Background: Low physical activity is strongly correlated with metabolic syndrome (MetS) and poor physical health. Although the prevalence of MetS is high in patients with first-episode schizophrenia (FES), little is still known about the level of and possible barriers for physical activity in FES. 

Aim: The purpose of the study was to compare physical activity in patients with FES with healthy controls; to investigate changes in physical activity over 1 year of follow-up; and to explore the correlations of physical activity and anomalous bodily experiences reported by patients with FES. 

Methods: Both physical activity and aerobic fitness were measured. Anomalous bodily experiences were measured by selected items from the Examination of Anomalous Self-Experience and The Body Awareness Scale. Psychopathological data comprising negative and positive symptoms and data on psychotropic medication were obtained from medical records of all patients. 

Results: Physical activity and aerobic fitness was significantly lower in patients with FES compared with healthy controls (p < 0.001). Over 1 year of follow-up patients had lower physical activity and aerobic fitness. Patients with more severe anomalous bodily experiences had significantly lower physical activity compared with patients with fewer such experiences (p = 0.030). In linear regression analyses only negative symptoms were significantly correlated with low physical activity (β = –0.88; 95% confidence interval = –1.48 to –0.29; p < 0.001). 

Conclusion: Physical activity and aerobic fitness is low in patients with FES. Both anomalous bodily experiences and negative symptoms are significantly correlated with low physical activity.