Immediate Psychological Responses to Aerobic and Resistance Exercise in People With Psychotic Disorders: A Randomized Controlled Trial in Psychiatric Rehabilitation.

Nicole Korman, Justin Chapman, Ahmed Jerome Romain, Urska Arnautovska, Brendon Stubbs, Simon Rosenbaum, Dan J Siskind, Robert Stanton, Mike Trott

Journal: Schizophrenia bulletin 2026;52(2):

PMID: 41863360

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Abstract

BACKGROUND AND HYPOTHESIS

People with psychotic disorders have limited strategies to manage acute psychological distress and emotions. Exercise has physical and mental health benefits but immediate psychological effects in this population remain underexplored. This study compared immediate psychological responses to resistance training (RT) and aerobic exercise among individuals with psychotic disorders in psychiatric rehabilitation and examined whether clinical characteristics were associated with these responses.

STUDY DESIGN

Fifty-three participants were randomized to RT or aerobic exercise. Immediate psychological responses-psychological distress, positive wellbeing, and fatigue-were assessed using the Subjective Exercise Experiences Scale at 2 timepoints within an 8-week trial (week 3: n = 52; week 8: n = 48), pre- and 10 min post-exercise. Baseline assessments included clinical and motivational variables. Primary analyses used linear mixed models for repeated measures.

STUDY RESULTS

Both exercise types led to large increases in positive wellbeing (RT: Hedges' g = 1.24; aerobic: g = 1.31) and reductions in psychological distress (RT: g = -0.91; aerobic: g = -1.05). A significant group-by-time interaction was observed for fatigue, which increased in RT (g = 0.43) and decreased in aerobic (g = -0.58). Higher fatigue was associated with greater controlled motivation (β = 1.72) and depressed mood (β = 0.80) at baseline.

CONCLUSIONS

RT and aerobic exercise improved positive wellbeing and reduced psychological distress whereas fatigue differed by exercise type. Findings suggest exercise may be a promising intervention for modulating immediate psychological responses in people with psychotic disorders in psychiatric rehabilitation.

Address: Metro South Addiction and Mental Health Service, Metro South Health, Brisbane, 4102, Australia.; Queensland Centre for Mental Health Research, Wacol, 4076, Australia.; Faculty of Medicine, Health and Behavioural Sciences, The University of Queensland, Brisbane, 4072, Australia.; Metro South Addiction and Mental Health Service, Metro South Health, Brisbane, 4102, Australia.; School of Pharmacy and Medical Sciences, Centre for Mental Health, Griffith University, Brisbane, QLD, 4111, Australia.; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, H1N3V2, Canada.; School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montréal, Québec, H3T1J4, Canada.; Department of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom, SE58AF.; Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, 1090, Austria.; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, 1090, Austria.; Nutrition, Exercise and Social Equity Research Group, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia.; School of Health, Medical, and Applied Sciences, Central Queensland University, Rockhampton, QLD, 4701, Australia.; Cluster for Resilience and Wellbeing, Appleton Institute, Central Queensland University, Wayville, South Australia, 5034, Australia.

DOI: 10.1093/schbul/sbag012

MeSH Terms: Humans, Male, Female, Adult, Psychotic Disorders, Resistance Training, Middle Aged, Exercise, Psychiatric Rehabilitation, Psychological Distress, Fatigue, Outcome Assessment, Health Care, Exercise Therapy, Schizophrenia