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exercise is medicine

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For nearly a century it has been hypothesized, that repetitive head trauma can lead to adverse neurological and psychiatric conditions [1]. Still, it took the discovery of Chronic Traumatic Encephalopathy (CTE) in a player of the National Football League to bring widespread public and scientific attention to this important topic on the intersection of neurology, psychiatry and sports medicine [2,3].
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The Olympic Games tradition dates back to antiquity. And we learned the quote „mens sana in corpore sano est“ coming from that period. It became a paradigm in the western world, undermining any efforts of psychiatric relevance in high performance sports. With world renowned athletes himself as suffering from depression, things began to move; nowadays, sport psychiatry has moved from a theoretical option to an accepted necessity in elite sports [1].
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Major depressive Disorder (MDD) is a widespread and burdensome disease. People with MDD suffer from loss of interest and pleasure in activities that they would usually enjoy. In addition, they report anxiety, complex somatic pain syndromes, cognitive restrictions, loss of sexual interest, impaired sleep and social withdrawal. MDD is the leading cause for years lived with disability (YLD) in women and men and has a lifetime prevalence of 10-20 %.
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Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder which is characterized by symptoms of inattention, hyperactivity, and impulsivity. The estimated prevalence of ADHD in the general population is 7,2% in children, with persistence into adulthood of approximately 35%. [1,2]
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Promoting physical activity (PA) has not yet been established as a standard procedure in psychiatric care. Psychiatric patients are at higher chance to be physically inactive which contributes to increased morbidity and mortality. Regular PA has shown to improve mental wellbeing in the general population and reduces the risk to develop several mental disorders. Assessing PA and motivation for change should be ­established as routine in psychiatric practice.
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The ongoing COVID-19 pandemic is a global crisis of unprecedented scale in modern times. The initial outbreak of COVID-19 in Wuhan spread rapidly, affecting other parts of China and soon other countries becoming a global threat. (1) On 11 March 2020, the WHO has declared the ‘Pandemic state’ calling the governments to take ‘urgent and aggressive action’ to delay and mitigate the peak of infection.
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Competitive and elite sport often challenges the balance between health and performance, especially when it involves youth athletes. As Lausanne was getting ready to host the 2020 winter Youth Olympic Games, we had the opportunity to reflect on these challenges and on what they mean for sports medicine practitioners. Elite sport pushes athletes to the limit, be it through their own intrinsic drive to achieve ever more, or through the pressures of the multiple stakeholders around sport.
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How fortunate to have been able to take part in the medical organisation of the Lausanne 2020 Winter Youth Olympic Games (YOG) as head of the Olympic Village Medical Clinic and Medical Education Programme manager, while introducing some innovations to the Games! From a clinical point of view, the temporary creation of a high quality interdisciplinary medical clinic provided all participants aged 14 to 18 years old with global and equitable care. We adopted the WHO criteria to offer an adolescent friendly setting.
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