Background: We conducted a systematic review and meta-analysis to compare functional and hemodynamic parameters between patients with Meth-APAH and idiopathic PAH (IPAH). Methods: MEDLINE, Scopus, and gray literature were searched up to September 2025. Eligible studies were observational and compared functional and hemodynamic parameters between patients with Meth-APAH and IPAH. All participants had undergone diagnostic right heart catheterization (RHC) and were classified by methamphetamine use history and/or toxicological screening. Primary outcomes included World Health Organization Functional Class III or IV (WHO-FC III/IV), six-minute walk distance (6-MWD), and mean pulmonary arterial pressure (mPAP). Secondary outcomes were cardiac index (CI), right atrial pressure (RAP), pulmonary vascular resistance (PVR), stroke volume index (SVI), pulmonary artery wedge pressure (PAWP), and heart rate (HR). Random-effects models were applied for pooled estimates. Results: Five studies comprising 1991 participants were included. Patients with Meth-APAH demonstrated a significantly higher risk of being classified as WHO-FC III/IV (RR 1.17, 95%CI 1.05–1.30, p = 0.01), as well as higher RAP (MD 1.59, 95%CI 0.07–3.11, p = 0.04) and reduced SVI (MD −3.57, 95%CI −6.74–−0.4, p = 0.04), but differences were modest. No significant differences were found for 6-MWD, mPAP, CI, PVR, PAWP, or HR. Conclusions: Meth-APAH could be associated with worse functional and hemodynamic profile compared to IPAH, but available studies are few with high heterogeneity, so that clear differences in several functional and hemodynamic parameters could not be established between these disease entities. These results highlight the need for further research in this direction.

Background: This randomized controlled trial aimed to assess the effects of a yearly Multi-Component Exercise Training (MCET) program performed within the hospital setting on the functional capacity and Health-Related Quality of Life (HRQoL) of inpatients with psychotic disorders. Methods: Forty-eight inpatients of a public Psychiatric Hospital with a diagnosis of psychosis participated in the study and were randomly assigned to two groups: (i) the intervention group (mean age: 46.6 ± 13.2) and (ii) the control group (mean age: 47.7 ± 8.9). The MCET program consisted of moderate-intensity aerobic exercise (AE), Pilates exercises, and strengthening, balance, corrective and flexibility exercises, using rubber bands, mobility sticks and balls. Sessions were implemented three times per week over a 12-month period and each group session lasted for 30–45 min. The primary outcomes of the study included functional capacity and HRQoL. Functional capacity was assessed through measurements of strength (using handgrip and leg dynamometer), balance, and body positioning, while HRQoL was evaluated using the 36-Item Short Form Health Survey (SF-36). Results: At the end of the treatment, participants in the intervention group demonstrated significantly increased lower and upper extremity muscle strength by 35.9% (p < 0.01) and 23.6% (p < 0.01), respectively, improved balance by 18.1% (p < 0.001), and enhanced sit-and-reach and sit-to-stand results by 47.6% (p < 0.001) and 18.2% (p < 0.001), respectively, as well as increased distance covered at 6MWT by 26.2% (p < 0.001). Regarding the HRQoL, all the parameters of the SF-36 were improved, including general and mental health (p < 0.05), physical (p < 0.001) and social function (p < 0.05), physical (p < 0.01) and emotional roles (p < 0.01) and vitality and bodily pain (p < 0.001 and p < 0.05, respectively). The Physical Component Summary score (PCS) was enhanced significantly (p < 0.001), while the Mental Component Summary score (MCS) remained unchanged. Compliance with the 1-year ET program was 80%. Conclusions: The findings of the study indicated that a 1-year moderate-intensity MCET performed three times per week was safe, well accepted and efficient in improving physical functioning and HRQoL among inpatients with psychotic disorders. These results suggest that structured exercise interventions could be prescribed as add-ons to the pharmacological treatment for psychotic disorders.