By: Melissa Yanovitch, MSc, MS
Exercise & Cognition
In people diagnosed with schizophrenia, deficits in cognitive functioning can lead to significant functional impairment and long-term disability (Green, Kern, Braaff & Mintz, 2000). A recent meta-analysis of 10 controlled trials studying the effects of exercise on cognitive functioning in people with schizophrenia found that exercise significantly improved global cognition, working memory, social cognition and attention/vigilance (Firth et al., 2016). The researchers found that higher doses of exercise were correlated with greater improvement in cognitive functioning. Another important finding from the meta-analysis was that exercise supervised by physical activity professionals was more effective (Firth et al., 2016). Potential implications of these findings include the promise of improved interventions for the deficits in cognitive functioning of people diagnosed with schizophrenia. This, in turn, holds the promise of mitigating the often devastating functional impairment that can be the result of such deficits.
Firth, J., Stubbs, B., Rosenbaum, S., Vancampfort, D., & Malchow, B. (2016). Aerobic Exercise Improves Cognitive Functioning in People With Schizophrenia: A Systematic Review and Meta-Analysis, 1–11. doi:10.1093/schbul/sbw115
Green MF, Kern RS, Braff DL, Mintz J. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the ‘right stuff’? Schizophrenia Bulletin 2000; 26:119–136.
For patients who meet criteria for psychosis risk syndrome, as determined by the Structured Interview for Prodromal Syndromes (SIPS), researchers Cannon et al. (in advance) have developed an individualized risk calculator to estimate the probability of conversion to psychosis in clinical high-risk patients. The study followed 596 clinical-high risk individuals for 2 years, and saw a 16% probability of conversion to psychosis within the sample. The researchers looked at functioning, clinical and neurocognitive predictor variables for conversion to psychosis and found that “higher levels of unusual thought content and suspiciousness, greater decline in social functioning, lower verbal learning and memory performance, slower speed of processing, and younger age at baseline each contributed to individual risk for psychosis” (p. 1). The variables that did not significantly predict conversion were trauma, stressful life events and family history of schizophrenia, which have been theorized as being predictive of psychosis in previous studies (Holtzman, Shapiro, Trotman, et al., 2012). A study by Carrion et al. (in advance) provided external validation of the risk calculator and supported the tool as a “meaningful step toward early intervention and the personalized treatment of psychotic disorders” (p. 1).
Cannon, T. D., Yu, C., Addington, J., Bearden, C. E., … Cadenhead, K. S. (n.d.). An Individualized Risk Calculator for Research in Prodromal Psychosis, (4), 1–9. doi:10.1176/appi.ajp.2016.15070890
Carrión, R. E., Cornblatt, B. A., Burton, C. Z., & Tso, I. F. (n.d.). Personalized Prediction of Psychosis: External Validation of the NAPLS-2 Psychosis Risk Calculator With the ECIPPP Project. Doi: 10.1176/appi.ajp.2016. 15121565
Holtzman CW, Shapiro DI, Trotman HD, et al: Stress and the prodromal phase of psychosis. Current Pharmaceutical Design 2012; 18:527–533