2021 Volume 18 Pages 64-68
We encountered a male patient in his 40 s with treatment-resistant schizophrenia (TRS) and frequent suicide attempts who showed sustained improvement of symptoms following exercise interventions. At age 19, he was diagnosed with schizophrenia. He had been hospitalized twice. He was admitted to our hospital because of a suicide attempt due to exacerbation of hallucinations and delusions. During hospitalization, he made several suicide attempts and the response to pharmacotherapy was poor. He achieved improvement under electroconvulsive therapy (ECT). However, soon after discharge, he made a serious suicide attempt, after which he was hospitalized with severe auditory hallucinations and imminent suicidal ideation. He was admitted to another hospital and received modified ECT. It was effective, but he was again hospitalized with delusions. Soon after admission, his psychotic symptoms worsened and he made frequent suicide attempts. We recommended him to play table tennis, badminton, conduct radio gymnastic exercises, and we taught him a variety of skills. These exercise interventions induced in him positive thinking for the first time and resulted in a gradual improvement in psychotic symptoms and suicidal ideation. In this case, exercise may not only have enhanced his self-esteem and resilience, but also produced the hope of living. This case suggests that exercise interventions may have beneficial effects for patients with severe TRS.
