Investigating the Benefits of Exercise in Early Psychosis

Background: Physical exercise has been shown to be an effective adjunctive treatmentin schizophrenia, for positive symptoms, negative symptoms, cognitivedeficits and cardio-metabolic dysfunction. However, this has yet to be exploredin first-episode psychosis (FEP). Poor adherence and high attrition have beena problem in previous exercise trials in schizophrenia, so any trial in the FEPgroup needs to evaluate interventions which are accessible and engaging.Methods: This study was a within-subjects feasibility trial of individualisedexercise interventions in FEP. Thirty participants were recruited fromEarly Intervention Services. Each met with a research assistant to formulatea 10-week exercise plan, based on their personal incentives, preferencesand required levels of support. Participants were also provided witha ‘training partner’ (research assistant) for two 1 hour sessions per weekto facilitate their engagement in chosen activities. Adherence and attritionwere recorded to determine the feasibility of implementing individualisedexercise in FEP. Participants also completed a broad range of physical, psychiatricand neurocognitive assessments pre-and-post intervention to determinesuitable outcome measures for future trials.Results: Participants had good adherence to exercise, achieving 107 minsof moderate/vigorous exercise per-week. Furthermore, only 2 participantsdropped out during the intervention. Measures of cardio-metabolic health,positive and negative symptoms, psychosocial functioning and cognitiveperformance showed significant improvement after 10 weeks of exercise.Blood tests and brain scans were not widely consented to by participants.Conclusion: We present a standardised method of formulating and deliveringindividualised exercise interventions in FEP. We found that exercise interventionswhich are tailored to individual preferences / needs are engaging andaccessible for FEP patients, widely enabling them to achieve sufficient levels ofmoderate-to-vigorous exercise per week. Furthermore, such interventions maysignificantly improve various physical and mental health outcomes in FEP,although randomised trials are required to establish the magnitude of effect.