Does high-intensity exercise combined with exposure sessions improve treatment out-comes in obsessive-compulsive disorder? A randomized controlled trial in inpatients
In brief
Inpatients had 3.14-point greater OCD score drop with post-exposure exercise
Among 97 inpatients receiving exposure therapy, high-intensity exercise immediately afterward led to 3.14 points greater reduction in obsessive-compulsive symptom scores at discharge than low-intensity exercise, with the difference still present at six months. More patients responded at discharge, 85.4% versus 61.2%, but remission rates did not differ; whether this adjunct benefits patients outside inpatient care remains unknown.
- Journal
- Psychotherapy and psychosomatics (Q1)
- Published
- 30 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Mark Muehlbacher, Rebecca Schennach, Thomas Boesl, Christoph Bamberg, Stefan Koch, Ulrich Voderholzer
- PMID
- 42814664
- DOI
- 10.1159/pps/aemag016
Why clinicians should know about it
- Picked for Emergency Medicine (top studies of the week, 4 October 2026): Not related to emergency resuscitation or acute care
- Picked for Psychiatry and Mental Health (top studies of the week, 4 October 2026): High‑intensity exercise after exposure improves OCD outcomes
Abstract
INTRODUCTION: Physical exercise administered before or after exposure has been shown to have beneficial effects on treatment outcomes in anxiety- and trauma-related disor-ders. However, this approach has not yet been examined for obsessive-compulsive dis-order (OCD). This randomized controlled trial investigated whether high-intensity exer-cise administered immediately after exposure therapy improves treatment outcomes in patients with obsessive-compulsive disorder (OCD). METHODS: Ninety-seven inpatients with OCD participated in an eight-week exposure-based treatment phase during inpa-tient care, comprising two sessions per week, and were randomly assigned to either high-intensity exercise (ExpoHI) or low-intensity control (ExpoLI) administered immedi-ately after a standardized exposure and response prevention (ERP) session. OCD se-verity was assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) at admission, discharge, and six-month follow-up. The secondary outcomes included gen-eral psychopathological symptoms. RESULTS: ExpoHI showed significantly greater reduc-tions in Y-BOCS scores at discharge (between-group difference: -3.14 points, p = .009), corresponding to a moderate-to-large between-group effect size (Cohen's d = 0.76), which was maintained at the six-month follow-up (p = .030; Cohen's d = 0.68). Re-sponder rates at discharge were significantly higher in the ExpoHI group (85.4%) than in the ExpoLI group (61.2%) (p = .011), whereas remission rates did not differ between groups. ExpoHI also showed greater reductions in depressive symptoms at follow-up. CONCLUSIONS: High-intensity exercise immediately following exposure therapy produced greater reductions in obsessive-compulsive symptoms than the active control condition. These findings suggest that exercise may be a feasible adjunct for exposure-based treatment.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.