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21.11.2015

Strength training works as medicine for schizophrenia

If people with schizophrenia do an hour-long workout twice a week in a fitness centre or gym the severity of their symptoms will decrease. Researchers at the Federal University of Rio de Janeiro write about this in an article that will appear soon in Revista Brasileira de Psiquiatria. Straightforward strength training creates the most positive effects in this group, but combined cardio and strength training also pays off.

Schizophrenia
Schizophrenia is one of the most serious mental diseases in the field of psychiatry. People suffering from schizophrenia develop realistic and often frightening hallucinations which are so disturbing that normal functioning becomes impossible. Schizophrenia sufferers hear voices, and see and smell things that are not there.

Schizophrenic people whose fantasy world takes over are often incapable of thinking clearly; they may also become hyperactive, aggressive, think they are the messiah or that they possess supernatural powers, or become paranoid or suffer from persecution mania. These, in a nutshell, are the positive symptoms of schizophrenia.

Hallucinations can be suppressed with antipsychotic drugs such as chlorpromazine, clozapine, olanzapine, risperidone, quetiapine and haloperidol.

People with schizophrenia can also develop negative symptoms. They can become emotionally and socially withdrawn, show passive behaviour and find it difficult to engage in abstract thinking.

Many schizophrenics experience positive and negative symptoms in cycles. Cycles during which negative symptoms dominate alternate with cycles in which positive symptoms have the upper hand. A phase with positive symptoms is also referred to as a psychosis.

Antipsychotics are less effective at fighting the negative symptoms than the positive symptoms of schizophrenia. In fact, antipsychotics can sometimes make the negative symptoms worse.

Study
The Brazilians did an experiment with 34 people suffering from schizophrenia, all of whom used medication to keep the disease under control. The researchers divided their subjects into 3 groups.

A control group [CTRL, Control] did nothing at all during the 20 weeks that the experiment lasted.

A second group trained twice a week for an hour using weights in a gym [Strength training]. So this group did strength training only. Information on how the training routine was built up can be found here.

The third group also trained for an hour twice a week. This group combined strength training with cardio training [Concurrent training]. Information on how their training routine was built up can be found here.

Just before the experiment started, halfway through, and at the end of the 20 weeks, the Brazilians got their subjects to complete the Positive and Negative Syndrome Scale questionnaire. This measures the positive and negative symptoms of schizophrenia. The best score you can get for both sides is 7; the worst is 49.

The Positive and Negative Syndrome Scale questionnaire also measures the extent of general psychopathology: a broad spectrum of psychological symptoms that almost everyone experiences at some time or other, such as concentration problems, restlessness, feelings of guilt and stress. The best score you can get on the general psychopathology part is 16; the worst is 112.

Results
The scores of the control group did not change throughout the experiment.

The scores improved in the two experimental groups. The patients who did strength training showed improvement in particular, as the figure below shows.

The subjects who had combined strength training with cardio workouts also showed some improvement. But this was less pronounced than in the patients who only did strength training.

Explanation
The researchers don't know how strength training relieves schizophrenia. Initially they theorised that strength training would lead to an increased concentration of IGF-1 and BDNF. The thinking was that the growth factors might repair defects in the brains of schizophrenia sufferers. But the researchers did not find any increase in IGF-1 or BDNF levels among the subjects of the experimental groups.

Conclusion
"Our results suggest that resistance or concurrent exercise programs improve symptoms [...] in patients with schizophrenia", the Brazilians wrote. "This study reinforces the importance of resistance and concurrent training as non-pharmacological strategies for the treatment of schizophrenia."

"Two sessions per week with progressive loading are sufficient to produce benefits. Physical exercise is an important, low-cost therapeutic tool."

Source:
Braz J Psychiatry. 2015 Oct-Dec;37(4):271-9.

More:
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Fish oil capsules prevent psychoses 11.02.2010

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