Exercise as an intervention for first‐episode psychosis: a feasibility study

Abstract

AimExercise can improve psychiatric symptoms, neurocognitive functioning and physical health in schizophrenia. However, the effects in early psychosis have not been explored. This study aimed to assess the feasibility of an exercise intervention for early psychosis and to determine if it was associated with changes in physical and mental health.MethodsThirty‐one patients with first‐episode psychosis (FEP) were recruited from early intervention services to a 10‐week exercise intervention. The intervention group received individualized training programmes, aiming to achieve ≥90 min of moderate‐to‐vigorous activity each week, using exercise programmes tailored to individual preferences and needs. A comparison FEP sample from the same services (n = 7) received treatment as usual.ResultsRates of consent and retention in the exercise group were 94% and 81%, respectively. Participants achieved an average of 107 min of moderate‐to‐vigorous exercise per week. Positive and Negative Syndrome Scale total scores reduced by 13.3 points after 10 weeks of exercise, which was significantly greater than the treatment as usual comparison group (P = 0.010). The greatest differences were observed in negative symptoms, which reduced by 33% in the intervention group (P = 0.013). Significant improvements were also observed in psychosocial functioning and verbal short‐term memory. Increases in cardiovascular fitness and processing speed were positively associated with the amounts of exercise achieved by participants.ConclusionIndividualized exercise training could provide a feasible treatment option for improving symptomatic, neurocognitive and metabolic outcomes in FEP.

Motivating factors and barriers towards exercise in severe mental illness: a systematic review and meta-analysis

“…2013; Firth et al 2016 c ). Although there is currently a lack of cost-effectiveness research examining supervised exercise in SMI, financial reports of exercise interventions for diabetes, mild depression and heart disease indicate that professionally delivered training programmes produce large economic benefits from avoided health system costs (Deloitte Access Economics, 2015).…”

Challenges in implementing an exercise intervention within residential psychiatric care: A mixed methods study

“…Therefore, the lack of participation could be due to some service users having a general interest in exercise, but are averse to this specific format. Thus, more targeted and personalized approaches to exercise coaching (rather than offering general classes) may benefit greater numbers of service users; as has been observed in other studies which tailor exercise interventions towards participant preference (Bartels et al., 2014, Firth et al., 2016a). The role of qualified exercise professionals in mental healthcare services could be extended beyond providing exercise classes to also include facilitating engagement in exercise activities available in service users local community; especially for those who feel unable to attend these activities alone (Bartels et al., 2014).…”

“…The specific measures used were selected to match those of a recent study of an exercise intervention in community psychiatric care (Firth, Carney, Elliott et al., 2016). The principal change outcome was psychiatric symptoms.…”

How much physical activity do people with schizophrenia engage in? A systematic review, comparative meta-analysis and meta-regression

“…234 full texts were reviewed and 199 were excluded with reasons (see Fig. 1), with 35 unique studies meeting the eligibility criteria (Arbour-Nicitopoulos et al, 2014;Arbour-Nicitopoulos et al, 2010;Attux et al, 2013;Baker et al, 2014;Beebe et al, 2011;Bredin et al, 2013;Brunero and Lamont, 2010;Curtis et al, 2015;Faulkner et al, 2006;Firth et al, 2016;Gardner-Sood et al, 2015;Gomes et al, 2014Gomes et al, , 2015Gorczynski et al, 2014;Janney, 2012;Janney et al, 2015;Keller-Varady et al, 2015;Kimhy et al, 2014;Leutwyler et al, 2013Leutwyler et al, , 2015Lindamer et al, 2008;Lovell et al, 2014;Masa-Font et al, 2015;McCreadie, 2003;McKibbin et al, 2006;McLeod et al, 2009;Morgan et al, 2014;Ostermann et al, 2012;Scheewe et al, 2013;Snethen et al, 2014;Vancampfort et al, 2013aVancampfort et al, , 2013cVancampfort et al, , 2015aVreeland et al, 2003;Wang et al, 2012) Full details of the search results are summarized in Fig. 1.…”

“…The mean BMI of participants was 30.1 (range 23.5-38.7) with the mean proportion of 94% (19.5-100%) taking antipsychotic medication (details, where available, in Table 1). Two studies recruited people with FEP (Curtis et al, 2015;Firth et al, 2016), the majority included people with schizophrenia spectrum (full details in Table 1). Overall, 12 studies assessed physical activity using an objective measure (Beebe et al, 2011;Gomes et al, 2014Gomes et al, , 2015Gorczynski et al, 2014;Kimhy et al, 2014;Leutwyler et al, 2013Leutwyler et al, , 2015McCreadie, 2003;Scheewe et al, 2013;Snethen et al, 2014;Wang et al, 2012), one utilized an objective and subjective measure (Lindamer et al, 2008), while the remaining studies used a SRQ, primarily the IPAQ SF (Table 1).…”