R1.0 Exercise Effects on Psychosis

The Effects of a Formal Exercise Program on the Positive and Negative Symptoms of Psychosis

Abstract

Recent studies have shown that physical activity may reduce positive and negative symptoms and improves cognitive functioning by improving cognition, symptoms, and physical health in people with schizophrenia. However, there is a growing need to explore the potential of physical exercise as an adjunct treatment for psychosis. The purpose of this study was to determine the effects of exercise on the positive and negative symptoms of psychosis. Fifty-four people aged 18-35 who have experienced the first episode of psychosis participated in this study and have continuing symptoms of psychosis. All participants were in the first-episode programs at (REDACTED). A formal exercise program was given to the participants at the beginning of the study, and participants would answer questions regarding their symptoms at the end of each week. At the end of the study, data on the amount of time the participants exercised and the amount of positive and negative symptoms the participants experienced were analyzed.

Keywords: psychosis, exercise, mental health, positive symptoms, negative symptoms, FEP

Introduction

Psychosis describes a collection of symptoms that one experiences that makes them perceive reality in a different way than the people around them. These symptoms usually emerge during adolescence and early adulthood. There are both positive and negative symptoms of psychosis. Positive symptoms include hallucinations, delusions, and confused thinking. Negative symptoms include difficulty talking, isolating oneself from social situations and relationships, lack of motivation, and emotional bluntness. There is evidence that supports the idea that childhood adversities, cannabis use, pregnancy and post-partum, adverse events during adulthood, and serum folate level potentially increase the risk of these symptoms (Brokmeier et. al, 2020).

Generally, people with severe mental illness have a higher mortality rate (Koivukangas et. al, 2010). People with psychosis or schizophrenia have an increased risk of many diseases and death at an earlier age. This could be partly because people with schizophrenia are more inactive than the general population, which increases their chance of cardiometabolic diseases (Firth et. al, 2018). Also, major risk factors for coronary heart disease, including obesity, hyperlipidemias, hypertension, and diabetes, are more common in patients with schizophrenia than in the general population (Koivukangas et. al, 2010). Even though there has been considerable progress in giving treatment, people with schizophrenia are 2-2.5 times more likely to die earlier than the general population, with an average life expectancy that is 15-20 years shorter (Larson et. al, 2019).

Research indicates that exercise can be helpful for people with mental illnesses. By increasing cardiorespiratory and metabolic health, exercise may reduce the physical health problems that are associated with schizophrenia, such as obesity and diabetes (Firth et. al, 2017). Therefore, this study aims to see how a formal exercise program affects the positive and negative symptoms of psychosis.

Review of the Literature

There is a growing need to explore the potential of physical exercise as an addition to pharmacological treatment for psychosis (Lambden et. al, 2018). It is found that exercise reduces positive and negative symptoms and improves cognitive functioning in people with schizophrenia, but this has not been explored in people who have first-episode psychosis (Firth et. al, 2018). There is, however, ample evidence that exercise does help brain functioning and physical health in people with either schizophrenia or psychosis. Exercise can reduce the negative symptoms and cognitive deficits of schizophrenia (Firth et. al, 2018). Increasing physical activity during first-episode psychosis can improve physical health and support functional recovery (Firth et. al, 2016). Exercise has also been found to increase hippocampal volume and white matter integrity in healthy older adults and those with schizophrenia (Firth et. al, 2017). Evidence has confirmed that exercise interventions can also significantly improve cognition in people with schizophrenia through increasing performance in working memory, attention/vigilance, and social cognition domains (Firth et. al, 2020). Physical activity may contribute to better functioning by improving cognition, symptoms, and physical health (Lee et. al, 2013).

Despite the benefits of exercise for people with psychosis, dropouts from exercise interventions are high (Vancampfort et. al, 2018). Also, people who have schizophrenia are more inactive than the general population. (Firth et. al, 2018). Patients with psychosis were less likely to receive medical check-ups and participate in rigorous exercise; this is also associated with low levels of physical health literacy (Kim et. al, 2019). Health literacy is the capacity of an individual to understand basic health information and services and the competence to use such information in ways that enhance their health (Kim et. al, 2019). Despite progress in treatment, people with schizophrenia are 2-2.5 times more likely to die earlier than the general population, with an average life expectancy that is 15-20 years shorter. (Larsen et. al, 2019). Lastly, individuals with schizophrenia display substantial deficits in social functioning (Kimhy et. al, 2021).

There are other popular forms of exercise that may have beneficial neurocognitive effects such as aerobic exercise and yoga (Lin et. al, 2015). The benefits of aerobic training extend to better social functioning, enhancing neurocognition, improving cardiovascular functioning, and helping with overall physical health (Kimhy et. al, 2021). Previous reviews and meta-analyses demonstrated that different types of physical exercise interventions like aerobic exercise, yoga, and tai chi resulted in significant effects on negative symptoms in schizophrenia (Vogel et. al, 2019).

There is evidence for the effectiveness of lifestyle interventions including diet, exercise, and educational measures to decrease and manage antipsychotic-induced weight gain (Gurusamy et. al, 2018). Various mental health symptoms may be associated with poor lifestyle factors such as low fruit and vegetable consumption and high levels of sedentary behavior (Martland et. al, 2021).

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