Meta-Analysis Finds Exercise Improves Cognition in Individuals with Schizophrenia

Shannon Peters
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A new review, published in Schizophrenia Bulletin, examines the effects of exercise on cognition in individuals diagnosed with ‘schizophrenia.’ The results of the meta-analysis provide evidence that physical activity is related to better cognitive functioning.

“Cognitive impairments contribute significantly to the poor functional outcomes and long-term disability often observed among patients. Antipsychotic medications have little impact on improving cognition, and other pharmacological approaches towards treating cognitive deficits have demonstrated limited efficacy thus far,” write the researchers, led by Joseph Firth, a postgraduate researcher at the University of Manchester, and Brendon Stubbs, a physiotherapist at South London and Maudsley NHS Foundation Trust.

Photo credit: Pixabay
Photo credit: Pixabay

Researchers have become interested in the many benefits exercise may have for individuals with ‘schizophrenia’ and studies have shown that exercise increases cognition in the general public. The authors write, “by increasing cardiorespiratory fitness and metabolic health, exercise may also reduce the physical health problems associated with schizophrenia, such as obesity and diabetes, which contribute towards reduced life expectancy.”

Although there have been a number of reviews on the effects of exercise for ‘schizophrenia,’ there has yet to be a meta-analysis showing benefit due to a previously low number of controlled trials. Recently, more studies have been conducted, providing the opportunity for a new meta-analysis.

In the current meta-analysis, Firth and colleagues aim to investigate the impact of exercise on cognition in individuals diagnosed with ‘schizophrenia,’ as well as identify which areas of cognition are most improved by exercise, and which types of intervention are most effective. The authors followed PRISMA guidelines to identify 10 relevant controlled trials, with a total of 385 eligible participants. Data on the primary outcome of global cognition, along with other cognitive domains and possible moderators, were then extracted. The authors used meta-regression analyses to interpret the data.

“Pooled effect sizes across all cognitive outcomes showed that exercise improves global cognition significantly more than control conditions,” state the authors. The researchers also found that being supervised by an exercise professional during physical activity led to more significant gains in cognitive functioning. Results also showed that more exercise may be related to greater cognitive improvements, but this finding was not statistically significant.

This meta-analysis provides evidence that exercise can improve cognition in individuals diagnosed with ‘schizophrenia,’ although more research is needed to understand this phenomenon. Since the standard treatment for schizophrenia, antipsychotic medication, has not been found effective in improving cognition and involves a number of side effects, it is important to explore alternative interventions. The authors recommend, “Given the known benefits of exercise for psychiatric symptoms, social functioning, and physical health, feasible and accessible methods for delivering exercise in clinical practice should be explored and implemented.”

 

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Firth, J., Stubbs, B., Rosenbaum, S., Vancampfort, D., Malchow, B., Schuch, F., … & Yung, A. R. (2016). Aerobic exercise improves cognitive functioning in people with schizophrenia: A systematic review and meta-analysis. Schizophrenia Bulletin, sbw115. doi: 10.1093/schbul/sbw115 (Abstract) 

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Shannon Peters
MIA Research News Team: Shannon Peters is a doctoral student at the University of Massachusetts Boston and has a master’s degree in mental health counseling. She is particularly interested in exploring the impacts of medicalization and pathologizing the experiences of individuals who have been affected by trauma. She is engaged in research on the effects of institutional corruption and financial conflicts of interest on research and practice.

18 COMMENTS

  1. I am astounded at the euphemistic avoidance of reality in the psychiatric research world!

    “Antipsychotic medications have little impact on improving cognition…”

    Really? Don’t you mean, “Antipsychotic medications appear to cause deteriorating cognition over time?” Who ever thought or expected that antipsychotics would IMPROVE cognition? They make it WORSE!

    “…exercise may also reduce the physical health problems associated with schizophrenia, such as obesity and diabetes, which contribute towards reduced life expectancy.”

    Are obesity and diabetes REALLY associated with ‘schizophrenia?’ Don’t you mean “health problems associated with drug ‘treatment’ for ‘schizophrenia?” Or more bluntly, health problems frequently CAUSED by atypical antipsychotic drugs?

    How do they get away with this tripe?

    —- Steve

    • I agree, nicely stated, Steve.

      But at least they do state “it is important to explore alternative interventions.” Which is progress.

      And this is a reasonably good recommendation, “Given the known benefits of exercise for psychiatric symptoms, social functioning, and physical health, feasible and accessible methods for delivering exercise in clinical practice should be explored and implemented.” Although, I don’t think psychiatrists are experts in exercise, that would technically be other professions. My psychiatrist tried to get me to stop exercising.

      And, I would imagine I’m one of the few, even here, who was even able to exercise while on antipsychotics, since they make you so incredibly lethargic and cognitively impaired. So, taking people off the antipsychotics will greatly increase people’s ability to even have the will and energy to exercise. That technically should be the psychiatrists role.

      And actually, since weaning people off the antipsychotics, can cause a drug withdrawal induced super sensitivity manic psychosis, utilizing exercise to work through this drug withdrawal issue, I found wonderfully helpful.

      When I was suffering through that, I would dance for two hours when I arose, go for a bike ride for another couple hours, garden, I rehabbed like a fiend. I lost about 10 pounds, my girlfriends finally told me I was getting too skinny.

      Exercise is good, antipsychotics are torture drugs.

  2. Steve: Thank you for pointing out the obvious! I was going to post a similar comment but you stated it so much better. The assumption that my daughter’s poor cognition (memory, ability to concentrate, etc.) is a symptom of my of my daughter’s “disease” and not due to the clozaril she is taking, is insulting to say the least.

    • Insulting, indeed. Anything bad that happens is caused by “the disease.” Anything good is caused by the amazing effects of their miracle drugs. The profession spent 10-20 years denying that tardive dyskinesia is caused by neuroleptic drugs, even though there was no rational way to deny the connection and there was an excellent scientific mechanism in place to explain it. There is no science going on in this field – it’s a religion.

  3. The Quakers knew and understood this 150 years ago! This is not new information. They took people in their asylums out for walks in the gardens and fields so that they could get fresh air and sunlight and exercise. I think it was called moral treatment or something along those lines. And of course, it goes without saying that people moved through their issues and reclaimed their lives. Something that very seldom happens today. Recovery rates before the advent of the drugs was about 60% whereas today it might be 16%, if that high.