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Background: Exercise may improve cardiorespiratory fitness in people with schizophrenia, however, possible condition-specific cardiorespiratory disadvantages, a scarcity of methodologically sound studies, and conflicting results raise questions about the effect of exercise on maximal oxygen uptake (VO 2max ) in this group. The primary aim of this study, therefore, was to investigate the effect of high-intensity interval training on VO 2max in people with schizophrenia. Second, we sought to determine whether the intervention would have an effect on general physical activity (PA) level and body composition., Methods: Eighty-two patients with schizophrenia were randomly assigned to supervised high-intensity interval training or computer gaming skills training, performed twice a week for 12 weeks. Oxygen uptake was measured directly, during a maximum exercise session on a treadmill. PA level were assessed using ActiGraph accelerometer, and body composition was assessed by bioelectrical impedance. Differences between groups were assessed by analysis of variance using a univariate general linear model., Results: There were no significant differences between the groups on any of the cardiorespiratory variables neither at baseline nor after the program. There were also no significant within-group differences in any of the cardiorespiratory fitness variables between the baseline and post-program time points, despite that 61% of the participants performing high-intensity interval training showed a significant increase in workload on the treadmill. However, 47% of the participants in the high-intensity interval training group had a ≥ 5% increase in VO 2max . Participants supervised by mental health care providers with PA competence (e.g. rehabilitation center staff, sport scientist, physical trainer) had a much larger increase in VO 2max compared to participants supervised by mental health workers without such competence, and when adding PA competence to the model, the intervention group increased VO 2max significantly compared to the comparison group. The intervention had no significant effect on PA level or body composition., Conclusions: The intervention did not improve VO 2max , PA level or body composition but succeeded in increasing workload on the treadmill. With regard to VO 2max , approximately half of the patients may be considered responders., Trial Registration: ClinicalTrials.gov ; NCT02205684 , registered July 2014.

Objective: We investigated whether the relationship between cardio-respiratory fitness (CRF) and cognition in schizophrenia is general, or due to selective relationships between CRF and specific aspects of cognitive function., Method: Eighty outpatients with schizophrenia spectrum disorders participated. Neurocognition was assessed with the Wechsler Adult Intelligence Scale version 4 General Ability Index (WAIS GAI), the MATRICS Consensus Cognitive Battery (MCCB) and the Emotion in Biological Motion (EBM) test. CRF was assessed with peak oxygen uptake measured directly during maximum exercise using a modified Balke protocol. Partial correlations, controlling for sex and age, were obtained for the perceptual and the verbal indices of WAIS GAI, six cognitive domains of MCCB, and the EBM total score. A factor analysis was conducted on all 15 subtests of the WAIS GAI and the MCCB, and the factors were subjected to separate regression analyses with CRF as predictor., Results: Significant, moderately sized correlations were found between CRF and all cognitive domains except processing speed. The correlation appeared strongest for CRF and the Verbal Comprehension Index of WAIS GAI (r = 0.29, p = .005). The factor analysis identified three factors: one speed/attention/executive function factor, one verbal factor, and one perceptual factor. Regression analyses showed that VO 2peak explained a significant amount of variance in the verbal factor only (R 2  = 0.06, β = 0.329, p = .03)., Conclusion: The results indicate that the relationship between CRF and cognition in schizophrenia is selectively tied to a modality-specific association with verbal cognitive abilities. These findings have implications for understanding the relation between cognitive factors and physical health in schizophrenia. ClinicalTrials.gov reg. number NCT02205684 (clinicaltrials.gov/ct2/show/NCT02205684)., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Objective: Thorough description of objectively assessed physical activity (PA) and sedentary time in people with schizophrenia is lacking, and previous studies comparing PA and cardiorespiratory fitness levels with healthy controls are limited by their small sample size and/or poor methodology., Method: PA, sedentary behavior, and cardiorespiratory fitness level were assessed in 67 adults diagnosed with schizophrenia (EPHAPS study) and compared with a population-based sample of 2809 adults (NPASS study)., Results: Fifty-five percent of the participants with schizophrenia had the unhealthy combination of not meeting the PA recommendations and sitting >7.5 h per day compared to 32% in the population-based sample. The PA level was especially low on weekday afternoons and evenings and throughout most of the day on weekends. The peak oxygen uptake for EPHAPS women was on average 23% lower than that for NPASS women, while EPHAPS men achieved on average 34% lower oxygen uptake on the exercise test compared with NPASS men., Conclusion: People with schizophrenia are significantly less physically active, more sedentary, and have a poorer cardiorespiratory fitness level compared with the general population. Tailor-made PA interventions for people with schizophrenia should target their PA and sedentary behavior on afternoons and weekends especially., (Copyright © 2018 Elsevier B.V. All rights reserved.)

While the influence of negative symptoms on vocational outcome is well documented, the specific contribution of apathy is less explored. The current study examined the influence of apathy on vocational outcome. A total of 148 participants were included in a vocational rehabilitation study, offering cognitive remediation (CR) or cognitive behavior therapy (CBT) to address work-related issues. Clinical and functional measures were assessed on inclusion and at posttreatment after approximately 10 months. The level of apathy was not related to the acquisition of work, but higher levels of apathy predicted fewer hours worked per week during the study. Previous employment predicted future employment, and higher education predicted more hours worked and higher score on the Work Behavior Inventory. The results did not differ across interventions. Thus, despite apathy, people with schizophrenia were able to work when the barriers to employment were addressed and adequate support was given.