This page was translated automatically from Turkish. Read the original

This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO335

Physical exercise in severe mental illness: a transdiagnostic approach to improving mental and physical health

PHYSICAL EXERCISE IN SEVERE MENTAL ILLNESS: A TRANSDIAGNOSTIC APPROACH TO IMPROVING MENTAL AND PHYSICAL HEALTH

Exercise in severe mental illness is an intervention that should be prescribed, rather than merely recommended, as an adjunctive treatment, with moderate effects particularly on depressive symptoms and quality of life.

The aim is to bring together current evidence on the effects, optimal prescription, and clinical implications of physical exercise in severe mental illness (SMI), encompassing schizophrenia spectrum disorders and bipolar disorder; these conditions are associated with a high psychiatric burden, cognitive impairment, and reduced life expectancy, largely attributable to cardiometabolic comorbidity. The method is a narrative review integrating recent systematic reviews and meta-analyses; it draws particularly on the systematic review and meta-analysis of exercise interventions in psychotic disorders by Rißmayer et al. (2024) and the umbrella review encompassing 103 meta-analyses by Lu et al. (2025). The outcomes of interest were psychiatric symptoms, cognitive functioning, quality of life, and physical health indicators, with consideration given to variability in exercise type, intensity, duration, and delivery format. Effect sizes reported in meta-analyses, predominantly involving psychotic disorders, are as follows: psychotic symptoms (PANSS total score), standardised mean difference (SMD) −0.37 (small-to-moderate effect); negative symptoms, SMD −0.33; positive symptoms, SMD −0.18; depressive symptoms, SMD −0.70 (larger effect); and quality of life, SMD +0.55 (larger effect). No consistent significant effects were found for physical outcomes such as body mass index and VO2peak. The evidence-based prescription recommendation is at least 3 sessions per week, moderate intensity as the default, 30 to 60 minutes per session, aerobic and resistance exercise with mind–body exercises (such as Tai Chi) as an alternative or addition, a duration of at least 12 weeks particularly for psychotic disorders, preferably supervised initially, and potentially delivered in a beneficial group format. Moderate-intensity exercise appears more effective than low-intensity exercise, more frequent weekly sessions may improve functioning, and mind–body exercises may provide additional benefits for positive symptoms and general psychopathology; however, results remain heterogeneous. Treatment effects are influenced by baseline functioning, treatment adherence, and illness severity. In conclusion, exercise is a scalable, cost-effective, transdiagnostic intervention with benefits extending across psychiatric, cognitive, and metabolic domains; the strongest evidence pertains to schizophrenia spectrum disorders, evidence specific to bipolar disorder is more limited, and future research should focus on optimising intervention design and integrating exercise into routine psychiatric services.

All WCP 2026 summaries