title: The effects and determinants of exercise participation in first-episode psychosis: a qualitative study.
abstract: BACKGROUND
  Previous qualitative studies have found that exercise may facilitate symptomatic and functional recovery in people with long-term schizophrenia. This study examined the perceived effects of exercise as experienced by people in the early stages of psychosis, and explored which aspects of an exercise intervention facilitated or hindered their engagement.
  
  
  METHODS
  Nineteen semi-structured interviews were conducted with early intervention service users who had participated in a 10-week exercise intervention. Interviews discussed people's incentives and barriers to exercise, short- and long-term effects, and opinions on optimal interventions. A thematic analysis was applied to determine the prevailing themes.
  
  
  RESULTS
  The intervention was perceived as beneficial and engaging for participants. The main themes were (a) exercise alleviating psychiatric symptoms, (b) improved self-perceptions following exercise, and (c) factors determining exercise participation, with three respective sub-themes for each.
  
  
  CONCLUSIONS
  Participants explained how exercise had improved their mental health, improved their confidence and given them a sense of achievement. Autonomy and social support were identified as critical factors for effectively engaging people with first-episode psychosis in moderate-to-vigorous exercise. Implementing such programs in early intervention services may lead to better physical health, symptom management and social functioning among service users.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN09150095. Registered 10 December 2013.
authors.affiliation: Institute of Brain, Behaviour and Mental Health, University of Manchester, Room 3.306, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK. joseph.firth@postgrad.manchester.ac.uk.
authors.forename: Joseph
authors.initials: J
authors.lastname: Firth
authors.affiliation: Institute of Brain, Behaviour and Mental Health, University of Manchester, Room 3.306, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
authors.forename: Rebekah
authors.initials: R
authors.lastname: Carney
authors.affiliation: Institute of Brain, Behaviour and Mental Health, University of Manchester, Room 3.306, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
authors.forename: Lauren
authors.initials: L
authors.lastname: Jerome
authors.affiliation: Institute of Brain, Behaviour and Mental Health, University of Manchester, Room 3.306, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.|Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Elliott
authors.affiliation: Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK.|Department of Psychological Sciences, The University of Liverpool, Liverpool, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: French
authors.affiliation: Institute of Brain, Behaviour and Mental Health, University of Manchester, Room 3.306, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.|Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK.
authors.forename: Alison R
authors.initials: AR
authors.lastname: Yung
mesh_terms: D000328:Adult; D015444:Exercise / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011618:Psychotic Disorders / Q000523:psychology* / Q000534:rehabilitation*; D036301:Qualitative Research; D020127:Recovery of Function; D012649:Self Concept; D055815:Young Adult