The impact of exercise training complementary to early intervention in patients with first-episode psychosis: a qualitative sub-study from a randomized controlled feasibility trial

TY - JOUR

T1 - The impact of exercise training complementary to early intervention in patients with first-episode psychosis

T2 - a qualitative sub-study from a randomized controlled feasibility trial

AU - Larsen, Lene Q

AU - Schnor, Helle

AU - Tersbøl, Britt P

AU - Ebdrup, Bjørn H

AU - Nordsborg, Nikolai Baastrup

AU - Midtgaard, Julie

N1 - CURIS 2019 NEXS 218

PY - 2019/6/21

Y1 - 2019/6/21

N2 - Background: Burgeoning evidence suggests that exercise improves physical and mental health in people with schizophrenia. However, little is known about the feasibility and acceptability of high-intensity training in patients with first-episode psychosis. This qualitative study explored motivation, social interaction and experiences of participants and instructors in relation to an eight-week moderate to high intensity exercise training programme in a clinical trial including patients with first-episode psychosis.Methods: The study used a combination of method, source and investigator triangulation. Data were collected by means of semi-structured individual interviews with participants at baseline (n = 16) and at follow-up (n = 9), as well as by means of participant observations during the programme (8 sessions × 1.5 h, 12 h in total) and focus group discussions with participants (n = 3) and instructors (n = 4), respectively, after the programme. Data were analysed using thematic analysis as described by Braun and Clarke.Results: Three main themes and ten subthemes emerged during the analysis: 1) motivation and expectations for enrolment (subthemes: routines and structure, social obligation, goal setting and self-worth); 2) new demands and opportunities (subthemes: practicalities of the training, an understanding exercise setting, and alone and together); and 3) looking ahead - reflections on impact (subthemes: restored sleep and circadian rhythm, energy and sense of achievement, changed everyday life, and hope of finding a new path). Findings suggest that the programme was appealing to, and appreciated by, the participants because of its potential to create an equally challenging and caring non-clinical environment.Conclusions: This study indicates that supervised, group-based, moderate to high intensity exercise training complementary to early intervention in psychosis is acceptable. Specifically, the intervention appeared to provide patients an opportunity to integrate the notion of being a young individual along with being a patient with a psychiatric diagnosis, thus supporting and promoting recovery.Trial registration: ClinicalTrials.gov identifier: NCT03409393. Registered January 24, 2018.

AB - Background: Burgeoning evidence suggests that exercise improves physical and mental health in people with schizophrenia. However, little is known about the feasibility and acceptability of high-intensity training in patients with first-episode psychosis. This qualitative study explored motivation, social interaction and experiences of participants and instructors in relation to an eight-week moderate to high intensity exercise training programme in a clinical trial including patients with first-episode psychosis.Methods: The study used a combination of method, source and investigator triangulation. Data were collected by means of semi-structured individual interviews with participants at baseline (n = 16) and at follow-up (n = 9), as well as by means of participant observations during the programme (8 sessions × 1.5 h, 12 h in total) and focus group discussions with participants (n = 3) and instructors (n = 4), respectively, after the programme. Data were analysed using thematic analysis as described by Braun and Clarke.Results: Three main themes and ten subthemes emerged during the analysis: 1) motivation and expectations for enrolment (subthemes: routines and structure, social obligation, goal setting and self-worth); 2) new demands and opportunities (subthemes: practicalities of the training, an understanding exercise setting, and alone and together); and 3) looking ahead - reflections on impact (subthemes: restored sleep and circadian rhythm, energy and sense of achievement, changed everyday life, and hope of finding a new path). Findings suggest that the programme was appealing to, and appreciated by, the participants because of its potential to create an equally challenging and caring non-clinical environment.Conclusions: This study indicates that supervised, group-based, moderate to high intensity exercise training complementary to early intervention in psychosis is acceptable. Specifically, the intervention appeared to provide patients an opportunity to integrate the notion of being a young individual along with being a patient with a psychiatric diagnosis, thus supporting and promoting recovery.Trial registration: ClinicalTrials.gov identifier: NCT03409393. Registered January 24, 2018.

KW - Faculty of Science

KW - Schizophrenia

KW - Exercise training

KW - Early intervention

KW - Young adults

KW - Recovery

KW - First-episode psychosis

KW - Thematic analysis

U2 - 10.1186/s12888-019-2179-3

DO - 10.1186/s12888-019-2179-3

M3 - Journal article

C2 - 31226959

SN - 1471-244X

VL - 19

JO - BMC Psychiatry

JF - BMC Psychiatry

M1 - 192

ER -