temporal associations between poly-drug use (i.e. heroin, cannabis, tranquilizers, and amphetamines) and mental distress over a 10-year period. MethodsA clinical cohort of 481 patients was recruited from substance use treatment facilities in Norway, and prospectively interviewed 1, 2, 7 and 10years after the initial data collection at treatment admission. At each assessment participants completed a questionnaire addressing their substance use and mental distress. Longitudinal growth models were used to examine whether, and if so, how, levels of drug use were associated with the level and rate of change in mental distress over time. ResultsResults from the longitudinal growth models showed a co-occurrence between active poly-drug use and mental distress, such that there was a dose–response effect where mental distress increased both in magnitude and over time with the number of drugs used. Reduction in mental distress during the 10-year study period was evident only in the no-drug use condition. Use of multiple drugs and mental distress appear strongly co-related over time. ConclusionsPre-treatment assessment should carefully identify individuals manifesting poly-drug use and mental disorders. Treatment and follow-up services should be tailored to their specific needs.

Using the SRQ–20 factor structure to examine changes in mental distress following typhoon exposure.

Empirical research is limited regarding postdisaster assessment of distress in developing nations. This study aimed to evaluate the factor structure of the 20-item Self-Reporting Questionnaire (SRQ-20) before and after an acute trauma, Typhoon Xangsane, in order to examine changes in mental health symptoms in an epidemiologic sample of Vietnamese adults. The study examined a model estimating individual item factor loadings, thresholds, and a latent change factor for the SRQ-20's single "general distress" common factor. The covariates of sex, age, and severity of typhoon exposure were used to evaluate the disaster-induced changes in SRQ-20 scores while accounting for possible differences in the relationship between individual measurement scale items and the latent mental health construct. Evidence for measurement noninvariance was found. However, allowing sex and age effects on the pre-typhoon and post-typhoon factors accounted for much of the noninvariance in the SRQ-20 measurement structure. A test of no latent change failed, indicating that the SRQ-20 detected significant individual differences in distress between pre- and post-typhoon assessment. Conditioning on age and sex, several typhoon exposure variables differentially predicted levels of distress change, including evacuation, personal injury, and peri-event fear. On average, females and older individuals reported higher levels of distress than males and younger individuals, respectively. The SRQ-20 is a valid and reasonably stable instrument that may be used in postdisaster contexts to assess emotional distress and individual changes in mental health symptoms.

Changes in mental distress following individualized physical training in patients suffering from chemical dependence

Thirty-three individuals suffering from chemical dependence and psychiatric disorders underwent 150–500 h of training over 8–15 months with assistance from dedicated training partners, who motivated them to carry out exercise and controlled the intensity of their workouts. To accurately monitor fitness development, direct measures of maximum oxygen uptake and lactate threshold performance were recorded at the start and end of the project. The participants improved moderately in aerobic power by ~5%, (P =0.02). Furthermore, lactate threshold performance increased by ~12% (P =0.03). All scores of depression, anxiety, social phobia, and general mental distress declined during the project (P≤0.03). However, the results of screening tests for alcoholism and drug abuse did not show any significant change (P≥0.28). With the use of accurate physical tests, it was possible to distinguish between responders and non-responders in terms of improvement in aerobic power. The responders showed reduced mental distress on more measures than the non-responders, although the post-treatment level of distress did not differ significantly between the two groups. Thus, it can be concluded that mastery of training and a feeling of being in a better shape may have positive effects on several aspects of mental health in patients suffering from substance dependence.