Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Neuroimaging Core Unit Munich (NICUM), University Hospital, LMU Munich, Munich, Germany.
Psychiatry Res. 2023 Oct;328:115480. doi: 10.1016/j.psychres.2023.115480. Epub 2023 Sep 10.
Current treatment methods do not achieve recovery for most individuals with schizophrenia, and symptoms such as negative symptoms and cognitive deficits often persist. Aerobic endurance training has been suggested as a potential add-on treatment targeting both physical and mental health. We performed a large-scale multicenter, rater-blind, parallel-group randomized controlled clinical trial in individuals with stable schizophrenia. Participants underwent a professionally supervised six-month training comprising either aerobic endurance training (AET) or flexibility, strengthening, and balance training (FSBT, control group), follow-up was another six months. The primary endpoint was all-cause discontinuation (ACD); secondary endpoints included effects on psychopathology, cognition, functioning, and cardiovascular risk. In total, 180 participants were randomized. AET was not superior to FSBT in ACD and most secondary outcomes, with dropout rates of 59.55% and 57.14% in the six-month active phase, respectively. However, both groups showed significant improvements in positive, general, and total symptoms, levels of functioning and in cognitive performance. A higher training frequency additionally promoted further memory domains. Participants with higher baseline cognitive abilities were more likely to respond to the interventions. Our results support integrating exercise into schizophrenia treatment, while future studies should aim to develop personalized training recommendations to maximize exercise-induced benefits.
目前的治疗方法并不能使大多数精神分裂症患者康复，阴性症状和认知缺陷等症状往往持续存在。有氧运动训练已被提议作为一种潜在的附加治疗方法，针对身心健康。我们在稳定的精神分裂症患者中进行了一项大规模的多中心、评估者盲法、平行组随机对照临床试验。参与者接受了为期六个月的专业监督训练，包括有氧运动耐力训练（AET）或柔韧性、力量和平衡训练（FSBT，对照组），随访期为另外六个月。主要终点是全因停药（ACD）；次要终点包括对精神病理学、认知、功能和心血管风险的影响。共有 180 名参与者被随机分配。AET 在 ACD 和大多数次要结局方面并不优于 FSBT，在六个月的活跃期，脱落率分别为 59.55%和 57.14%。然而，两组在阳性、一般和总症状、功能水平以及认知表现方面都有显著改善。更高的训练频率还促进了进一步的记忆领域。基线认知能力较高的参与者更有可能对干预措施做出反应。我们的结果支持将运动融入精神分裂症治疗中，而未来的研究应旨在制定个性化的训练建议，以最大限度地发挥运动带来的益处。
