{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:29:10Z","timestamp":1787027350663,"version":"build-2736575974"},"reference-count":10,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010414","name":"Health Research Board","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010414","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Irish Clinical Academic Training Programme","award":["ICAT-2022-001"],"award-info":[{"award-number":["ICAT-2022-001"]}]}],"content-domain":{"domain":["hrbopenresearch.org"],"crossmark-restriction":false},"short-container-title":["HRB Open Res"],"abstract":"<ns5:p>Background Individuals with psychotic disorders face a 20-year mortality gap compared to the general population, largely driven by cardiovascular disease and metabolic syndrome. Antipsychotic medications, while essential, exacerbate this risk through rapid weight gain and metabolic dysregulation, particularly in the first three months of treatment. Resistance training improves body composition and metabolic health, particularly glucose regulation. Its effects on muscle strength and hypertrophy are enhanced by a caloric surplus that, in its absence, would otherwise lead to accumulation of adipose tissue. Its feasibility and efficacy in drug-na\u00efve or minimally treated First-Episode Psychosis (FEP) patients has not been previously explored. Methods The START GAAIMS study is a multicentre, two-arm, crossover, randomised controlled feasibility trial. Forty adults (18\u201365\u00a0years) with FEP and\u00a0&lt;\u00a04\u00a0weeks of antipsychotic exposure will be recruited from services in Dublin and Cork. Participants will be randomised (1:1) to an Intervention Group (12-week supervised RT programme + Treatment as Usual [TAU]) or a Control Group (TAU only). After 12\u00a0weeks, the control group will crossover to receive the intervention. Outcome Measures The primary outcome is the feasibility of the trial design (recruitment, retention, adherence) and a preliminary estimate of the effect size for change in body fat percentage at 12\u00a0weeks. Secondary outcomes include muscular power, metabolic biomarkers (glucose, lipids, inflammatory markers), and psychiatric symptoms (BPRS). Discussion This study will determine preliminary measures of the effects of resistance training on body composition in people with FEP starting antipsychotic medication, as well as its feasibility and acceptability in this cohort. Findings will inform the design of a definitive RCT to establish RT as a standard co-treatment for metabolic health in early psychosis.<\/ns5:p>","DOI":"10.12688\/hrbopenres.14320.1","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T10:49:07Z","timestamp":1777546147000},"page":"47","update-policy":"https:\/\/doi.org\/10.12688\/hrbopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Strategic Timing of Resistance Training to Guard Against Antipsychotic-Induced Metabolic Syndrome (START GAAIMS): A Feasibility Study Protocol"],"prefix":"10.12688","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1530-0167","authenticated-orcid":false,"given":"Brian","family":"O'Mahony","sequence":"first","affiliation":[{"name":"Dublin Leinster University College Dublin College of Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3757-3972","authenticated-orcid":false,"given":"Kate","family":"Pumpa","sequence":"additional","affiliation":[{"name":"Dublin Leinster University College Dublin College of Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donal","family":"O'Shea","sequence":"additional","affiliation":[{"name":"Dublin Leinster University College Dublin College of Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"O'Connor","sequence":"additional","affiliation":[{"name":"Cork County Cork University College Cork"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7420-9339","authenticated-orcid":false,"given":"Michael","family":"Norton","sequence":"additional","affiliation":[{"name":"Dublin Leinster University College Dublin College of Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"O'Donoghue","sequence":"additional","affiliation":[{"name":"Dublin Leinster University College Dublin College of Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"101-104","DOI":"10.1016\/j.schres.2011.06.006","article-title":"Life expectancy among persons with schizophrenia or bipolar affective disorder.","volume":"131","author":"T Laursen","year":"2011","journal-title":"Schizophr. Res."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1827-1835","DOI":"10.1016\/S0140-6736(19)32316-5","article-title":"A comprehensive analysis of mortality-related health metrics associated with mental disorders: a nationwide, register-based cohort study.","volume":"394","author":"O Plana-Ripoll","year":"2019","journal-title":"Lancet."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"238","DOI":"10.3390\/ph14030238","article-title":"Atypical antipsychotics and metabolic syndrome: from molecular mechanisms to clinical differences.","volume":"14","author":"M Carli","year":"2021","journal-title":"Pharmaceuticals."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"547-562","DOI":"10.2165\/00023210-200822070-00002","article-title":"Antipsychotic-induced weight gain in chronic and first-episode psychotic disorders: a systematic critical reappraisal.","volume":"22","author":"M Alvarez-Jimenez","year":"2008","journal-title":"CNS Drugs."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"41-51","DOI":"10.1017\/S146114571300091X","article-title":"Course of weight gain and metabolic abnormalities in first treated episode of psychosis: the first year is a critical period for development of cardiovascular risk factors.","volume":"17","author":"R P\u00e9rez-Iglesias","year":"2014","journal-title":"Int. J. Neuropsychopharmacol."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"42-46","DOI":"10.1097\/00003677-200601000-00009","article-title":"Resistance training improves insulin signaling and action in skeletal muscle.","volume":"34","author":"B Yaspelkis","year":"2006","journal-title":"Exerc. Sport Sci. Rev."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"801-807","DOI":"10.1007\/s40279-015-0320-0","article-title":"A review of resistance training-induced changes in skeletal muscle protein synthesis and their contribution to hypertrophy.","volume":"45","author":"F Damas","year":"2015","journal-title":"Sports Med."},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1177\/00048674251361681","article-title":"The feasibility of resistance training versus aerobic exercise in a rehabilitation setting for people living with psychotic disorders: A randomised controlled trial.","author":"N Korman","year":"2025","journal-title":"Aust. N. Z. J. Psychiatry."},{"key":"ref9","article-title":"Prevention of weight gain in antipsychotic-na\u00efve individuals with a first-episode psychosis, a systematic review and meta-analysis.","author":"B O'Mahony"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.5281\/zenodo.18214167","article-title":"Reporting guidelines and extended data for: START GAAIMS. UCD Research Data Repository.","author":"B O\u2019Mahony","year":"2026"}],"container-title":["HRB Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/hrbopenresearch.org\/articles\/9-47\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/hrbopenresearch.org\/articles\/9-47\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/hrbopenresearch.org\/articles\/9-47\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:04:08Z","timestamp":1787025848000},"score":1,"resource":{"primary":{"URL":"https:\/\/hrbopenresearch.org\/articles\/9-47\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":10,"URL":"https:\/\/doi.org\/10.12688\/hrbopenres.14320.1","relation":{"has-review":[{"id-type":"doi","id":"10.21956\/hrbopenres.15763.r56961","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/hrbopenres.15763.r56967","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/hrbopenres.15763.r55212","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/hrbopenres.15763.r56967","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/hrbopenres.15763.r56961","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/hrbopenres.15763.r55212","asserted-by":"object"}]},"ISSN":["2515-4826"],"issn-type":[{"value":"2515-4826","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]},"assertion":[{"value":"Indexed","URL":"https:\/\/hrbopenresearch.org\/articles\/9-47\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/hrbopenres.15763.r55212, Dongyu Kang, Hartford Hospital, Hartford, 02 Jun 2026, version 1, indexed","URL":"https:\/\/hrbopenresearch.org\/articles\/9-47\/v1#referee-response-55212","order":0,"name":"referee-response-55212","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/hrbopenres.15763.r56961, Nicole Laurent, Independent Researcher, Vancouver, Washington, 17 Aug 2026, version 1, indexed","URL":"https:\/\/hrbopenresearch.org\/articles\/9-47\/v1#referee-response-56961","order":1,"name":"referee-response-56961","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/hrbopenres.15763.r56967, Scott Teasdale, University of New South Wales, Sydney, New South Wales, 18 Aug 2026, version 1, indexed","URL":"https:\/\/hrbopenresearch.org\/articles\/9-47\/v1#referee-response-56967","order":2,"name":"referee-response-56967","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work is supported by the Health Research Board (ICAT-2022-001) and the ICAT Programme.\r\nIrish Clinical Academic Training Programme, University College Dublin\r\ncommunications@ucd.ie\r\nThe funder has no role in study design, data collection, analysis, or the decision to submit the report for publication. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}