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October 23, 2023
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Lifestyle intervention based on exercise and behavioural counselling and its effect on physical and psychological health in outpatients with schizophrenia spectrum disorders. An exploratory, pragmatic randomized clinical trial

Publicated to:Schizophrenia Research. 261 256-268 - 2023-11-01 261(), DOI: 10.1016/j.schres.2023.09.036

Authors: Fernández-Abascal, B; Suárez-Pinilla, M; Cobo-Corrales, C; Crespo-Facorro, B; Suárez-Pinilla, P

Affiliations

Centro de Investigación Biomédica En Red de Salud Mental , Hospital Universitario Marqués de Valdecilla - Author
Centro de Investigación Biomédica En Red de Salud Mental , Hospital Universitario Virgen del Rocío - Author
Hosp Univ Marques Valdecilla, Dept Psychiat, Avda Valdecilla S-N, Santander 39008, Spain - Author
Hospital Universitario Marqués de Valdecilla - Author
Inst Salud Carlos III, Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid 28029, Spain - Author
Univ Cantabria, Sch Educ, Santander 39005, Spain - Author
Univ Cantabria, Univ Hosp Marques Valdecilla, Dept Psychiat, IDIVAL,Med Sch, Santander 39011, Spain - Author
Univ Hosp Virgen Rocio IBiS, Sch Med, Dept Psychiat, Seville 41013, Spain - Author
Univ Politecn Madrid UPM, Ctr Biomed Technol, Lab Clin Neurosci, Madrid 28223, Spain - Author
Universidad de Cantabria - Author
Universidad Politécnica de Madrid - Author
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Abstract

Patients with Schizophrenia Spectrum Disorders (SSD) often lead unhealthy lifestyles. This pragmatic trial evaluated the effectiveness of a lifestyle intervention, consisting of a 12-week aerobic exercise program and behavioural counselling, in SSD outpatients with metabolic syndrome (MetS). It also aimed to assess persistence of potential effects in a 24-month long-term follow-up. Effectiveness was measured in terms of a wide range of outcomes involving physical and psychological health, quality of life, physical activity and changes in motivation to exercise within the context of the self-determination theory. Our primary outcome was waist circumference change. Thirty-three out of 48 participants completed the study. No differences between groups were found in terms of BMI change or other metabolic parameters. However, the active group (AG) showed improvement regarding waist circumference, negative symptomatology and identified motivation to exercise during the study and follow-up. The AG exhibited changes toward a more active pattern of activity after intervention. Moreover, belonging to the AG was a significant predictor for achieving any degree of clinical improvement after 24-month follow-up. Combined interventions of exercise and behavioural counselling in SSD patients with MetS should be considered as an essential part of the integral treatment in the context of mental health services.

Keywords

aerobic exerciseblood-pressurebody-compositionclinical trialexercisefollow-up studiesimpactindividualsinduced weight-gainmetabolic abnormalitiesmetabolic syndromephysical activityrisksex-differencesClinical trialCounselingExerciseFollow-up studiesHumansLife styleMetabolic syndromeOutpatientsPhysical activityQuality of lifeSchizophreniaSelf-determination theory

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Schizophrenia Research due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2023, it was in position 66/279, thus managing to position itself as a Q1 (Primer Cuartil), in the category Psychiatry.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 1.59, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-13, the following number of citations:

  • WoS: 1

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-13:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 38.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 69 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 0.5.
  • The number of mentions on the social network X (formerly Twitter): 2 (Altmetric).