Association of regular exercise with metabolic and psychiatric outcomes in schizophrenia: a 6-month study in a community mental health center

Background Schizophrenia is associated with elevated cardiometabolic risk. Exercise may support metabolic and psychiatric health, but community-based evidence remains limited.Aim To examine whether regular exercise was associated with 6-month changes in metabolic risk factors and psychiatric symptoms in adults with schizophrenia attending a Community Mental Health Center.Method This exploratory observational cohort included 60 adults in remission on stable antipsychotic treatment (30 exercisers, 30 controls). Allocation was non-random and based on patient preference and clinician referral. Exercisers completed supervised treadmill or elliptical sessions (≥40 min/day) for 6 months. The primary outcome was waist circumference. Secondary outcomes included BMI, fasting glucose, lipids, metabolic syndrome status, and PANSS scores.Results Exercisers were younger and more likely to smoke at baseline. Exercise participation was associated with a more favorable change in waist circumference (DiD −3.47 cm). Secondary outcomes showed favorable changes in BMI, LDL-C, total cholesterol, fasting glucose, and PANSS scores; however, HDL-C changed minimally and triglycerides increased in both groups.Conclusion Exercise participation was associated with favorable changes in selected metabolic and psychiatric outcomes. Findings should be interpreted cautiously because of non-random allocation, clinically relevant baseline imbalances, and limited sample size.