Hiking in suicidal patients: neutral effects on markers of suicidality

Am J Med. 2013 Oct;126(10):927-30. doi: 10.1016/j.amjmed.2013.05.008. Epub 2013 Aug 13.


Background: Regular physical activity promotes physical and mental health. Psychiatric patients are prone to a sedentary lifestyle, and accumulating evidence has identified physical activity as a supplemental treatment option.

Methods: This prospective, randomized, crossover study evaluated the effects of hiking in high-risk suicidal patients (n = 20) who performed 9 weeks of hiking (2-3 hikes/week, 2-2.5 hours each) and a 9-week control period.

Results: All patients participated in the required 2 hikes per week and thus showed a compliance of 100%. Regular hiking led to significant improvement in maximal exercise capacity (hiking period Δ: +18.82 ± 0.99 watt, P < .001; control period: P = .134) and in aerobic capability at 70% of the individual heart rate reserve (hiking period Δ: +8.47 ± 2.22 watt; P = .010; control period: P = .183). Cytokines, associated previously with suicidality (tumor necrosis factor-α, interleukin-6, S100), remained essentially unchanged.

Conclusions: Hiking is an effective and safe form of exercise training even in high-risk suicidal patients. It leads to a significant improvement in maximal exercise capacity and aerobic capability without concomitant deterioration of markers of suicidality. Offering this popular mode of exercise to these patients might help them to adopt a physically more active lifestyle.

Keywords: Depression; Endurance training; Hiking; Hopelessness; Physical exercise training; Suicide prevention.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cross-Over Studies
  • Cytokines / analysis*
  • Exercise / physiology
  • Exercise / psychology*
  • Exercise Therapy / methods*
  • Exercise Therapy / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Oxygen Consumption / physiology*
  • Physical Endurance / physiology
  • Prospective Studies
  • Suicidal Ideation*
  • Walking / physiology
  • Walking / psychology*


  • Cytokines