Schizophrenia is a chronic, complex neuropsychiatric disorder that affects approximately 24 million people worldwide, according to the World Health Organisation. This disorder has a significant impact on the quality of life of those affected and their families, in addition to the stigma and discrimination of society.

A study conducted by Sara Maldonado-Martin and Mikel Tous-Espelosin in GIKAFIT (Gizartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea), the Society, Sports and Physical Exercise Research Group of the UPV/EHU, in collaboration with the Psychiatric Hospital of Álava and the University of Deusto, aimed to investigate the effect on people with schizophrenia of an adjunct programme of out-patient physical exercise as a complement to the usual treatment. The aim was to see whether there were improvements in overall health, while addressing the lack of focus on homogenous groups of patients and giving people with schizophrenia a voice to find out about their subjective experiences. Tous-Espelosin explained that “physical exercise has been seen to exert highly beneficial effects on health in various vulnerable populations”, and added that “not only does it improve the physical side, but it can also improve other aspects of the disease”.

"Schizophrenia has three types of symptoms: positive, negative and cognitive,” explained Tous-Espelosin. "The positive ones may be delusions or hallucinations and can normally be treated with medication. For negative symptoms (sadness, lack of energy, apathy) there is no medication that can treat them, but thanks to physical exercise symptoms of this type may improve. Physical exercise is like a brain modulator that leads to an increase in the expression of certain proteins and improves the brain's own plasticity, i.e. functional and structural adaptations of the brain are produced and which are associated with improvements in learning, memory and cognitive function.”

A concurrent exercise programme

Participants diagnosed with schizophrenia underwent an intensive programme of concurrent, out-patient physical exercise (training combining an aerobic component with an endurance and resistance circuit) for five months, three times a week. Qualitative data were gathered through semi-structured individual interviews, and then organised and analysed using thematic analysis. “Both before and after the participants did their physical exercise, we interviewed them for about 35 minutes. In the interviews we asked them about their experience with respect to physical exercise in the past, and whether or not they continued to do physical exercise because of the condition. When they started the programme, we asked them about their feelings, and once it was over, what benefits they felt,” explained the UPV/EHU researcher.

The findings of this research support the strategic use of physical exercise as part of the treatment and maintenance of overall health in individuals with schizophrenia. “Physical exercise can be an adjunct treatment,” added the researcher, “it can help the pharmacological treatment itself. The results show that patients feel that the out-patient physical exercise programme could be a very welcome and beneficial complement to their usual treatment, and demonstrate that physical exercise has helped them to take their minds off their problems. “This study is a real-life characterisation of what happens to people with schizophrenia and how they feel when they exercise properly. Ideally, psychiatric hospitals should designate a physical-sports trainer with whom a properly designed and supervised physical exercise programme can be run, which is why we would like to thank the Álava Psychiatric Hospital for having placed their trust in our trainer,” he concluded.

Additional information

Mikel Tous-Espelosín is a predoctoral student of the UPV/EHU and Sara Maldonado-Martín is a lecturer and researcher in the Department of Physical Education and Sports of the Faculty of Education and Sport (UPV/EHU).