Using sport-based interventions for people with severe mental disorders: results from the European EASMH study.

People with severe mental disorders report significantly poorer physical health and a higher mortality rate compared with the general population. Several interventions have been proposed in order to challenge this mortality gap, the promotion of physical activities represents one of the most important strategies. In fact, in people with severe mental disorders, physical activity can improve body composition, quality of life, personal functioning, self-esteem, cognition, and cardiorespiratory fitness, as well as reducing affective, psychotic and anxiety symptoms, cardiometabolic burden and increase the global recovery. While sport-based programs are consistently being proposed as an integral part of effective personalized treatment approaches for people with severe mental disorders, their routine implementation is hampered by poor working task integration among different professionals and the lack of training programmes for sport professionals focused on people with severe mental disorders. In this paper, we will: (a) review the efficacy of exercise/sport-based interventions for people with severe mental disorders; (b) describe the main difficulties in engaging patients with severe mental disorders in these interventions; and (c) report the results of the first study on the best practices available in Europe in the field of sport and mental health carried out in the context of the European Alliance for Sport and Mental Health (EASMH) project. According to the EASMH survey, sport-based psychosocial interventions are not frequently available in mental health services, with significant differences at the European level. In the near future, it would be advisable to promote the integration and collaboration between mental health professionals and sport professionals, in order to improve the dissemination and availability of sport-based interventions in routine clinical practice. The EASMH project aims to fill this gap by creating a network of collaborators, researchers and stakeholders with different backgrounds in order to improve the dissemination of sport-based rehabilitation interventions and by developing an innovative training programme for sport coaches in order to improve their skills in interacting and building an effective relationship with people with severe mental disorders.

Integrated neurocognitive therapy in chronic schizophrenic inpatients: preliminary data and considerations.

BACKGROUND: The present paper aims at studying the efficacy of the Integrated Neurocognitive Therapy (INT), according to Roder's model, in a group of chronic schizophrenics in a long term residential condition. This kind of treatment is particularly interesting because, according to the most recent studies concerning schizophrenia as a neurodevelopmental disorder, allows to act on the neuro- and socio- cognitions areas, which are the most deteriorated ones. Moreover the INT program includes also computer aided activities (Cog PacK), which largely proved their efficacy on neurocognition. MATERIALS AND METHODS: The study sample consists of 10 inpatients suffering of Schizophrenia (according to DSM-5), 5 Male and 5 Female, average age 52, disorder average length 24,9 years, with IQ not <80. The sample took part in the 18 months INT program and has been evaluated through the neurocognitive set RBANS and MCST (modified version of WCST for the survey of the executive functions: abstraction, categorization, set shifting at the beginning of the treatment (T0), after 12 months (T1), and at its end, after 18 months (T2). RESULTS: As regards neurocognition, starting from the preliminary result analysis, the only statistical significance refers to time factor concerning the immediate memory measured by RBANS at T2. We can also point out an improvement trend in T1 evaluations for the single cognitive functions and for the general cognitive profile. Concerning the executive functions (MCST), even without any statistical significance, a general improvement trend is present (completed categories, persisting and not persisting mistakes). CONCLUSIONS: The data presented, even in a numerically reduced sample, encourage however an optimistic perspective concerning the INT rehabilitation use in schizophrenic inpatients, substantially confirming the data already present in literature. We have to pay specific attention even in the evaluation of computerized programs, whose use can aid the general sociocognitive functioning. We hope that later and wider studies will support what we have herein preliminarly presented and discussed.

Equine-Assisted Intervention in a child diagnosed with autism spectrum disorder: a case report.

An increasing number of studies have shown the beneficial effects of both recreational and therapeutic interventions assisted by animals for children with Autism Spectrum Disorders (ASD). The observed effects are believed to be mainly due to the ability of some animals to positively engage people, thus potentially counteracting the social withdrawal characterizing these subjects. Here we report the case of a child with high-functioning autism who has been included in an Equine-Assisted Intervention (EAI) program for 2 years. In particular, the relationship with the animal was used to encourage child's narrative abilities as a primary means of improving cognition and communication. This case represents a first attempt to theorize the role of human-animal interaction as an adjunct to classic therapeutic strategies in ASD. During the intervention, the child appeared to gradually abandon his attitude to avoid the contact with the present and to hide in imaginative past and future. We propose animal-assisted interventions as complementary approaches capable to facilitate the verbalization of the patient's internal states and to promote psychological well-being through the development of a bond with the animal.

Effectiveness of a Standardized Equine-Assisted Therapy Program for Children with Autism Spectrum Disorder.

In this study the effectiveness of an equine-assisted therapy (EAT) in improving adaptive and executive functioning in children with autism spectrum disorder (ASD) was examined (children attending EAT, n = 15, control group n = 13; inclusion criteria: IQ > 70). Therapeutic sessions consisted in structured activities involving horses and included both work on the ground and riding. Results indicate an improvement in social functioning in the group attending EAT (compared to the control group) and a milder effect on motor abilities. Improved executive functioning was also observed (i.e. reduced planning time in a problem-solving task) at the end of the EAT program. Our findings provide further support for the use of animal-assisted intervention programs as complementary intervention strategies for children with ASD.

Non conventional psychiatric rehabilitation in schizophrenia using therapeutic riding: the FISE multicentre Pindar project.

The FISE (Federazione Italiana Sport Equestri) Pindar is a multicentre research project aimed at testing the potential effects of therapeutic riding on schizophrenic patients. Twenty-four subjects with a diagnosis of schizophrenia were enrolled for a 1 year-treatment involving therapeutic riding sessions. All subjects were tested at the beginning and at the end of treatment with a series of validated test batteries (BPRS and 8 items-PANSS). The results discussed in this paper point out an improvement in negative symptoms, a constant disease remission in both early onset and chronic disease subjects, as well as a reduced rate of hospitalization.