Schizophrenia is associated with a premature mortality gap of 15–20 years compared with that in the general population (1). The majority of years of life lost in schizophrenia results from poor physical health, specifically cardiovascular and cardiometabolic diseases (2). The rates of cardiovascular disease (CVD), coronary heart disease (CHD), type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) are at least two-fold higher in people with schizophrenia compared with the general population (2, 3). The increased incidence and deleterious impact of cardiovascular and cardiometabolic disease in schizophrenia are multifactorial including genetic predisposition, the illness itself, side-effects of antipsychotic medication, social determinants and lifestyle behaviours (3). Despite a growing interest in the mental and physical interface and advances in health care, the unfortunate reality is that the number of years of life lost due to physical health conditions is increasing in this population group (4). Recently, there is growing interest in lifestyle interventions such as physical activity as a method of protecting physical health and wellbeing among people with schizophrenia (3). This is for good reason since outside of mental health services, there is robust evidence that physical activity is equally as effective as common pharmacological treatments to prevent and manage cardiovascular disease and mortality (5). Despite this, people with schizophrenia spend on average 476.0 min per day being sedentary and engage in substantially less physical activity than matched controls (6). People with schizophrenia experience many barriers to engagement in physical activity, including sedative effects of psychotropic medication, complications from poor physical health, lack of support and avolition (7). A pressing focus of current research (and implementation in clinical practice) is to increase the reach of exercise-based interventions amongst people with schizophrenia and establish optimal programmes for individuals (8). The positive effects of physical activity and exercise interventions for people with schizophrenia have been researched in an abundance of randomised controlled trials (RCTs), systematic reviews and meta-analyses. A recent meta-review of 20 systematic reviews and meta-analyses displayed a therapeutic benefit of physical activity in people with severe mental illnesses, including schizophrenia (8). Specifically, physical activity and exercise interventions improved psychiatric symptoms, body weight, body mass index (BMI), waist circumference (WC), body fat percentage, cardiorespiratory fitness and cognitive domains amongst people with schizophrenia, although evidence was hampered by a small number of RCTs for each outcome, and small sample size (8). Additional to these benefits, physical activity and exercise interventions may improve sleep quality (9) and help people quit smoking and reduce cravings (10). Thus, physical activity may be a modifiable lifestyle factor that can revise cardiovascular and cardiometabolic ill health and improve wellbeing. Hence, the recent EPA guidance recommends utilising physical activity as an adjunctive treatment for schizophrenia spectrum disorders (8). Whilst promising evidence now exists about the benefits of physical activity in schizophrenia, most trials have focussed on the benefits of continuous aerobic exercise over longer periods of time on health outcomes, for instance, completing three sessions of at least 30 min of moderate exercise which can seem unachievable for some. Additionally, a small number of trials have considered the therapeutic benefits of resistance training (8). Recently, there has been growing interest in high-intensity interval training (HIIT). HIIT has been proposed as a time efficient form of exercise that may overcome some of the motivational barriers associated with traditional forms of continuous longer duration exercise. HIIT is a type of exercise involving alternating short bursts (typically 30 s to 4 min) of exercise at ≥ 85% peak heart rate (HRpeak), followed by similar length periods of light exercise or

中文翻译：

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高强度间歇训练：精神分裂症谱系障碍的辅助治疗？

与一般人群相比，精神分裂症与过早死亡的差距为 15-20 年 (1)。精神分裂症失去的大部分生命年是由于身体健康状况不佳，特别是心血管和心脏代谢疾病 (2)。与一般人群相比，精神分裂症患者的心血管疾病 (CVD)、冠心病 (CHD)、2 型糖尿病 (T2DM) 和代谢综合征 (MetS) 的发病率至少高两倍 (2, 3) . 精神分裂症中心血管和心脏代谢疾病的发病率增加和有害影响是多因素的，包括遗传倾向、疾病本身、抗精神病药物的副作用、社会决定因素和生活方式行为 (3)。尽管人们对精神和身体的相互作用以及医疗保健的进步越来越感兴趣，但不幸的现实是，在这一人群中，由于身体健康状况而损失的生命年数正在增加 (4)。最近，人们对生活方式干预越来越感兴趣，例如将体育活动作为保护精神分裂症患者身体健康和福祉的方法 (3)。这是有充分理由的，因为在心理健康服务之外，有强有力的证据表明，体育活动与预防和管理心血管疾病和死亡率的常用药物治疗同样有效 (5)。尽管如此，精神分裂症患者每天平均花费 476.0 分钟久坐不动，并且与匹配的对照组相比，他们进行的体力活动要少得多 (6)。精神分裂症患者在参与体育活动时会遇到许多障碍，包括精神药物的镇静作用、身体健康状况不佳导致的并发症、缺乏支持和意志力 (7)。当前研究（以及临床实践中的实施）的一个紧迫重点是增加基于运动的干预措施在精神分裂症患者中的覆盖范围，并为个体制定最佳计划 (8)。大量随机对照试验 (RCT)、系统评价和荟萃分析研究了身体活动和运动干预对精神分裂症患者的积极影响。最近对 20 项系统评价和荟萃分析的荟萃回顾显示，体育锻炼对包括精神分裂症在内的严重精神疾病患者具有治疗益处 (8)。具体来说，体育活动和锻炼干预改善了精神分裂症患者的精神症状、体重、体重指数 (BMI)、腰围 (WC)、体脂百分比、心肺健康和认知领域，尽管少数 RCT 阻碍了证据每个结果，以及小样本量 (8)。除了这些好处之外，身体活动和运动干预可以改善睡眠质量 (9) 并帮助人们戒烟和减少烟瘾 (10)。因此，体育锻炼可能是一种可改变的生活方式因素，可以改善心血管和心脏代谢疾病并改善幸福感。因此，最近的 EPA 指南建议利用体育活动作为精神分裂症谱系障碍的辅助治疗 (8)。虽然现在有关于身体活动对精神分裂症的益处的有希望的证据，但大多数试验都集中在长时间持续有氧运动对健康结果的益处上，例如，完成至少 30 分钟的适度运动的三个阶段，这可以对某些人来说似乎无法实现。此外，少数试验已经考虑了阻力训练的治疗益处 (8)。最近，人们对高强度间歇训练 (HIIT) 越来越感兴趣。HIIT 已被提议作为一种节省时间的锻炼形式，可以克服与传统形式的持续较长时间锻炼相关的一些动机障碍。HIIT 是一种以 ≥ 85% 峰值心率 (HRpeak) 交替进行短时间爆发（通常为 30 秒至 4 分钟）的运动，