Effects of aerobic exercise on cognitive performance and individual psychopathology in depressive and schizophrenia patients

Abstract

Cognitive deficits are core symptoms in patients with schizophrenia (SZ) and major depressive disorder (MDD), but specific and approved treatments for cognitive deterioration are scarce. Experimental and clinical evidence suggests that aerobic exercise may help to reduce psychopathological symptoms and support cognitive performance, but this has not yet been systematically investigated. In the current study, we examined the effects of aerobic training on cognitive performance and symptom severity in psychiatric inpatients. To our knowledge, to date, no studies have been published that directly compare the effects of exercise across disease groups in order to acquire a better understanding of disease-specific versus general or overlapping effects of physical training intervention. Two disease groups (n=22 MDD patients, n=29 SZ patients) that were matched for age, gender, duration of disease and years of education received cognitive training combined either with aerobic physical exercise or with mental relaxation training. The interventions included 12 sessions (3 times a week) over a time period of 4 weeks, lasting each for 75 min (30 min of cognitive training+45 min of cardio training/mental relaxation training). Cognitive parameters and psychopathology scores of all participants were tested in pre- and post-testing sessions and were then compared with a waiting control group. In the total group of patients, the results indicate an increase in cognitive performance in the domains visual learning, working memory and speed of processing, a decrease in state anxiety and an increase in subjective quality of life between pre- and post-testing. The effects in SZ patients compared with MDD patients were stronger for cognitive performance, whereas there were stronger effects in MDD patients compared with SZ patients in individual psychopathology values. MDD patients showed a significant reduction in depressive symptoms and state anxiety values after the intervention period. SZ patients reduced their negative symptoms severity from pre- to post-testing. In sum, the effects for the combined training were superior to the other forms of treatment. Physical exercise may help to reduce psychopathological symptoms and improve cognitive skills. The intervention routines employed in this study promise to add the current psychopathological and medical treatment options and could aid the transition to a multidisciplinary approach. However, a limitation of the current study is the short time interval for interventions (6 weeks including pre- and post-testing).

Effects of Exercise on Physical and Mental Health, and Cognitive and Brain Functions in Schizophrenia: Clinical and Experimental Evidence

“…These studies supported the importance of doseresponse on the relationship between exercise and mental health [5,6]. In general, the effects and improvement of cognitive performance and psychological well-being as a result of a physical exercise program has been observed in several studies [4,[7][8][9][10]. Few studies have been published correlating effects of physical exercise in schizophrenia, but there is increasing evidence that suggests that exercise can improve negative symptoms in these patients [11][12][13][14].…”

“…There has been a growing interest in investigating the relationship between physical activity and mental health [1][2][3][4]. These studies supported the importance of doseresponse on the relationship between exercise and mental health [5,6].…”

“…Some studies show that effects on symptoms, cognition and brain activity as a result of exercise practice, depending exclusively on its duration, intensity, and how to conduct the exercise individually [33]. It seems that there is a discreet decrease in the severity of the disorder and improvement in cognition of schizophrenia patients who perform physical exercise [4]. These studies show a decrease in the severity of symptoms and a significant improvement in cognition in schizophrenic patients who perform aerobic exercise [4,34].…”

Aerobic exercise in major psychiatric disorders: promises and challenges

“…Recent evidence suggests that volume reduction in the hippocampus correlates with episodic memory deficits in schizophrenia [1]. Aerobic exercise comprising endurance training alone or in combination with cognitive training was demonstrated to increase hippocampal volume, N-acetyl-aspartate/creatinine ratio, to improve episodic memory in schizophrenia patients and working memory in major depression [2][3][4] and thus is promising to contribute to recovery. However, our subsequent study in a larger cohort of chronic schizophrenia patients that combined endurance training with cognitive remediation for a period of 3 months did not replicate hippocampal findings, but found the volume of the left temporal cortex to be increased [5].…”

Suicide ideation, stability of symptoms and effects of aerobic exercise in major depression

“…As a new therapeutic approach in severe psychiatric disorders, Oertel-Knöchel et al [4] compared aerobic exercise in patients with major depression and patients with schizophrenia. Physical activity increased cognitive performance in both patient groups, while patients with major depression showed a reduction in depressive symptoms and state anxiety after the intervention period.…”