Exercise Beneficial for Physical and Mental Health Outcomes in Schizophrenia

Caroline Cassels

May 12, 2010

May 12, 2010 — Regular physical exercise programs for individuals with schizophrenia and schizophrenia-like illnesses are feasible and may help improve the mental and physical well-being of these patients, the results of a new Cochrane review suggest.

However, although the overall results were positive, the review included only 3 small studies, prompting the authors to point out that larger randomized trials are needed "before any definitive conclusions can be drawn."

"Current guidelines for exercise appear to be just as acceptable to individuals with schizophrenia in terms of potential physical and mental health benefit, so 30 minutes of moderate physical activity on most, or all, days of the week is a good goal to aim for. Start slowly and build up," the review's lead author Guy Faulkner, PhD, Faculty of Physical Education and Health, University of Toronto, Ontario, Canada, said in a statement.

According to the review, it is well documented that exercise can improve mental health, but to date there has been only limited evidence with respect to its impact on schizophrenia.

"There is a growing recognition that physical activity can enhance mental health. With regard to the effects of exercise on schizophrenia, there is limited evidence to suggest that such benefits are also reported in populations characterized by serious mental illness such as schizophrenia," the authors write.

To determine the mental health effects of exercise or physical activity programs for individuals with schizophrenia, the researchers performed a search to find all randomized controlled trials comparing any intervention where physical activity or exercise was considered to be the main or an active component with standard care or other treatments in this patient population.

The review focused on 3 recent, small studies that compared the effects of 12- to 16-week exercise programs, including components such as jogging, walking, and strength training, with standard care or yoga on physical and mental health outcomes.

The researchers found that exercise programs improved mental state for measures such as anxiety and depression, particularly when compared with standard care. Changes in physical health outcomes were seen, but they were not significant overall. However, the researchers suggest this may be due to the short timescale of the trials.

Two previous reviews have found exercise therapy to be beneficial in schizophrenia but called for more rigorous research. "This new review suggests that such calls are starting to be addressed," said Dr. Faulkner.

"But we still need more research that will help us learn how we can get individuals with schizophrenia engaged in exercise programs in the first place and how such programs can be developed and implemented within mental health services. That’s one of the biggest challenges for this type of intervention," he added.

The authors have disclosed no relevant financial relationships.

Cochrane Database Syst Rev. Published online May 12, 2010.