# The Impact of Exercise Interventions on the Network Structure of Psychotic Symptoms: Analysis From Two Clinical Trials

## TL;DR

This study shows that exercise can change how psychotic symptoms are connected, potentially offering a new way to understand how exercise helps in mental disorders.

## Contribution

The study is the first to demonstrate that exercise can alter the network structure of psychotic symptoms.

## Key findings

- At baseline, the PANSS network was densely connected with strong positive connections.
- After exercise, the network became less dense and less connected with different connections.
- Network structures before and after exercise were significantly different in terms of structure but not global strength.

## Abstract

In people with psychotic disorders, exercise is known to improve psychotic symptoms; however, the mechanisms underlying these effects are unclear. In the network approach, mental disorders are conceptualised as complex systems of interacting symptoms. In this context, exercise interventions could modify the dynamic of psychotic symptoms within the network. Using data from two independent clinical trials using exercise, the aim was to investigate the impact of exercise interventions on network connectivity, then compare the network structure pre and post intervention.

Combined data from two clinical trials on exercise with a total of 106 participants with a diagnosis of psychotic disorder were included. The Positive and Negative Syndrome Scale (PANSS) was used to assess symptom severity using semi‐structured interviews. Networks analyses were performed to compare before and after exercise.

At baseline, the PANSS network was densely connected with several strong positive connections. Symptoms being most central were negative symptoms. After exercise, the network was less dense and less connected, and the connections were different. When the networks before and after exercise were compared, they were significantly different in terms of structure, but not global strength.

This study is the first to show that exercise seems to favour a disconnection between psychotic symptoms and could modify the network structure, providing a first mechanism of action which would require more investigation.