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.
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.
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
Improvements were noted in:
- Working memory
- Verbal planning
- Visual learning
- Speed of processing
- Reasoning and problem solving
- Large overall improvement in cognitive functioning
- 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.
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)