Exercise interventions in patients with schizophrenia: inspiration to get fit
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LETTER TO THE EDITOR
Exercise interventions in patients with schizophrenia: inspiration to get fit Fulvio A. Scorza1,2 · Antonio‑Carlos G. de Almeida2,3 · Carla A. Scorza1,2 · Josef Finsterer4 Received: 2 September 2020 / Accepted: 14 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Dear Editor, In the “real world”, the complexity of the relationship between mental and physical health is ever present in people with schizophrenia [1]. Further, individuals with a psychotic disorder are far more likely to have significantly poorer physical health when compared to the overall population, with an important year’s reduction in life expectancy due to multiple factors including cardiovascular and metabolic diseases, and poor lifestyle behaviours, such as low physical activity [1]. In this context, we enjoyed reading the recent article entitled, “Aerobic endurance training to improve cognition and enhance recovery in schizophrenia: design and methodology of a multicenter randomized controlled trial” by Maurus and colleagues published in your esteemed journal [2]. The authors strongly support that exercise is an important element in the treatment concept for patients with schizophrenia, recommending exercise interventions as an add-on therapy to promote their recovery [2]. Considering the eminent clinical importance of this study, we would like to add some thoughts that may open the debate about the positive cardiovascular effects mediated by aerobic exercise in patients with schizophrenia. Before that, it is prudent to us clarifying our point of view. * Fulvio A. Scorza [email protected] 1
Disciplina de Neurociência, Escola Paulista de Medicina/ Universidade Federal de São Paulo (EPM/UNIFESP), Rua Pedro de Toledo, 669, 1° andar, 04039‑032 São Paulo, SP, Brasil
2
Centro de Neurociências e Saúde da Mulher “Professor Geraldo Rodrigues de Lima.”, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brasil
3
Laboratório de Neurociência Experimental e Computacional, Departamento de Engenharia de Biossistemas, Universidade Federal de São João del-Rei (UFSJ), São Paulo, Brasil
4
Klinik Landstrasse, Messerli Institute, Vienna, Austria
Individuals with schizophrenia have an increased risk to die prematurely compared to those without this severe mental illness [3]. Thus, this excess of mortality is the result of a combination of some risk factors including patients’ life style, suicide, premature development of cardiovascular disease, pre-existing cardiomyopathy, high prevalence of metabolic syndrome, and cardiotoxicity by neuroleptics [3]. Furthermore, an important additional factor of premature death in schizophrenia patients, extensively debated in the literature, is sudden unexpected death in schizophrenia (SUDS)—estimated to account for up to 10% of mortality in these patients [3]. The mechanisms responsible for SUDS remains poorly understood, but it has been strongly suggested that cardiac arrhythmias play a significant role in this context [3].
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