Exercise Intervention for Youth at Risk for Psychosis Shows Promise

A new pilot study finds that an exercise intervention can lead to improvement in clinical, social, and cognitive domains

Bernalyn Ruiz
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Researchers from the University of Colorado Boulder recently completed a pilot study of an exercise intervention with young adults determined to be at high-risk for developing psychosis. This pilot provided evidence of improvement in positive and negative symptoms and functioning setting the stage for a phase 2 randomized controlled study.

“These results suggest that exercise interventions are feasible within UHR samples and may help to improve important domains that are affected during the development of psychosis,” the authors write.

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Studies have shown that exercise protects against depressive symptoms in older adults, improves cognition in individuals diagnosed with schizophrenia, and can help reduce ADHD symptoms over time. Research has also been growing in support of physical activity/exercise as an adjunct treatment for those identified as high risk for developing psychosis.

The authors of this study cite evidence that “exercise interventions in populations with schizophrenia have been found to improve symptoms, cognitive, cardiovascular, social and role functioning, and neurobiological domains, potentially facilitating greater quality of life and well-being.“ Moreover, past research has also found that persons at-risk of developing psychosis spend less time being physically active and are more likely to engage in poor health behaviors than healthy controls.

Participants included 12 young adults identified as being at high risk for psychosis. They were enrolled in a 12-week exercise intervention at the University of Colorado Boulder’s Adolescent Development and Prevention Treatment (ADAPT) program. Participants were assigned to exercise 2 or 3 times per week between 65%-85% of maximum oxygen capacity for 30 minutes.

Outcome measures included the positive and negative symptoms assessed with the Structured Interview for Prodromal Syndromes, meeting criteria for psychotic disorder diagnosis utilizing the Structured Clinical Interview for DSM-IV, social and role functioning (Global Functioning Scale: Social and Role; GFS:S, GFS:R), cognitive functioning assessed with the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) battery, and cardiovascular fitness measured by maximum oxygen uptake (Vo2max). Structural MRI scans and resting state functional connectivity MRI (fcMRI) were also completed.

Results:

Nine of the 12 participants completed the exercise intervention and follow–up assessment.

Social and Role Functioning

  • Small to medium improvement in social functioning and role functioning
  • Participants reported a medium to large decrease in positive symptoms after exercise and small to medium decrease in negative symptoms

Cognitive Improvement

Improvements were noted in:

  • Working memory
  • Verbal planning
  • Visual learning
  • Speed of processing
  • Attention/vigilance
  • Reasoning and problem solving
  • Large overall improvement in cognitive functioning

Physical Fitness

  • No improvements in physical fitness measured by Vo2max

Structural Imaging & Resting-State Functional Connectivity

  • Using left hippocampus seed increase in functional connectivity to bilateral occipital cortices after the exercise intervention
  • Right hippocampus seed showed no changes in connectivity

Within this study participants saw a reduction in positive and negative symptoms, improved social and role functioning, and improved cognition.  The results of this pilot intervention add to the growing literature that bolsters the positive potential for exercise/physical activity interventions for youth at risk for psychosis.

 

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Dean, D. J., Bryan, A. D., Newberry, R., Gupta, T., Carol, E., & Mittal, V. A. (2017). A Supervised Exercise Intervention for Youth at Risk for Psychosis: An Open-Label Pilot Study. The Journal of clinical psychiatry. (Link) 

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Bernalyn Ruiz
MIA Research News Team: Bernalyn Ruiz is a doctoral student at the University of Massachusetts Boston and has a master’s degree in clinical psychology from Columbia University. She is engaged in research on psychosis and stigma from a social justice perspective. She is a proud daughter of Mexican immigrants and hopes to play her small part in improving Latinx mental health.

2 COMMENTS

  1. It is so important to educate the “mental health professionals” about the importance of exercise. Thank you. And you should likely change the DSM to reflect the fact that regular moderate exercise, and the weight one loses through such efforts, are not a symptom of “depression” or “bipolar.”

    From the DSM “depression” symptom check list:
    “3. Significant weight change (5%) or change in appetite”

    Since the “mental health professionals” have wrongly believed for decades that any changes in weight, due to adopting a regime of regular moderate exercise, are a symptom of “depression” or “bipolar.”

    When one takes her orthopedic surgeon’s recommendations to start a regime of regular moderate exercise to reduce problems due to a “bad fix” on a broken bone, which led to back problems, and she loses 30 pounds. This should not actually be used by the crazy and ignorant “mental health professionals” to claim she is “bipolar.” But this type of idiocy has been going on by the “mental health professionals” for decades.

    Please do encourage changes to the dumber than dirt DSM checklists, or better yet, toss the scientifically invalid DSM “bible” into the toilet where it belongs.

    https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml

    But thanks so much for pointing out the stupidity of the DSM, and absolutely today’s “mental health professionals” do need to be educated as to the importance and benefits of exercise.

    Losing weight, due to adopting an exercise regime is beneficial to one’s health, not a “symptom of depression,” as the DSM incorrectly states. I had no idea an entire industry of self proclaimed “professionals,” could be so insanely stupid.

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