Lab-Based and Self-Reported Indices of Fitness Show Lowered Fitness and Insight into Fitness in Individuals at Clinical High Risk for Psychosis

Abstract

Introduction:Exercise is a promising intervention for clinical high-risk for psychosis (CHR) populations, who have attenuated positive symptoms, but evidence suggests that these youth may require tailored exercise interventions. Presently, the scope of the problem is unknown, as these youth may not be reliable reporters on fitness. This issue is compounded by the fact that there have been no investigations that utilized a formal fitness assessment in this critical population.The present study aims to determine the level of fitness in CHR youth with lab-based measures, test how effectively self-report measures characterize objective fitness indices, and explore clinical factors that may be interrupting reliable self-report-an important tool if these interventions are to be taken to scale.Methods: Forty CHR individuals completed an exercise survey and lab-based indices of fitness (i.e., VO2max and BMI). Forty healthy volunteers completed lab indices of fitness and a structured clinical interview ruling out the presence of psychiatric illness.Results: CHR youth showed greater BMI and lower VO2max compared to healthy volunteers. In the CHR group, abstract self-report items (perceived fitness) did not reflect lab indices of fitness, whereas specific exercise behaviors (intensity of exercise) showed stronger correlations with laboratory-based fitness measurements. Exploratory analyses suggested that positive symptoms involving grandiosity, and negative symptoms such as avolition, correlated with discrepancy between self-perception and laboratory findings of fitness. Discussion:Results suggest that CHR individuals are less objectively fit than matched controls, and that it will be important to consider unique population characteristics when weighing selfreport data.

The efficacy and safety of exercise and physical activity on psychosis: A systematic review and meta-analysis

“…Physical activity and exercise are one treatment strategy used to manage side effects such as weight gain and metabolic syndrome as well as the primary cognitive, negative, and positive symptoms associated with psychosis (5,6). In a study by Damme et al (8) the group with high risk for psychosis had significantly lower VO2max than the healthy controls (8), however, this relationship may be confounded by body mass index (BMI) (9). Recent systematic reviews have looked at the effect of exercise and physical activity as a treatment strategy for people with psychosis (10)(11)(12)(13).…”