Psychological effects of training in coronary patients: a critical review of the literature.

Past studies have claimed that vigorous exercise programmes have positive effects on postinfarction patients' mental health. Results of controlled studies suggest that a significant antidepressant effect of exercise on postinfarction patients has not been shown reliably. The evidence also suggests that in the long run neither anxiety and pain threshold nor social anxiety are reduced by physical exertion. Furthermore, sustained exercise may cause some psychological harm, and it seems that adherence to exercise is difficult for those patients who feel uncomfortable in social interactions and whose capacities to cope with stressful life events are relatively impaired. A comprehensive treatment package which includes exercising as one component among other techniques is recommended for the improvement of patients' status of mental health.