Immediate Psychological Responses to Aerobic and Resistance Exercise in People With Psychotic Disorders: A Randomized Controlled Trial in Psychiatric Rehabilitation

Background and Hypothesis People with psychotic disorders have limited strategies to manage acute psychological distress and emotions. Exercise has physical and mental health benefits but immediate psychological effects in this population remain underexplored. This study compared immediate psychological responses to resistance training (RT) and aerobic exercise among individuals with psychotic disorders in psychiatric rehabilitation and examined whether clinical characteristics were associated with these responses. Study Design Fifty-three participants were randomized to RT or aerobic exercise. Immediate psychological responses—psychological distress, positive wellbeing, and fatigue—were assessed using the Subjective Exercise Experiences Scale at 2 timepoints within an 8-week trial (week 3: n = 52; week 8: n = 48), pre- and 10 min post-exercise. Baseline assessments included clinical and motivational variables. Primary analyses used linear mixed models for repeated measures. Study Results Both exercise types led to large increases in positive wellbeing (RT: Hedges’ g = 1.24; aerobic: g = 1.31) and reductions in psychological distress (RT: g = –0.91; aerobic: g = –1.05). A significant group-by-time interaction was observed for fatigue, which increased in RT (g = 0.43) and decreased in aerobic (g = –0.58). Higher fatigue was associated with greater controlled motivation (β = 1.72) and depressed mood (β = 0.80) at baseline. Conclusions RT and aerobic exercise improved positive wellbeing and reduced psychological distress whereas fatigue differed by exercise type. Findings suggest exercise may be a promising intervention for modulating immediate psychological responses in people with psychotic disorders in psychiatric rehabilitation.