Exercise benefits physical, mental health in schizophrenia

By Mark Cowen, Senior medwireNews Reporter

Exercise therapy improves mental health and cardiovascular fitness in patients with schizophrenia, researchers report.

In a study of 63 patients with schizophrenia, Thomas Scheewe (University Medical Center Utrecht, the Netherlands) and co-authors found that 1 or 2 hours of exercise therapy per week significantly reduced positive and negative symptoms, depression, and the need for care, and improved cardiovascular fitness compared with occupational therapy.

"Exercise therapy appears to be an effective add-on treatment in schizophrenia," they write in Acta Psychiatrica Scandinavica.

In total, 31 patients were randomly assigned to undertake 6 months of exercise therapy, which was primarily designed to improve cardiovascular fitness but also included muscle strengthening exercises for variety, and 32 to receive occupational therapy, which comprised creative and recreational activities such as painting, reading, and computer activities.

In intention-to-treat analyses, which included all randomized participants, the team found that exercise therapy was associated with a significant 7.6% increase in W_peak (peak work rate at the moment of exhaustion in Watts) compared with a 2.9% decrease with occupational therapy. There was also a trend-level 30.2% reduction in Montgomery Åsberg Depression Rating Scale (MADRS) scores with exercise therapy compared with a 8.5% reduction with occupational therapy.

Moreover, in per protocol analysis, which only included patients in both groups who had a compliance rate of at least 50%, exercise therapy was associated with a significant 20.7% reduction in Positive and Negative Syndrome Scale (PANSS) scores, a significant 36.6% reduction in MADRS scores, a significant 9.7% increase in W_peak, and a significant 22.0% reduction in Camberwell Assessment of Needs (CAN) scores.

By contrast, occupational therapy was associated with 3.3% increase in PANSS scores, a 4.4% reduction in MADRS scores, a 3.3% reduction in W_peak, and a 4.0% reduction in CAN scores.

Scheewe and team conclude: "Exercise therapy 1 to 2 hours weekly evidently improved mental health, improved cardiovascular fitness and reduced need of care in patients with schizophrenia.

"Future studies should enrol larger number of patients with longer follow-up periods to validate our findings."

They add that "given limited effects in intention-to-treat analyses, methods should be investigated to improve exercise therapy compliance."

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