Oertel-Knöchel Viola, Mehler Pia, Thiel Christian, Steinbrecher Kristina, Malchow Berend, Tesky Valentina, Ademmer Karin, Prvulovic David, Banzer Winfried, Zopf Yurdagül, Schmitt Andrea, Hänsel Frank
Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany,
Eur Arch Psychiatry Clin Neurosci. 2014 Oct;264(7):589-604. doi: 10.1007/s00406-014-0485-9. Epub 2014 Feb 2.
Cognitive deficits are core symptoms in patients with schizophrenia (SZ) and major depressive disorder (MDD), but specific and approved treatments for cognitive deterioration are scarce. Experimental and clinical evidence suggests that aerobic exercise may help to reduce psychopathological symptoms and support cognitive performance, but this has not yet been systematically investigated. In the current study, we examined the effects of aerobic training on cognitive performance and symptom severity in psychiatric inpatients. To our knowledge, to date, no studies have been published that directly compare the effects of exercise across disease groups in order to acquire a better understanding of disease-specific versus general or overlapping effects of physical training intervention. Two disease groups (n=22 MDD patients, n=29 SZ patients) that were matched for age, gender, duration of disease and years of education received cognitive training combined either with aerobic physical exercise or with mental relaxation training. The interventions included 12 sessions (3 times a week) over a time period of 4 weeks, lasting each for 75 min (30 min of cognitive training+45 min of cardio training/mental relaxation training). Cognitive parameters and psychopathology scores of all participants were tested in pre- and post-testing sessions and were then compared with a waiting control group. In the total group of patients, the results indicate an increase in cognitive performance in the domains visual learning, working memory and speed of processing, a decrease in state anxiety and an increase in subjective quality of life between pre- and post-testing. The effects in SZ patients compared with MDD patients were stronger for cognitive performance, whereas there were stronger effects in MDD patients compared with SZ patients in individual psychopathology values. MDD patients showed a significant reduction in depressive symptoms and state anxiety values after the intervention period. SZ patients reduced their negative symptoms severity from pre- to post-testing. In sum, the effects for the combined training were superior to the other forms of treatment. Physical exercise may help to reduce psychopathological symptoms and improve cognitive skills. The intervention routines employed in this study promise to add the current psychopathological and medical treatment options and could aid the transition to a multidisciplinary approach. However, a limitation of the current study is the short time interval for interventions (6 weeks including pre- and post-testing).
认知缺陷是精神分裂症（SZ）和重度抑郁症（MDD）患者的核心症状，但针对认知衰退的特异性且获批的治疗方法却很稀缺。实验和临床证据表明，有氧运动可能有助于减轻精神病理症状并支持认知表现，但这尚未得到系统研究。在本研究中，我们考察了有氧训练对精神科住院患者认知表现和症状严重程度的影响。据我们所知，迄今为止，尚未发表过直接比较不同疾病组运动效果的研究，以便更好地理解体育锻炼干预的疾病特异性效应与一般效应或重叠效应。两个年龄、性别、病程和受教育年限相匹配的疾病组（n = 22名MDD患者，n = 29名SZ患者）接受了认知训练，训练方式为结合有氧体育锻炼或精神放松训练。干预包括在4周时间内进行12次训练（每周3次），每次持续75分钟（30分钟认知训练 + 45分钟有氧训练/精神放松训练）。所有参与者的认知参数和精神病理学评分在测试前和测试后进行检测，然后与等待对照组进行比较。在患者总组中，结果表明，测试前和测试后相比，视觉学习、工作记忆和加工速度等领域的认知表现有所提高，状态焦虑有所降低，主观生活质量有所提高。与MDD患者相比，SZ患者在认知表现方面的效果更强，而在个体精神病理学值方面，MDD患者比SZ患者的效果更强。干预期后，MDD患者的抑郁症状和状态焦虑值显著降低。SZ患者从测试前到测试后，其阴性症状严重程度有所降低。总之，联合训练的效果优于其他治疗形式。体育锻炼可能有助于减轻精神病理症状并提高认知技能。本研究采用的干预程序有望增加当前的精神病理和医学治疗选择，并有助于向多学科方法的转变。然而，本研究的一个局限性是干预的时间间隔较短（包括测试前和测试后共6周）。
