Physical exercise for negative symptoms of schizophrenia: Systematic review of randomized controlled trials and meta-analysis

Sabé, Michel; Kaiser, Stefan; Sentissi, Othman

doi:10.1016/j.genhosppsych.2019.11.002

Cited by 64 publications

(77 citation statements)

References 45 publications

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“…Theoretically, to have a real effect on disease progression and complications, a longer period of treatment is usually needed to have an effect on physical fitness or risk factor levels; however, there is a growing amount of data from RCT-based meta-analyses in which the main outcome is related to disease progression (Table 4) [8, 28, 32, 34, 51-67]. There is no single generally accepted criterion for following up on the progression of each chronic disease, but disease-specific clinical indicators such as findings from imaging studies, need for hospitalizations due to progression, or disease-specific scores of disease activity or stage can be used to characterize some aspects of disease severity or progression.…”

Section: Methodsmentioning

confidence: 99%

Summary of the Effects of Exercise Therapy in Non-Communicable Diseases: Clinically Relevant Evidence from Meta-Analyses of Randomized Controlled Trials

Kujala

2021

Preprint

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There is strong evidence that exercise therapy leads to better measured and self-reported physical fitness and function in patients with chronic diseases, along with improvements in body composition. The evidence for other health benefits has not been summarized as systematically across different chronic diseases. Given the volume of research that has appeared in the past decade, this review of meta-analyses of randomized controlled trials (RCTs) in patients with specific chronic diseases summarizes the evidence regarding exercise therapy for various outcomes to help practitioners in prescribing exercise therapy for their patients. Meta-analyses published before Jan 1, 2021, based on at least four RCTs, and investigating the effect of exercise therapy on the same outcome among patients with a specific chronic disease were screened. These meta-analyses show that, in addition to improvements in fitness and function, various cardio-metabolic risk factor levels are improved in most of the common cardio-metabolic diseases, pain is reduced in musculoskeletal diseases, mood (depression and anxiety) and health-related quality of life are improved in various disease categories, and disease-specific indicators of disease progression are improved for conditions such as type 2 diabetes, hypertension, coronary heart disease, heart failure, claudication, chronic obstructive pulmonary disease, rheumatoid arthritis, fibromyalgia, depression, anxiety, and schizophrenia. Physicians should consider prescribing exercise to their patients with chronic disease conditions to improve their physical fitness, mood, and health-related quality of life and to slow down the progression of disease. This improves a patient's possibility to enjoy an active and independent life.

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Section: Methodsmentioning

confidence: 99%

Summary of the Effects of Exercise Therapy in Non-Communicable Diseases: Clinically Relevant Evidence from Meta-Analyses of Randomized Controlled Trials

Kujala

2021

Preprint

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“…A recent meta-analysis by Vogel and colleagues focused on negative symptoms and found a beneficial effect across a broad range of interventions including mind-body and aerobic exercise [80]. Sabé and colleagues found a beneficial effect specifically for aerobic exercise [81].…”

Section: Recommendation 9 [78]mentioning

confidence: 99%

EPA guidance on treatment of negative symptoms in schizophrenia

et al. 2021

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Negative symptoms of schizophrenia remain a major therapeutic challenge. The progress in the conceptualization and assessment is not yet fully reflected by treatment research. Nevertheless, there is a growing evidence base regarding the effects of biological and psychosocial interventions on negative symptoms. The importance of the distinction between primary and secondary negative symptoms for treatment selection might seem evident, but the currently available evidence remains limited. Good clinical practice is recommended for the treatment of secondary negative symptoms. Antipsychotic treatment should be optimized to avoid secondary negative symptoms due to side effects and due to positive symptoms. For most available interventions, further evidence is needed to formulate sound recommendations for primary, persistent, or predominant negative symptoms. However, based on currently available evidence recommendations for the treatment of undifferentiated negative symptoms (including both primary and secondary negative symptoms) are provided. Although it has proven difficult to formulate an evidence-based recommendation for the choice of an antipsychotic, a switch to a second-generation antipsychotic should be considered for patients who are treated with a first-generation antipsychotic. Antidepressant add-on to antipsychotic treatment is an option. Social skills training is recommended as well as cognitive remediation for patients who also show cognitive impairment. Exercise interventions also have shown promise. Finally, access to treatment and to psychosocial rehabilitation should be ensured for patients with negative symptoms. Overall, there is definitive progress in the field, but further research is clearly needed to develop specific treatments for negative symptoms.

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“…Xu & Jiang, 2015). Exercise has been shown to improve both positive and negative symptoms of schizophrenia, as well as quality of life, hippocampal function and volume, and cognition (Girdler et al, 2019;Mitsadali et al, 2020;Sabe et al, 2020;Shimada et al, 2019).…”

Section: Non-western and Novel Treatments For Schizophreniamentioning

confidence: 99%

Schizophrenia: Epidemiology, Causes, Neurobiology, Pathophysiology, and Treatment

Volkan¹

2020

jhms

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Schizophrenia is a severe mental illness that has devastating consequences for those who suffer from the disorder. The epidemiology of schizophrenia indicates that it occurs relatively often, in many different contexts, and in conjunction with other disorders, decreasing quality of life and causing premature death. There has been an enormous amount of research into the causes of schizophrenia and there is now have a much better understanding of the genetic, environmental, and psychological factors that contribute to the disease. While there are numerous ways to understand and conceptualize schizophrenia, a unified picture of the neurobiology, changes in brain structure, cognitive and social-cognitive impairments related to the disorder has yet to emerge. Convulsive therapies and psychosurgery were used unsuccessfully, indiscriminately and without scientific validation in the past to treat schizophrenia. Medical advances including advanced imaging technology have now provided the ability to perform specifically focused neuromodulation and psychosurgery in severe and treatment resistant cases of schizophrenia. While still at a preliminary stage, these approaches have the potential to yield effective treatments in the future. For the last 70 years antipsychotic medication has become the prevailing treatment for schizophrenia. However, many people suffering from the disorder have trouble with side-effects and adhering to a regimen of antipsychotic medication. Newer pharmacological agents are being developed and include not only novel antipsychotic drugs, but anti-inflammatory and immunomodulating agents as well. These new agents, used either alone or in combination, have the potential to improve outcomes for people suffering from schizophrenia. Nevertheless, conclusively better pharmacotherapies will likely not arise until there is better understanding of the pathophysiology underlying schizophrenia. After the development of antipsychotic medication, psychotherapeutic methods for treating schizophrenia fell out of favor, but there is currently some reversal of this trend. The use of newer psychotherapies and modified forms of older therapeutic treatments are not only targeting the symptoms of schizophrenia but are also now focusing on recovery from the disorder. These newer approaches as well as efforts at preventing schizophrenia show promise in reducing the suffering caused by this disease.

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Physical exercise for negative symptoms of schizophrenia: Systematic review of randomized controlled trials and meta-analysis

Cited by 64 publications

References 45 publications

Summary of the Effects of Exercise Therapy in Non-Communicable Diseases: Clinically Relevant Evidence from Meta-Analyses of Randomized Controlled Trials

Summary of the Effects of Exercise Therapy in Non-Communicable Diseases: Clinically Relevant Evidence from Meta-Analyses of Randomized Controlled Trials

EPA guidance on treatment of negative symptoms in schizophrenia

Schizophrenia: Epidemiology, Causes, Neurobiology, Pathophysiology, and Treatment

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