Abstract: Onset of psychosis is believed to be associated with neuronal dysregulation and degeneration. Reductions in brain volumes have been related in part to neuronal loss but more substantially to loss of neuronal connectivity, loss of dendritic spines, and reductions in supporting glial cells. These changes have been associated with alterations in neurotrophic factors in the brain. Recent evidence suggests that aggressive synaptic pruning may underlie onset of psychosis for some individuals. While reductions in regional brain volumes have been demonstrated in individuals in their first episode of schizophrenia, further deterioration has been shown to occur even after initiation of treatment. The disruption of myelination has been proposed as one mechanism underlying these effects. Duration of untreated psychosis is associated with both symptom severity and poor functional outcomes. Therefore, the time around onset of psychosis is considered a critical period when neuronal systems in the brain are vulnerable to deterioration, fragile, unstable, and in need of protection and, possibly, regeneration.
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The participant will explain how individuals with psychotic disorders may benefit from establishing an exercise regimen as part of their care.
This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.
Estimated Time to Complete
Duration: 1 hour
Begin Date: March 1, 2018
End Date: February 28, 2020
How to Earn Credit
In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the quiz and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™). A score of 60% or higher is required to receive credit.
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Faculty and Planner Disclosures
Title: Therapeutic Potential of Physical Exercise in Early Psychosis
Authors: Douglas L. Noordsy, M.D., Jonathan D. Burgess, B.A., Kate V. Hardy, Clin.Psych.D., Lynn M. Yudofsky, M.D., Jacob S. Ballon, M.D., M.P.H.
Affiliations: From the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, Calif. (D.L.N., J.D.B., K.V.H., L.M.Y., J.S.B.).
Disclosures: Dr. Noordsy has received research grants from Alkermes, Janssen, and NIDA. Dr. Ballon has received research funding from Alkermes and Otsuka America Pharmaceutical and has served on a subject matter expert panel for Pear Therapeutics. The other authors report no financial relationships with commercial interests.
Discussion of unapproved or investigational use of products*: No.
*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.
Robert Freedman, M.D. (Editor-in-Chief, AJP); Susan K. Schultz, M.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP); Michael A. Pogachar (Online Content Manager, Journals).
Dr. Schultz has received research support from the Alzheimer’s Disease Cooperative Study for projects conducted in partnership with Toyama Chemical Company and in partnership with Eli Lilly and Company. Dr. Freedman, Mr. Roy, and Mr. Pogachar report no financial relationships with commercial interests.
Optimal System Configuration:
- Flash Player: Adobe Flash Player 10.1+
- Browser: Firefox 3+, Internet Explorer 8.0+, Safari 4.0+, or Google Chrome 7.0+
- Operating System: Windows XP+ or Mac OS X 10.4+
- Internet Connection: 1 Mbps or higher
- Screen Resolution: 1024 x 768 pixels.
- Windows PC:500-MHz Pentium II; Windows XP or higher; 128 MB RAM; Video Card at least 64MB of video memory; Sound Card at least 16-bit; Macromedia Flash Player 10 or higher, audio playback with speakers for programs with video content; Firefox 1.1+, Internet Explorer 7.0+, Safari 1.0+, Google Chrome, or Opera
- Macintosh: Mac OS X 10.3 or higher with latest updates installed; 1.83MHz Intel Core Duo or faster; RAM: 128MB or more; Video Card: at least 64MB of video memory; Sound Card: at least 16-bit
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