Does physical activity reduce the risk of psychosis? A systematic review and meta-analysis of prospective studies
Open accessAbstract
Longitudinal prospective cohorts have suggested that physical activity (PA) may be a protective factor against psychosis and schizophrenia. However, no meta-analysis has been conducted. The study aims to examine the prospective relationship between PA and incident psychosis/schizophrenia. Major databases were searched from inception to July 2019 for prospective studies that calculated the odds ratio (OR) or the adjusted odds ratio (AOR) of incident psychosis/schizophrenia in people with higher PA against people with lower PA. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was conducted, for OR and AOR, separately. Across 4 cohorts (N = 30,025 median males = 50%, median follow-up = 32 years), people with high self-reported PA (versus low PA) were at reduced odds of developing psychosis/schizophrenia (OR = 0.73, 95%CI 0.532 to 0.995, p = 0.047). Analysis including 2 cohorts presenting AOR were not statistically significant (AOR = 0.59, 95%CI 0.253 to 1.383, p = 0.226). Overall study quality was high (mean NOS = 7.0). The literature on the topic is scarce, whilst crude analysis suggests that PA may be a protective factor against the emergence of psychosis/schizophrenia, but when adjusting for covariates, the association is no longer significant. Further studies with objective physical activity and adjustment for confounders are needed.
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Across five prospective comparisons, with 4-32 years of follow-up, higher levels of physical activity significantly reduced risk of incident psychosis (OR=0.728, 95% CI: 0.532-0.995, I2=36.9%).
“Across five prospective comparisons, with 4-32 years of follow-up, higher levels of physical activity significantly reduced risk of incident psychosis (OR=0.728, 95% CI: 0.532-0.995, I²=36.9%).”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [38]
The Meta-analysis section reports five crude-odds comparisons from four studies, a significant association (OR≈0.73, 95% CI 0.532–0.995), and I²=36.93%; Studies details gives 4–32 years of follow-up. But the adjusted analysis was not significant, so the unqualified statement that activity significantly reduced risk overstates the finding and implies causation the paper does not establish. Page numbers are unavailable in our copy. (LLM, conf=0.88)
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- Authors
- Brokmeier, L. L., Firth, J., Vancampfort, D., Smith, L., Deenik, J., Rosenbaum, S., Stubbs, B., & Schuch, F. B.
- Affiliations
- University of Konstanz (DE)
- The University of Melbourne (AU)
- KU Leuven (BE)
- Anglia Ruskin University (GB)
- Maastricht University (NL)
- Black Dog Institute (AU)
- King's College London (GB)
- Universidade Federal de Santa Maria (BR)
- Corresponding author
- Schuch, Felipe Barreto
- ORCID
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2020-02
- Volume
- 284
- Pages
- 112675
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2984146898
- Cited by
- 56
- References
- 43
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 14 · 2023: 8 · 2022: 1 · 2021: 9 · 2020: 8
- FWCI
- 0.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, cc-by-nc-nd)
- Lirias (KU Leuven) (submittedVersion, other-oa)
- Anglia Ruskin Research Online (Anglia Ruskin University) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Figshare (submittedVersion, cc-by-nc-nd)
- Research Portal (King's College London) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Funders
- National Institute for Health and Care Research (ICA-CL-2017-03-001, NIHR-INF-0685)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Life-span and Life-course Studies › Sports and Physical Education Studies
- Keywords
- physical activity, psychosis, schizophrenia, protective factors, prospective cohort, self-reported physical activity, confounding adjustment
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Prospective Studies, Psychotic Disorders, Risk Factors, Schizophrenia, Exercise, Incidence, Odds Ratio, Risk Reduction Behavior, Self Report
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