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Primary Prevention – Improves mental health

Improves mental health

Evidence summary

Individuals with serious mental health conditions, such as schizophrenia, are significantly less physically active, more sedentary and have a lower cardiorespiratory fitness level, with increased morbidity & mortality compared to the general population (1). Physical activity, including the practice of yoga (2) has been shown to treat both the positive & negative symptoms of schizophrenia, when used in combination with pharmacological therapy (and in addition can help to reduce the weight gain associated with drug treatment). A case-controlled RCT demonstrated that an aerobic exercise intervention improved both negative and general symptoms of schizophrenia, and that the negative symptoms continued to improve after completion. Those with more severe symptoms at the start of the intervention showed a trend towards greater improvement. Although a review of RCTs evaluating exercise interventions did not show a significant change in BMI, it did demonstrate possible improvements in physical fitness and reduced psychiatric symptoms. Participant education and motivation may improve the uptake of physical activity in this group (3). Physical activity is also associated with neuroprotective effects, such as reduced inflammation, increased neurogenesis & neuroplasticity, and remyelination of white matter tracts (4). There is good evidence that physical activity can improve the symptoms of mental illness, work is now required to identify the optimal type and dose, as well as strategies for participant uptake and behavioural change.

Quality of evidence

Moderate quality

Strength of recommendation

Strong

References

  1. Physical activity pattern and cardiorespiratory fitness in individuals withschizophrenia compared with a population-based sample.

Schizophr Res. 2018 May 31 [epub ahead of print]

  1. Holistic Management of Schizophrenia Symptoms Using Pharmacological and Non-Pharmacological Treatment

Ganguly P, Soliman A, Moustafa AA.

Front Public Health. 2018 Jun 7;6:166

  1. Improving life expectancy in people with serious mental illness: should we place more emphasis on primary prevention?

Br J Psychiatry. 2017 Oct;211(4):194-197

  1. Therapeutic Potential ofPhysicalExercisein Early Psychosis.

Am J Psychiatry. 2018 Mar 1;175(3):209-214

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