Abstract
Psychiatric disorders have a high lifetime
prevalence affecting about 30% of the global population. Not much is known about high altitude (HA) sojourns
in individuals living with a psychiatric condition. This lack of scientific evidence contrasts with the anticipated
increase in numbers of individuals with preexisting psychiatric conditions seeking medical advice on HA
exposure. Not only are there risks associated with a HA climb, but physical activity in general is known to
improve symptoms of many psychiatric disorder and enhance measures of mental well-being like quality of life
and resilience. There are additional positive effects of alpine environments on mental health beyond those of
physical activity. All individuals going to HA with a preexisting psychiatric condition should be in a state of
stable disease with no recent change in medication. Specific considerations and recommendations apply to
individual psychiatric disorders. During the HA sojourn the challenge is to separate altitude-related symptoms
such as insomnia from prodromal symptoms of the underlying disorder (e.g., depressive episode) or altituderelated
hyperventilation from panic attacks. In case an individual with preexisting anxiety disorder decides to go
to HA there might be a predisposition toward acute mountain sickness (AMS), but it should always be considered
that many symptoms of anxiety and AMS overlap. Any medication that is anticipated to be taken during ascent
or at HA should be tested for compatibility with the psychiatric condition and medication before the trip.