Coupling physical exercise with dietary glucose supplement for treating cognitive impairment in schizophrenia: A theoretical model and future directions

Aims: Metabolic dysregulation may disrupt the complex neuroprotective mechanisms essential for brain health. Recent studies have pointed out the possible aetiological role of metabolic dysregulation in the onset of schizophrenia and the associated cognitive impairment. In this paper, we aimed to generate a theoretical model of how a combination of physical exercise and dietary glucose supplement may help to alleviate cognitive impairment in schizophrenia. Methods: Literature on metabolic dysregulation, especially insulin resistance, in relation to the onset of schizophrenia and the associated cognitive impairment is reviewed. The cognitive enhancement effects of physical exercise and dietary glucose supplement are then summarised. Finally, we propose a theoretical model based on the concerted effects of physical exercise and glucose supplement. Results: In general, the joint action of physical exercise and dietary glucose supplement could up-regulate glucose and insulin transport into the brain, as well as augmenting the release of insulin growth factor-1 and brain-derived neurotrophic factor. Physical exercise and glucose supplement could enhance energy supply and neuroplasticity in brain, subsequently leading to potential cognitive enhancement in schizophrenia. However, glucose supplement is not suitable for patients with abnormal metabolic profile. Conclusions: The combination of physical exercise and glucose supplement has potential therapeutic values in treating cognitive impairment in schizophrenia. Further research is necessary to investigate the optimal patterns of exercise and doses of glucose for treating cognitive impairment in schizophrenia. © 2013 Wiley Publishing Asia Pty Ltd.link_to_subscribed_fulltex

Sexual dysfunction in Chinese patients with first-episode psychosis: Prevalence, clinical correlates and functioning

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Impact of physical activity on functioning of patients with first-episode psychosis - A 6months prospective longitudinal study

There has been increasing interest in studying the impact of physical activity on the psychological and physical well-being and functioning in patients with first-episode psychosis. The exploration of factors which contribute to physical activity in psychosis may open up opportunities for improvement of functional outcome. The purpose of this study was to examine the association between physical activity level and functioning in psychosis. A total of 283 patients with first-episode psychosis were recruited from a specialized early intervention service for adult-onset psychosis (Jockey Club Early Psychosis Project) in Hong Kong. The level of physical activity, sociodemographics and clinical characteristics was assessed at study entry. Functioning was assessed at 6-months period. Ninety-six (33.9%) patients were categorized as physically inactive, and 187 (66.1%) of them were physically active. Being physically inactive (β = 0.163, P= 0.003), having more positive and negative symptoms [SAPS total score (β = -0.161, P= 0.005), and SANS total score (β = -0.202, P = 0.001)], and having lower household income (β = 0.207, P= 0.001) at baseline predicted poorer functioning at 6. months. Early intervention for psychosis should target to improve patients' physical activity level which may help subsequent functioning. © 2013 Elsevier B.V.link_to_subscribed_fulltex