Illustrative AI review — based on a real open-access article (Åsa Anger et al., BMC Psychiatry, 2023; DOI: 10.1186/s12888-023-05053-8; License: CC-BY 4.0). Not a real journal decision.
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ANALYSIS REPORTFictional sample20.08.2026

Introducing Braining—physical exercise as adjunctive therapy in psychiatric care: a retrospective cohort study of a new method

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Key Points

  • 1Retrospective cohort evaluation of 'Braining' — a structured group exercise programme — in 239 inpatients and outpatients with predominantly affective and anxiety disorders at a Swedish psychiatric clinic; absence of a comparison group and standardised symptom outcomes limits causal inference.

Major Issues

Methods / Design: No control or comparison group: participants who did not attend Braining (or attended <3 sessions) are not compared, making it impossible to distinguish programme effects from natural illness trajectory, regression to the mean, or non-specific treatment engagement effects.
Methods: No validated psychiatric symptom scale (PHQ-9, GAD-7, HDRS, PANSS) used as a primary outcome; medical record review for subjective improvement is highly susceptible to documentation bias and clinician variability in charting language.
Methods: The ≥3-session adherence threshold for inclusion is not clinically or statistically justified; sensitivity analyses with ≥5 and ≥8 sessions are not reported, making the dose–response relationship unclear.
Results: Attrition and session completion distributions are incompletely reported; median sessions attended and IQR are not provided, preventing calculation of effective dose received by the average participant.
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