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Exercise effects on cognitive functioning in young adults with first-episode psychosis: FitForLife

Published online by Cambridge University Press:  06 May 2018

Mats Hallgren*
Deparment of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
Maria Skott
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
Örjan Ekblom
Swedish School of Sport and Health Sciences, Stockholm, Sweden
Joseph Firth
NICM Health Research Institute, Western Sydney University, Sydney, Australia Department of Psychology and Mental Health, University of Manchester, Manchester, UK
Adrian Schembri
Cogstate Pty Ltd, Melbourne, Australia
Yvonne Forsell
Deparment of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
Author for correspondence: Mats Hallgren, E-mail:



Exercise has mood-enhancing effects and can improve cognitive functioning, but the effects in first-episode psychosis (FEP) remain understudied. We examined the feasibility and cognitive effects of exercise in FEP.


Multi-center, open-label intervention study. Ninety-one outpatients with FEP (mean age = 30 years, 65% male) received usual care plus a 12-week supervised circuit-training program, consisting of high-volume resistance exercises, aerobic training, and stretching. Primary study outcome was cognitive functioning assessed by Cogstate Brief Battery (processing speed, attention, visual learning, working memory) and Trailmaking A and B tasks (visual attention and task shifting). Within-group changes in cognition were assessed using paired sample t tests with effect sizes (Hedges’ g) reported for significant values. Relationships between exercise frequency and cognitive improvement were assessed using analysis of covariance. Moderating effects of gender were explored with stratified analyses.


Participants exercised on average 13.5 (s.d. = 11.7) times. Forty-eight percent completed 12 or more sessions. Significant post-intervention improvements were seen for processing speed, visual learning, and visual attention; all with moderate effect sizes (g = 0.47–0.49, p < 0.05). Exercise participation was also associated with a positive non-significant trend for working memory (p < 0.07). Stratified analyses indicated a moderating effect of gender. Positive changes were seen among females only for processing speed, visual learning, working memory, and visual attention (g = 0.43–0.69). A significant bivariate correlation was found between total training frequency and improvements in visual attention among males (r = 0.40, p < 0.05).


Supported physical exercise is a feasible and safe adjunct treatment for FEP with potential cognitive benefits, especially among females.

Original Articles
Copyright © Cambridge University Press 2018 

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