Exercise Dependence: Diagnostic and Therapeutic Issues for Patients in Psychotherapy

Health promotion and exercise is recognized as an important ingredient in health maintenance. Within the diagnostic category of obsessive-compulsive disorders has been the increased recognition by clinicians of a phenomena best described as "exercise dependence." Reviewed herein is its definition, theoretical framework and a spectrum of factors often associated with exercise. Realizing that exercise dependence as a clinical entity is not yet recognized in either the International Classification of Disorders (ICD-9) or the Diagnostic and Statistical Manual (DSM-IV-R), proposed criteria for its inclusion are offered. Where a pattern of behavior shows the presence of symptoms consistent with "exercise dependence," clinical diagnosis should be made to assure that appropriate treatment might be offered to manage the condition and continue to make exercise an important part of a healthy lifestyle. Diagnostic and therapeutic considerations are offered for the contemporary psychotherapist.