Exploration of barriers and facilitators to physical activity in adults with schizophrenia involved in a long-term psychosocial rehabilitation programme: a mixed method study

Regular physical activity benefits cardiometabolic health, fitness, neurocognition and quality of life in people with schizophrenia (pwSCZ). However, pwSCZ exhibit high levels of physical inactivity and poor adherence to exercise programs. This study investigated physical activity facilitators and barriers in stable pwSCZ in long-term psychosocial rehabilitation. Forty-three pwSCZ (age = 29 (12) years; n = 12 female) of a French rehabilitation centre underwent semi-structured interviews and rated pre-identified physical activity barriers and facilitators on a 5-point scale. Two facilitator classifications (conventional and motivation-based) and one barrier classification emerged. Frequent facilitators included weight loss, improving well-being, enjoyment of activity and self-pride. Main barriers were fatigue, low motivation, lack of time or competing priorities, social difficulties, and addictive substance use. While most factors are shared with other severe mental illnesses, social difficulties, addictive substance consumption and feelings of self-pride emerged more specifically in our sample. The motivational classification highlighted the prevalence of autonomous motivation, which supports durable behaviours. Barriers reflected schizophrenia-related symptoms not addressed by antipsychotics, underlining the need for multidisciplinary care, especially as some of them are not specific to physical activity uptake. Psychosocial rehabilitation settings could use our findings to adapt physical activity promotion in pwSCZ. Many factors to physical activity in schizophrenia are shared with other severe mental illnesses.Social difficulties, addictive substance consumption and feelings of self-pride emerge as more specific factors influencing physical activity.Autonomous motivation, which supports durable behaviours, was prevalent in our participants.Barriers reflected schizophrenia-related symptoms not addressed by antipsychotics, underlining the need for multidisciplinary care. Many factors to physical activity in schizophrenia are shared with other severe mental illnesses. Social difficulties, addictive substance consumption and feelings of self-pride emerge as more specific factors influencing physical activity. Autonomous motivation, which supports durable behaviours, was prevalent in our participants. Barriers reflected schizophrenia-related symptoms not addressed by antipsychotics, underlining the need for multidisciplinary care.