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Bueno-Antequera J, Oviedo-Caro MÁ, Munguia-Izquierdo D. Sedentary behaviour patterns in outpatients with severe mental illness: a cross-sectional study using objective and self-reported methods. The PsychiActive project. Psychiatry Res 2017; 255:146-152. [PMID: 28550755 DOI: 10.1016/j.psychres.2017.05.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/03/2017] [Accepted: 05/09/2017] [Indexed: 12/01/2022]
Abstract
This study aimed to quantify and compare sedentary behaviour patterns in patients with severe mental illness as stratified by gender, age, body mass index, distress, illness duration and antipsychotic medication using both objective and self-reported methods. Sedentary behaviour patterns were measured in 90 outpatients (mean age±SD: 41.6±9.2 years, 20% women) with severe mental illness (primarily schizophrenia, n=63) using the SenseWear Armband and the Sedentary Behaviour Questionnaire. They spent 58% of waking time sedentary, primarily watching television. Differences between methods were not significant for the overall group or for stratified groups. Both methods showed significant correlation for weekday for the overall group. According to the stratified groups, youngers showed a significant correlation for weekday and average day sedentary time, and the high illness duration and low antipsychotic medication groups for weekday. Significant differences in sedentary behaviours between stratified groups were only detected with the SenseWear. Patients with severe mental illness had high levels of sedentary behaviours, with watching television being the most prevalently reported. We found a low validity in the self-reported estimates of sedentary time by this population, being higher on weekdays for the overall group and for the younger, high illness duration and low antipsychotic medication groups.
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Affiliation(s)
- Javier Bueno-Antequera
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain
| | - Miguel Ángel Oviedo-Caro
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain
| | - Diego Munguia-Izquierdo
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain; Biomedical Research Networking Center on Frailty and Healthy Aging, Madrid, Spain.
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52
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Matthews E, Cowman M, Denieffe S. Using experience-based co-design for the development of physical activity provision in rehabilitation and recovery mental health care. J Psychiatr Ment Health Nurs 2017; 24:545-552. [PMID: 28544037 DOI: 10.1111/jpm.12401] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2017] [Indexed: 01/01/2023]
Affiliation(s)
- E Matthews
- Department of Nursing and Health Care, Waterford Institute of Technology, Waterford, Ireland
| | - M Cowman
- Department of Sport and Exercise Sciences, Centre for Health Behaviour Research, Waterford Institute of Technology, Waterford, Ireland
| | - S Denieffe
- Department of Nursing and Health Care, Waterford Institute of Technology, Waterford, Ireland
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53
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Nam JY, Kim J, Cho KH, Choi J, Shin J, Park EC. The impact of sitting time and physical activity on major depressive disorder in South Korean adults: a cross-sectional study. BMC Psychiatry 2017; 17:274. [PMID: 28754158 PMCID: PMC5534054 DOI: 10.1186/s12888-017-1439-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 07/23/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies have examined associations between sitting time and negative health outcomes and mental health. However, the relationship between overall sitting time and major depressive disorder (MDD) in South Korea has not been studied. This study examined the association between MDD and overall sitting time and physical activity in South Koreans. METHODS Data from the sixth Korean National Health and Nutrition Examination Survey (KNHANES), a cross-sectional, nationally representative survey, were analyzed. Total participants were 4145 in 2014. MDD was assessed using the Patient Health Questionnaire (PHQ-9). Participants' data regarding self-reported sitting time and physical activity were analyzed via multiple logistic regression. RESULTS Results showed that people who sat for 8-10 h (OR: 1.56, 95% CI: 1.15-2.11) or more than 10 h (OR: 1.71, 95% CI: 1.23-2.39) had increased risk of MDD compared to those who sat for less than 5 h a day. Subgroup analysis showed that the strongest effect of reported sitting time on risk of MDD was found in men with lower levels of physical activity who sat for 8 to 10 h (OR: 3.04, 95% CI: 1.15-8.01) or more than 10 h (OR: 3.43, 95% CI: 1.26-9.35). Level of physical activity was not an independent predictor for MDD. CONCLUSIONS Sitting for long periods was associated with greater risk of MDD in South Korean adults. Reducing sitting time in people with MDD could help to prevent associated physical health problems and may improve mental health.
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Affiliation(s)
- Jin Young Nam
- 0000 0004 0470 5454grid.15444.30Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea ,0000 0004 0470 5454grid.15444.30Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Juyeong Kim
- 0000 0004 0470 5454grid.15444.30Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea ,0000 0004 0470 5454grid.15444.30Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Kyoung Hee Cho
- 0000 0004 0470 5454grid.15444.30Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Jaewoo Choi
- Busan Public Health Policy Institute, Busan, Republic of Korea
| | - Jaeyong Shin
- 0000 0004 0470 5454grid.15444.30Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea ,0000 0004 0470 5454grid.15444.30Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, 120-752 Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea. .,Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea.
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Stubbs B, Koyanagi A, Schuch F, Firth J, Rosenbaum S, Gaughran F, Mugisha J, Vancampfort D. Physical Activity Levels and Psychosis: A Mediation Analysis of Factors Influencing Physical Activity Target Achievement Among 204 186 People Across 46 Low- and Middle-Income Countries. Schizophr Bull 2017; 43:536-545. [PMID: 27562855 PMCID: PMC5464271 DOI: 10.1093/schbul/sbw111] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Physical activity (PA) can help reduce cardiovascular disease and premature mortality in people with psychosis. However, there is a paucity of representative data on PA in people with psychosis, especially from low- and middle-income countries (LMICs). Moreover, data on subclinical psychosis and PA is absent. This study explored whether complying with PA recommendations of 150 minutes of moderate-vigorous PA per week is related to: (1) psychotic symptoms without a psychosis diagnosis (subclinical psychosis); and (2) clinical psychosis (psychosis diagnosis). A total of 204 186 participants aged 18-64 years from 46 LMICs recruited via the World Health Survey were subdivided into those with (1) no psychosis diagnosis and no psychotic symptoms in the past 12 months (controls); (2) subclinical psychosis; and (3) psychosis diagnosis. People with a psychosis diagnosis had significantly higher odds for low PA in the overall sample (OR = 1.36; 95% CI = 1.04-1.78; P = .024) and among males (OR = 2.29; 95% CI = 1.57-3.34; P < .0001) but not females (OR = 0.93; 95% CI = 0.67-1.30; P = .6712). No difference was found among those with subclinical psychosis vs controls. Mediation analyses demonstrated that mobility difficulties explained the largest amount of low PA among males (18.5%) followed by self-care difficulties (16.3%), depression (16.1%), cognition (11.8%), pain and discomfort (11.4%), interpersonal activities (8.6%), sleep and energy (7.2%), and vision (3.0%). The results from the largest dataset on PA and psychosis and first in LMICs, found that psychosis diagnosis (especially among males) but not subclinical psychosis, is associated with physical inactivity. Population level interventions seeking to increase PA among people with psychosis may help improve health outcomes.
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Affiliation(s)
- Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK;,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain;,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Felipe Schuch
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil;,Programa de Pós Graduação em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Joseph Firth
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Simon Rosenbaum
- Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Fiona Gaughran
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - James Mugisha
- Kyambogo University, Kampala, Uganda;,Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium;,KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
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55
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Stubbs B, Ku PW, Chung MS, Chen LJ. Relationship Between Objectively Measured Sedentary Behavior and Cognitive Performance in Patients With Schizophrenia Vs Controls. Schizophr Bull 2017; 43:566-574. [PMID: 27555659 PMCID: PMC5463792 DOI: 10.1093/schbul/sbw126] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Sedentary behavior (SB) is associated with poor cognitive performance in the general population. Although people with schizophrenia are highly sedentary and experience marked cognitive impairments, no study has investigated the relationship between SB and cognition in people with schizophrenia. METHODS A total of 199 inpatients with schizophrenia (mean [SD] age 44.0 [9.9] years, 61.3% male, mean [SD] illness duration 23.8 [6.5]) and 60 age and sex matched controls were recruited. Sedentary behavior and physical activity (PA) were captured for 7 consecutive days with an accelerometer. Cognitive performance was assessed using the Vienna Test System, and the Grooved Pegboard Test. Multivariate regression analyses adjusting for important confounders including positive and negative symptoms, illness duration, medication, and PA were conducted. RESULTS The 199 patients with schizophrenia engaged in significantly more SB vs controls (581.1 (SD 127.6) vs 336.4 (SD 107.9) min per day, P < .001) and performed worse in all cognitive performance measures (all P < .001). Compared to patients with high levels of SB (n = 89), patients with lower levels of SB (n = 110) had significantly (P < .05) better motor reaction time and cognitive processing. In the fully adjusted multivariate analysis, SB was independently associated with slower motor reaction time (β = .162, P < .05) but not other cognitive outcomes. Lower levels of PA were independently associated with worse attention and processing speed (P < .05). CONCLUSION Our data suggest that higher levels of sedentary behavior and physical inactivity are independently associated with worse performance across several cognitive domains. Interventions targeting reductions in SB and increased PA should be explored.
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Affiliation(s)
- Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK;,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Po-Wen Ku
- Graduate Institute of Sports and Health, National Changhua University of Education, Changhua, Taiwan;,Department of Epidemiology and Public Health, University College London, London, UK
| | - Ming-Shun Chung
- Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
| | - Li-Jung Chen
- Department of Epidemiology and Public Health, University College London, London, UK;,Department of Exercise Health Science, National Taiwan University of Sport, 271, Lixing Road, Taichung City 404, Taiwan
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Abstract
Schizophrenia is a devastating mental illness that has profound effects on a person's health and quality of life. Exercise represents a promising new treatment option that may supplement current psychosocial and pharmacological interventions for psychosis. A large body of work suggests that exercise can improve cardio-metabolic and health behavior and facilitate neurogenesis in areas of the brain that are notably impacted by psychosis. Recent efforts to incorporate exercise as either stand-alone or adjunctive treatment for individuals with schizophrenia range from yoga and light stretching to moderately intense walking, bike riding, or team sports. These interventions suggest that moderately intense exercise may be beneficial for improving both positive and negative symptomatology, cognition and functioning. Indeed, exercise may be beneficial for decreasing risk factors for a wide range of health problems often observed in patients with schizophrenia, including weight gain and metabolic syndrome as well as tobacco and substance use. Given the positive results from interventions in schizophrenia patients, there is an impetus for incorporating exercise in the early stages of the disorder. Notably, individuals at ultrahigh risk (UHR) for psychosis report more sedentary behavior and perceive less benefit from exercise; interventions prior to the onset of the disorder may be helpful for increasing health behaviors, perhaps delaying or preventing the onset of psychosis. Taken together, for individuals with psychosis, exercise may provide holistic benefits for the neural to the social impairments.
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57
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Teasdale SB, Samaras K, Wade T, Jarman R, Ward PB. A review of the nutritional challenges experienced by people living with severe mental illness: a role for dietitians in addressing physical health gaps. J Hum Nutr Diet 2017; 30:545-553. [PMID: 28419586 DOI: 10.1111/jhn.12473] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
People experiencing a severe mental illness (SMI), such as schizophrenia, schizoaffective disorder, bipolar affective disorder or depression with psychotic features, have a 20-year mortality gap compared to the general population. This 'scandal of premature mortality' is primarily driven by preventable cardiometabolic disease, and recent research suggests that the mortality gap is widening. Multidisciplinary mental health teams often include psychiatrists, clinical psychologists, specialist mental health nurses, social workers and occupational therapists, offering a range of pharmacological and nonpharmacological treatments to enhance the recovery of clients who have experienced, or are experiencing a SMI. Until recently, lifestyle and life skills interventions targeting the poor physical health experienced by people living with SMI have not been offered in most routine clinical settings. Furthermore, there are calls to include dietary intervention as mainstream in psychiatry to enhance mental health recovery. With the integration of dietitians being a relatively new approach, it is important to review and assess the literature to inform practice. This review assesses the dietary challenges experienced by people with a SMI and discusses potential strategies for improving mental and physical health.
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Affiliation(s)
- S B Teasdale
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,School of Psychiatry, University of New South Wales, Kensington, Australia
| | - K Samaras
- Department of Endocrinology, St Vincent's Hospital, Darlinghurst, Australia.,Diabetes and Metabolism Division, Garvan Institute of Medical Research, Darlinghurst, Australia
| | - T Wade
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia
| | - R Jarman
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia
| | - P B Ward
- School of Psychiatry, University of New South Wales, Kensington, Australia.,Schizophrenia Research Unit, South Eastern Sydney Local Health District & Ingham Institute for Applied Medical Research, Liverpool, Australia
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58
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Stubbs B, Chen LJ, Chung MS, Ku PW. Physical activity ameliorates the association between sedentary behavior and cardiometabolic risk among inpatients with schizophrenia: A comparison versus controls using accelerometry. Compr Psychiatry 2017; 74:144-150. [PMID: 28167327 DOI: 10.1016/j.comppsych.2017.01.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/04/2017] [Accepted: 01/15/2017] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE A lack of clarity exists regarding the relationship between objectively measured physical activity (PA) and sedentary behavior (SB) and cardiometabolic outcomes in people with schizophrenia. We conducted a large study investigating the independent relationships of PA and SB among inpatients with schizophrenia versus healthy controls (HCs). METHODS A cross sectional study including 199 inpatients with schizophrenia (mean age 44.0years, mean illness duration 23.8years) versus 60 age/sex/body mass index matched HCs. Participants wore accelerometers for 7days to capture SB and daily steps. Cardiometabolic outcomes included blood pressure, fasting blood glucose (FBG), triglycerides, high-density lipoprotein cholesterol (HDL-C) and waist circumference (WC). Multivariate regression analyses adjusting for multiple confounders were undertaken. RESULTS Compared to HCs, patients engaged in more sedentary behavior and less daily steps versus HCs (p<0.001). Patients with higher levels of SB (n=89) had increased fasting glucose compared to patients with low levels of SB (105.2 vs. 96.3mg/dl, p<0.05). In the multivariate analysis, sedentary behavior was associated with higher FBG (β = .146, p=.041) but this was ameliorated when daily steps were inserted in to the model (β = .141, p=.059). In the final model, higher daily steps were associated with more favorable HDL-C (β=-.226, p=.004), independent of SB and other confounders. CONCLUSIONS Our data suggest that higher than while sedentary behavior is related to worse fasting glucose, this relationship is attenuated when PA is taken into account. Physical activity is also associated with favorable HDL-C. Interventions targeting replacing sedentary behavior with PA may improve metabolic risk.
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Affiliation(s)
- Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom.
| | - Li-Jung Chen
- Department of Exercise Health Science, National Taiwan University of Sport, 271, Lixing Road, Taichung City 404, Taiwan; Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
| | - Ming-Shun Chung
- Jianan Psychiatric Center, Ministry of Health and Welfare, 80, Lane 870, Zhongshan Road, Tainan 717, Taiwan.
| | - Po-Wen Ku
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK; Graduate Institute of Sports and Health, National Changhua University of Education, 1, Jin-De Road, Changhua 500, Taiwan.
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Schuch F, Vancampfort D, Firth J, Rosenbaum S, Ward P, Reichert T, Bagatini NC, Bgeginski R, Stubbs B. Physical activity and sedentary behavior in people with major depressive disorder: A systematic review and meta-analysis. J Affect Disord 2017; 210:139-150. [PMID: 28033521 DOI: 10.1016/j.jad.2016.10.050] [Citation(s) in RCA: 323] [Impact Index Per Article: 46.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/16/2016] [Accepted: 10/23/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Low levels of physical activity (PA) and sedentary behavior (SB) are independent risk factors for cardiovascular disease and premature mortality in people with major depressive disorder (MDD). AIMS Investigate levels of PA and SB and their predictors in people with MDD. METHODS Electronic databases were searched from inception till 04/2016 for articles measuring PA and SB with a self-report questionnaire (SRQ) or objective measure (e.g. accelerometer) in people with MDD. Random-effects meta-analyses and meta-regression analyses were conducted. RESULTS Twenty-four eligible studies were identified including 2901 people with MDD (78.4% female, mean age=54 years; range: 21-77 years). People with MDD spent 126.0min (95%CI=91.9-160.1) per day engaging in all types of PA and spent 8.5hours (95%CI=7.51-9.62) during their waking day being sedentary. Compared to controls, people with MDD spent less time in total PA (SMD=-0.25, 95%CI=-0.03 to 0.15) and moderate to vigorous PA (SMD=-0.30, 95%CI=-0.40 to 0.21) and engaged in higher levels of SB (SMD=0.09, 95%CI=0.01-0.18). The proportion of people with MDD not meeting the recommended PA guidelines was 67.8% (n=13 studies), which was higher in studies relying on objective versus self-report measures (85.7% v 62.1%, p=0.04). People with MDD were more likely than controls to not meeting the recommended PA guidelines (OR = 1.50, 95%CI = 1.10–2.10). LIMITATIONS Heterogeneity was evident in most analyses. CONCLUSIONS Adults with MDD engage in low levels of PA and high levels of SB. PA and SB are independent predictors of mortality, therefore, future lifestyle interventions targeting both the prevention of SB and adoption and maintenance of PA are warranted.
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Affiliation(s)
- Felipe Schuch
- Unilasalle, Canoas, Brazil; Escola de Educação Física, Fisioterapia e Dança, Porto Alegre, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
| | - Davy Vancampfort
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Centre, Leuven-Kortenberg, Belgium
| | - Joseph Firth
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Simon Rosenbaum
- Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Liverpool NSW 2170, Sydney, Australia; The Black Dog Institute, University of New South Wales, Hospital Road, Prince of Wales Hospital, Randwick 2031, NSW, Australia
| | - Philip Ward
- School of Psychiatry, US Australia, Sydney and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Thaís Reichert
- Escola de Educação Física, Fisioterapia e Dança, Porto Alegre, Brazil
| | | | - Roberta Bgeginski
- Obstetrics and Gynecology Department, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
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Wynaden D, Heslop B, Heslop K, Barr L, Lim E, Chee GL, Porter J, Murdock J. The chasm of care: Where does the mental health nursing responsibility lie for the physical health care of people with severe mental illness? Int J Ment Health Nurs 2016; 25:516-525. [PMID: 27416949 DOI: 10.1111/inm.12242] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 04/17/2016] [Accepted: 04/18/2016] [Indexed: 12/20/2022]
Abstract
The poor physical health of people with a severe mental illness is well documented and health professionals' attitudes, knowledge and skills are identified factors that impact on clients' access to care for their physical health needs. An evaluation was conducted to determine: (i) mental health nurses' attitudes and beliefs about providing physical health care; and, (ii) the effect that participant demographics may have on attitudes to providing physical health care. It was hypothesized that workplace culture would have the largest effect on attitudes. Nurses at three health services completed the "Mental health nurses' attitude towards the physical health care of people with severe and enduring mental illness survey" developed by Robson and Haddad (2012). The 28-item survey measured: nurses' attitudes, confidence, identified barriers to providing care and attitudes towards clients smoking cigarettes. The findings demonstrated that workplace culture did influence the level of physical health care provided to clients. However, at the individual level, nurses remain divided and uncertain where their responsibilities lie. Nursing leadership can have a significant impact on improving clients' physical health outcomes. Education is required to raise awareness of the need to reduce cigarette smoking in this client population.
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Affiliation(s)
- Dianne Wynaden
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | - Brett Heslop
- Rockingham/ Peel Mental Health Service, Rockingham, Western Australia, Australia
| | - Karen Heslop
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | - Lesley Barr
- State Forensic Mental Health Service, Brockway, Western Australia, Australia
| | - Eric Lim
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | - Gin-Liang Chee
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | - James Porter
- Rockingham/ Peel Mental Health Service, Rockingham, Western Australia, Australia
| | - Jane Murdock
- Fremantle Mental Health Services, Fremantle, Western Australia, Australia
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Nam JY, Kim J, Cho KH, Choi Y, Choi J, Shin J, Park EC. Associations of sitting time and occupation with metabolic syndrome in South Korean adults: a cross-sectional study. BMC Public Health 2016; 16:943. [PMID: 27605021 PMCID: PMC5015318 DOI: 10.1186/s12889-016-3617-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 08/31/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Previous evidence suggests that there is a correlation between prolonged sitting time and cardio-metabolic disease, such as metabolic syndrome (MS). Cardiovascular disease is the second-leading cause of mortality in South Korea, a country with the longest working hours among all member states of the Organization for Economic Co-operation and Development. However, no previous study has investigated the relationships of overall sitting-time and occupation with MS in South Korea. Accordingly, the present study examined these relationships in a South Korean population. METHODS Data from the sixth Korean National Health and Nutrition Examination Survey (KNHANES), a nationally representative survey with a cross-sectional design, were used in the present study. MS diagnoses were evaluated using the International Diabetes Foundation (IDF) criteria. Participants self-reported their overall sitting times, and occupations were classified using the Korean version of the Standard Classification of Occupations (KSCO). A multiple logistic regression analysis was conducted to evaluate the associations of sitting time and occupation with MS. RESULTS The risk of MS was 1.21-fold higher among participants who sat for >7 h/day than among those who sat for ≤7 h/day (odds ratio [OR]: 1.21, 95 % confidence interval [CI]: 1.00-1.46). Regarding occupation, office workers had a two-fold higher risk of MS than did agriculture, forestry, and fishery (AFF) workers (OR: 2.01, 95 % CI: 1.26-3.22). In a combined analysis of sitting time and occupation, male participants who sat for >7 h/day and reported an occupation that involves office work (OW) or machine fitting (MF) were significantly more likely to have MS when compared to those who sat for ≤7 h/day and were employed as AFF workers (>7 h/day × OW, OR: 2.41, 95 % CI: 1.05-5.51; >7 h/day × MF, OR: 2.92, 95 % CI: 1.43-5.93). CONCLUSIONS Excessive sitting time and a sedentary occupation correlated positively with MS in South Korean adults. Accordingly, a reduction in the overall sitting time or inclusion of energy-expending activities in the workplace might improve the rate of MS.
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Affiliation(s)
- Jin Young Nam
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Juyoung Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Kyung Hee Cho
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Young Choi
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Jaewoo Choi
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Jaeyong Shin
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Vancampfort D, Firth J, Schuch F, Rosenbaum S, De Hert M, Mugisha J, Probst M, Stubbs B. Physical activity and sedentary behavior in people with bipolar disorder: A systematic review and meta-analysis. J Affect Disord 2016; 201:145-52. [PMID: 27235817 DOI: 10.1016/j.jad.2016.05.020] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 04/18/2016] [Accepted: 05/13/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND Mortality rates are approximately two to three times higher in people with bipolar disorder (BD) than in general population. Lack of physical activity (PA) and sedentary behavior (SB) are independent risk factors for cardiovascular disease and premature mortality. AIMS We conducted a meta-analysis to investigate PA and SB levels and its predictors in BD. METHODS Major electronic databases were searched from inception till 02/2016 for articles measuring PA and SB with a self-report questionnaire (SRQ) or objective measure (e.g. accelerometer) in BD. A random effects meta-analysis and meta-regression analysis were conducted. RESULTS Six studies were eligible including 279 (129♂) people with BD (mean age=43.9 years; range: 32.0-51.5 years). The trim and fill analysis demonstrated people with BD spent in total 210.1min (95%CI=146.3-273.9min) per day being physically active and 613.3min (95%CI=389.9-836.6min) during waking hours being sedentary. No significant difference in total PA per day was observed between people with BD and controls (g=-0.62, 95% CI=-1.55 to 0.31, I(2)=88.5%, n BD =82, n controls =86). Objective measures of PA recorded significantly lower levels (P=0.03) compared to self-report PA. Meta-regression demonstrated that older age and a higher body mass index predicted lower PA levels. LIMITATIONS Only a limited number of studies were identified assessing SB in people with BD. CONCLUSIONS Adults with BD engage in high levels of sedentary behavior during waking hours. Given that sedentary behavior is an independent predictor of cardiovascular disease, future lifestyle interventions specifically targeting the prevention of sedentary behavior are warranted.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Leuven, Kortenberg, Belgium.
| | - Joseph Firth
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Felipe Schuch
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Programa de Pós-Graduação em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Simon Rosenbaum
- Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Marc De Hert
- KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Leuven, Kortenberg, Belgium
| | - James Mugisha
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda; Kyambogo University, Kampala, Uganda
| | - Michel Probst
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
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Vancampfort D, Sienaert P, Wyckaert S, De Hert M, Stubbs B, Probst M. Sitting time, physical fitness impairments and metabolic abnormalities in people with bipolar disorder: An exploratory study. Psychiatry Res 2016; 242:7-12. [PMID: 27235986 DOI: 10.1016/j.psychres.2016.05.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 04/04/2016] [Accepted: 05/17/2016] [Indexed: 12/17/2022]
Abstract
A sedentary lifestyle is an independent risk factor for cardiovascular disease and mortality. Little is known however about sedentary behavior in people with bipolar disorder (BD). The primary aim of this study was to explore associations between sitting time (as a proxy for a sedentary lifestyle) and physical fitness and metabolic parameters in BD. A secondary aim was to investigate associations between psychiatric symptoms, psychotropic medication use and sitting time. Thirty-nine (21♀) participants (43.7±12.4 years) completed a full metabolic screening, the sitting time item of the International Physical Activity Questionnaire, the Quick Inventory of Depressive Symptomatology self-report and the Hypomania Checklist-32. Additionally participants performed the Eurofit-test battery and 6-min walk test. The mean time spent sitting per day for the entire sample was 7.0±3.0h. A higher body mass index, worse physical fitness and higher antipsychotic medication dose were identified as independent predictors of higher levels of sitting behavior. The model explained 76.5% of the variability in the sitting time. Given that a sedentary lifestyle is an independent predictor of cardiovascular disease, future interventions specifically targeting time spend sitting are warranted in BD, with a particular emphasis on those with high body mass index and low fitness levels.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Center KU Leuven, Kortenberg, Leuven, Belgium.
| | - Pascal Sienaert
- KU Leuven - University of Leuven, University Psychiatric Center KU Leuven, Kortenberg, Leuven, Belgium
| | - Sabine Wyckaert
- KU Leuven - University of Leuven, University Psychiatric Center KU Leuven, Kortenberg, Leuven, Belgium
| | - Marc De Hert
- KU Leuven - University of Leuven, University Psychiatric Center KU Leuven, Kortenberg, Leuven, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Michel Probst
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
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Fraser SJ, Chapman JJ, Brown WJ, Whiteford HA, Burton NW. Physical activity and sedentary behaviour among inpatient adults with mental illness. J Sci Med Sport 2016; 19:659-63. [DOI: 10.1016/j.jsams.2015.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 07/21/2015] [Accepted: 09/17/2015] [Indexed: 11/25/2022]
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Suetani S, Waterreus A, Morgan V, Foley DL, Galletly C, Badcock JC, Watts G, McKinnon A, Castle D, Saha S, Scott JG, McGrath JJ. Correlates of physical activity in people living with psychotic illness. Acta Psychiatr Scand 2016; 134:129-37. [PMID: 27218211 DOI: 10.1111/acps.12594] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVE In the light of the high prevalence of physical comorbidities in people with psychotic illness, there is a need to explore modifiable risk factors that may contribute to this disease burden. The benefits of physical activity to both physical and mental health have been well established. We aimed to examine the prevalence and correlates of physical activity in a national sample of adults living with psychotic illness. METHODS Physical activity was assessed in 1801 people using the International Physical Activity Questionnaire. Participants were dichotomised into low and moderate-high physical activity groups and associations between physical activity and a range of sociodemographic, clinical and physical comorbidity variables were examined using logistic regression. RESULTS More than half the participants were categorised in the moderate-high physical activity group with nearly half of the sample engaged in physical activity every day. There were significant associations between low physical activity and older age, unemployment, educational non-participation, antipsychotic medication use, social dysfunction, self-reported loneliness and obesity. However, there was no significant association between physical activity and sex, psychosis type, illness duration, physical comorbidity or negative symptoms. CONCLUSION The findings from this study may inform future interventions designed to increase physical activity in people with psychotic illness.
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Affiliation(s)
- S Suetani
- School of Medicine, University of Queensland, Brisbane, QLD, Australia.,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
| | - A Waterreus
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia
| | - V Morgan
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia.,Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia
| | - D L Foley
- Orygen, The National Centre for Excellence in Youth Mental Health, Centre for Youth Mental Health, University of Melbourne, Melbourne, Vic., Australia
| | - C Galletly
- School of Medicine, University of Adelaide, Adelaide, SA, Australia.,Ramsay Health Care (SA) Mental Health, Adelaide, SA, Australia.,Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - J C Badcock
- Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia.,Cooperative Research Centre - Mental Health, Carlton, Vic., Australia
| | - G Watts
- Lipid Disorders Clinic, Metabolic Research Centre, School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia.,Royal Perth Hospital, Perth, WA, Australia
| | - A McKinnon
- Orygen, The National Centre for Excellence in Youth Mental Health, Centre for Youth Mental Health, University of Melbourne, Melbourne, Vic., Australia
| | - D Castle
- Department of Psychiatry, University of Melbourne, Melbourne, Vic., Australia.,St Vincent's Hospital, Melbourne, Vic., Australia
| | - S Saha
- School of Medicine, University of Queensland, Brisbane, QLD, Australia.,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
| | - J G Scott
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,University of Queensland Centre for Clinical Research, University of Queensland, Herston, Australia.,Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - J J McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
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66
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Yang CY, Lo SC, Peng YC. Prevalence and Predictors of Metabolic Syndrome in People With Schizophrenia in Inpatient Rehabilitation Wards. Biol Res Nurs 2016; 18:558-66. [PMID: 27268516 DOI: 10.1177/1099800416653184] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Atypical antipsychotic medications increase the risk of developing metabolic syndrome (MetS) and cardiovascular diseases in people with schizophrenia. AIM To explore the prevalence of MetS and the predictors associated with the number of MetS components in people with chronic schizophrenia. METHODS We recruited 357 participants from 10 rehabilitation wards in northern Taiwan. The Beck Anxiety Inventory, Beck Depression Inventory-II, Health-Promoting Lifestyle Profile (HPLP), and modified Baecke physical activity questionnaire were used to evaluate the participants. MetS prevalence was calculated using the modified Adult Treatment Panel III criteria for Asians. RESULTS The prevalence of MetS in this sample was 37.8%. Multinomial logistic regression revealed that the HPLP-exercise score (odds ratio [OR] = 0.411, p = .002) and depressive symptoms (OR = 0.949, p = .040) were protective factors for ≥4 MetS components. The leisure physical activity level (OR = .536, p = .024) was a protective factor for three MetS components. Body mass index ≥24 kg/m(2) was the strongest risk factor for two MetS components (OR = 8.057, p < .001), three MetS components (OR = 11.287, p < .001), and ≥four MetS components (OR = 15.621, p < .001). Additionally, participants' age >40 (OR = 3.638, p = .012) was a risk factor for ≥four MetS components. CONCLUSION In this study, the prevalence of MetS was higher than that reported for patients utilizing community-based services in Taiwan. The important risk factors for MetS were being overweight and older than 40. The protective factors for MetS were a high HPLP-exercise score and leisure-based physical activities.
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Affiliation(s)
- Chiu-Yueh Yang
- Department of Nursing, National Yang-Ming University, Taipei, Taiwan
| | - Su-Chen Lo
- Department of Nursing, Bali Psychiatric Center, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Ying-Chieh Peng
- Department of Nursing, Bali Psychiatric Center, Ministry of Health and Welfare, New Taipei City, Taiwan
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Vancampfort D, Correll CU, Galling B, Probst M, De Hert M, Ward PB, Rosenbaum S, Gaughran F, Lally J, Stubbs B. Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: a systematic review and large scale meta-analysis. World Psychiatry 2016; 15:166-74. [PMID: 27265707 PMCID: PMC4911762 DOI: 10.1002/wps.20309] [Citation(s) in RCA: 411] [Impact Index Per Article: 51.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is highly predictive of cardiovascular diseases and can have particularly deleterious health impacts in people with severe mental illness (SMI), i.e. schizophrenia, bipolar disorder or major depressive disorder. This meta-analysis aimed: a) to describe pooled frequencies of T2DM in people with SMI; b) to analyze the influence of demographic, illness and treatment variables as well as T2DM assessment methods; and c) to describe T2DM prevalence in studies directly comparing persons with each specific SMI diagnosis to general population samples. The trim and fill adjusted pooled T2DM prevalence among 438,245 people with SMI was 11.3% (95% CI: 10.0%-12.6%). In antipsychotic-naïve participants, the prevalence of T2DM was 2.9% (95% CI: 1.7%-4.8%). There were no significant diagnostic subgroup differences. A comparative meta-analysis established that multi-episode persons with SMI (N=133,470) were significantly more likely to have T2DM than matched controls (N=5,622,664): relative risk, RR=1.85, 95% CI: 1.45-2.37, p<0.001. The T2DM prevalence was consistently elevated in each of the three major diagnostic subgroups compared to matched controls. Higher T2DM prevalences were observed in women with SMI compared to men (RR=1.43, 95% CI: 1.20-1.69, p<0.001). Multi-episode (versus first-episode) status was the only significant predictor for T2DM in a multivariable meta-regression analysis (r(2) =0.52, p<0.001). The T2DM prevalence was higher in patients prescribed antipsychotics, except for aripriprazole and amisulpride. Routine screening and multidisciplinary management of T2DM is needed. T2DM risks of individual antipsychotic medications should be considered when making treatment choices.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven ‐ University of Leuven, Department of Rehabilitation SciencesLeuvenBelgium,KU Leuven ‐ University of Leuven, Z.org KU LeuvenKortenbergBelgium
| | - Christoph U. Correll
- Zucker Hillside HospitalGlen OaksNYUSA,Hofstra North Shore LIJ School of MedicineHempsteadNYUSA
| | | | - Michel Probst
- KU Leuven ‐ University of Leuven, Department of Rehabilitation SciencesLeuvenBelgium
| | - Marc De Hert
- KU Leuven ‐ University of Leuven, Z.org KU LeuvenKortenbergBelgium
| | - Philip B. Ward
- School of Psychiatry and Ingham Institute of Applied Medical ResearchUniversity of New South WalesSydneyAustralia
| | - Simon Rosenbaum
- School of Psychiatry and Ingham Institute of Applied Medical ResearchUniversity of New South WalesSydneyAustralia
| | - Fiona Gaughran
- Department of Psychosis StudiesInstitute of Psychiatry, King's College LondonLondonUK
| | - John Lally
- Department of Psychosis StudiesInstitute of Psychiatry, King's College LondonLondonUK
| | - Brendon Stubbs
- Department of Psychosis StudiesInstitute of Psychiatry, King's College LondonLondonUK,Physiotherapy Department, South London and Maudsley NHS Foundation TrustLondonUK,Health Service and Population Research DepartmentInstitute of Psychiatry, King's College LondonLondonUK
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68
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Wu CS, Gau SSF. Association Between Antipsychotic Treatment and Advanced Diabetes Complications Among Schizophrenia Patients With Type 2 Diabetes Mellitus. Schizophr Bull 2016; 42:703-11. [PMID: 26721264 PMCID: PMC4838103 DOI: 10.1093/schbul/sbv187] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Antipsychotic drug use is an established risk factor for the development of type 2 diabetes mellitus. However, the effect of antipsychotic drug on the progression of diabetes complications remains unclear. This study aimed to explore the association between antipsychotic treatment and advanced diabetes outcome among schizophrenia patients with type 2 diabetes. METHODS The authors conducted a retrospective cohort study using Taiwan's universal health insurance database. A total of 17 629 schizophrenia patients with newly-diagnosed diabetes were enrolled. The mean duration of follow-up, after excluding the first 6-month observation period, was 4.8 years, ranged from 1 month to 11.5 years. Antipsychotic treatment patterns within a 6-month time window were classified into none, irregular use, and regular use. Antipsychotics were further categorized into the high, intermediate, and low metabolic risks. The status of exposure was treated as time-dependent variables. The outcomes measures included any advanced diabetes complications, macrovascular and microvascular complications, and all-cause mortality. RESULTS Compared to no antipsychotic treatment in the past 6 months, regular antipsychotic use was associated with a lower risk of any advanced diabetes complications (adjusted hazard ratio, aHR = 0.81, 95% CI = 0.69-0.95), macrovascular complications (aHR = 0.80, 95% CI = 0.66-0.97), and all-cause mortality (aHR = 0.73, 95% CI = 0.62-0.85). The hazard ratios for advanced diabetes complications with regular use of antipsychotics with a high, intermediate, and low metabolic risk were 0.69 (95% CI = 0.53-0.91), 0.82 (95% CI = 0.68-0.99), and 0.85 (95% CI = 0.70-1.02), respectively. CONCLUSIONS Regular antipsychotic treatment in the past 6 months was associated with reduced risks of any diabetes complications, compared to no antipsychotic treatment.
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Affiliation(s)
- Chi-Shin Wu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan;,Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, and Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
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69
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Chouinard VA, Pingali SM, Chouinard G, Henderson DC, Mallya SG, Cypess AM, Cohen BM, Öngür D. Factors associated with overweight and obesity in schizophrenia, schizoaffective and bipolar disorders. Psychiatry Res 2016; 237:304-10. [PMID: 26805561 DOI: 10.1016/j.psychres.2016.01.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 11/17/2015] [Accepted: 01/13/2016] [Indexed: 12/19/2022]
Abstract
Evidence suggests abnormal bioenergetic status throughout the body in psychotic disorders. The present study examined predictors of elevated body mass index (BMI) across diagnostic categories of schizophrenia, schizoaffective and bipolar disorders. In a cross-sectional study, we studied demographic and clinical risk factors for overweight and obesity in a well-characterized sample of 262 inpatients and outpatients with schizophrenia (n=59), schizoaffective disorder (n=81) and bipolar I disorder (n=122). Across the three diagnostic categories, the prevalence of overweight (29.4%) and obesity (33.2%) combined was 62.6% (164/262). Logistic regression analyses, adjusted for age, sex and ethnicity, showed that schizoaffective disorder, lifetime major depressive episode, presence of prior suicide attempt, and more than 5 lifetime hospitalizations were significantly associated with BMI≥25. Patients with schizophrenia had significantly lower risk for overweight and obesity. Overall, we found that affective components of illness were associated with elevated BMI in our cross-diagnostic sample. Our results show that patients with schizoaffective disorder have a greater risk for obesity. Identifying predictors of elevated BMI in patients with psychotic and mood disorders will help prevent obesity and related cardiovascular and cerebral complications. Future studies are needed to elucidate the mechanistic nature of the relationship between obesity and psychiatric illness.
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Affiliation(s)
- Virginie-Anne Chouinard
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA; Harvard Medical School, Department of Psychiatry, Boston, MA, USA.
| | | | - Guy Chouinard
- Clinical Pharmacology and Toxicology Program, McGill University and Mental Health Institute of Montreal Fernand Seguin Research Centre, Montreal, Canada
| | - David C Henderson
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA; Schizophrenia Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sonal G Mallya
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
| | - Aaron M Cypess
- Translational Physiology Section, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, USA
| | - Bruce M Cohen
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA; Harvard Medical School, Department of Psychiatry, Boston, MA, USA
| | - Dost Öngür
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA; Harvard Medical School, Department of Psychiatry, Boston, MA, USA
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Alvares GA, Quintana DS, Hickie IB, Guastella AJ. Autonomic nervous system dysfunction in psychiatric disorders and the impact of psychotropic medications: a systematic review and meta-analysis. J Psychiatry Neurosci 2016; 41:89-104. [PMID: 26447819 PMCID: PMC4764485 DOI: 10.1503/jpn.140217] [Citation(s) in RCA: 264] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Autonomic nervous system (ANS) dysfunction is a putative underlying mechanism for increased cardiovascular disease risk in individuals with psychiatric disorders. Previous studies suggest that this risk may be related to psychotropic medication use. In the present study we systematically reviewed and analyzed published studies of heart rate variability (HRV), measuring ANS output, to determine the effect of psychiatric illness and medication use. METHODS We searched for studies comparing HRV in physically healthy adults with a diagnosed psychiatric disorder to controls and comparing HRV pre- and post-treatment with a psychotropic medication. RESULTS In total, 140 case-control (mood, anxiety, psychosis, dependent disorders, k = 151) and 30 treatment (antidepressants, antipsychotics; k = 43) studies were included. We found that HRV was reduced in all patient groups compared to controls (Hedges g = -0.583) with a large effect for psychotic disorders (Hedges g = -0.948). Effect sizes remained highly significant for medication-free patients compared to controls across all disorders. Smaller and significant reductions in HRV were observed for specific antidepressants and antipsychotics. LIMITATIONS Study quality significantly moderated effect sizes in case-control analyses, underscoring the importance of assessing methodological quality when interpreting HRV findings. CONCLUSION Combined findings confirm substantial reductions in HRV across psychiatric disorders, and these effects remained significant even in medication-free individuals. Reductions in HRV may therefore represent a significant mechanism contributing to elevated cardiovascular risk in individuals with psychiatric disorders. The negative impact of specific medications on HRV suggest increased risk for cardiovascular disease in these groups, highlighting a need for treatment providers to consider modifiable cardiovascular risk factors to attenuate this risk.
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Affiliation(s)
| | | | | | - Adam J. Guastella
- Correspondence to: A.J. Guastella, Brain & Mind Centre, University of Sydney, 94 Mallett St, Camperdown NSW Australia;
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71
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Stubbs B, Williams J, Gaughran F, Craig T. How sedentary are people with psychosis? A systematic review and meta-analysis. Schizophr Res 2016; 171:103-9. [PMID: 26805414 DOI: 10.1016/j.schres.2016.01.034] [Citation(s) in RCA: 190] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 01/05/2016] [Accepted: 01/15/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Sedentary behavior (SB) is an independent risk factor for cardiovascular disease and mortality. We conducted a meta-analysis to investigate SB levels and predictors in people with psychosis. METHOD Major electronic databases were searched from inception till 09/2015 for articles measuring SB with a self-report questionnaire (SRQ) or objective measure (e.g. accelerometer) in people with psychosis, including schizophrenia spectrum and bipolar disorders. A random effects meta-analysis and meta regression analysis were conducted. RESULTS Thirteen studies were eligible including 2033 people with psychosis (mean age 41.3years (range 25.1-60), 63.2% male (range 35-89%), body mass index 28.7 (range 25.9-32.1). The trim and fill analysis demonstrated people with psychosis spent 660.8min (95% CI 523.2-798.4, participants=2033) or 11.0h (95% CI 8.72-13.3) per day being sedentary. Objective measures of SB recorded significantly higher levels (p<0.001) of SB (12.6h per day, 95% CI 8.97-16.2, studies=7, participants=254) compared to self-report SB (6.85h per day, 95% CI 4.75-8.96, studies=6, participants=1779). People with psychosis engaged in significantly more SB than controls (g=1.13, 95% CI 0.496-1.77, P<0.001, n psychosis=216, n controls=159) equating to a mean difference of 2.80 (95% CI 1.47-4.1) hours per day. Multivariate meta-regression confirmed that objective measurement of SB predicted higher levels of sedentariness. CONCLUSIONS People with psychosis engage in very high levels of sedentary behavior in their waking day and current SRQ may underestimate SB. Given that SB is an independent predictor of cardiovascular disease, future interventions specifically targeting the prevention of SB are warranted.
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Affiliation(s)
- Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London Box SE5 8AF, United Kingdom; The Collaboration for Leadership in Applied Health Research and Care (CLAHRC), South London Psychosis Research Team, United Kingdom.
| | - Julie Williams
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London Box SE5 8AF, United Kingdom; The Collaboration for Leadership in Applied Health Research and Care (CLAHRC), South London Psychosis Research Team, United Kingdom
| | - Fiona Gaughran
- The Collaboration for Leadership in Applied Health Research and Care (CLAHRC), South London Psychosis Research Team, United Kingdom; Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Tom Craig
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London Box SE5 8AF, United Kingdom; The Collaboration for Leadership in Applied Health Research and Care (CLAHRC), South London Psychosis Research Team, United Kingdom
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72
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Vancampfort D, Rosenbaum S, Probst M, Connaughton J, du Plessis C, Yamamoto T, Stubbs B. What are the top 10 physical activity research questions in schizophrenia? Disabil Rehabil 2016; 38:2235-43. [DOI: 10.3109/09638288.2015.1116622] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Stanton R, Donohue T, Garnon M, Happell B. Participation in and Satisfaction With an Exercise Program for Inpatient Mental Health Consumers. Perspect Psychiatr Care 2016; 52:62-7. [PMID: 25728913 DOI: 10.1111/ppc.12108] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 12/11/2014] [Accepted: 01/29/2015] [Indexed: 12/16/2022] Open
Abstract
PURPOSE This study examines attendance at, and satisfaction with, a group exercise program in an inpatient mental health setting. DESIGN AND METHOD Thirty-two inpatients completed discharge surveys to evaluate group activities. Data were analyzed for participation and satisfaction. FINDINGS More inpatients (n = 16, 50%) rated exercise as "excellent" compared with all other activities. Nonattendance rates were lowest for cognitive behavioral therapy (n = 2, 6.3%), highest for the relaxation group (n = 6, 18.8%), and 12.5% (n = 4) for the group exercise program. PRACTICE IMPLICATIONS Group exercise programs delivered by highly trained personnel are well attended and achieve high satisfaction ratings by inpatient mental health consumers.
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Affiliation(s)
- Robert Stanton
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Trish Donohue
- Archerview Clinic, Hillcrest Private Hospital, Rockhampton, Queensland, Australia
| | - Michelle Garnon
- Archerview Clinic, Hillcrest Private Hospital, Rockhampton, Queensland, Australia
| | - Brenda Happell
- Research Centre for Nursing and Midwifery Practice, University of Canberra, Faculty of Health and ACT Health, Canberra Hospital, Woden, Australian Capital Territory, Australia
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74
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Soundy A, Freeman P, Stubbs B, Probst M, Vancampfort D. The value of social support to encourage people with schizophrenia to engage in physical activity: an international insight from specialist mental health physiotherapists. J Ment Health 2015; 23:256-60. [PMID: 25222369 DOI: 10.3109/09638237.2014.951481] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Research is needed to understand how mental health physiotherapists use social support when promoting physical activity. AIMS The aim of this study was to establish which dimensions of social support are used within physiotherapy sessions for individuals with schizophrenia. METHOD A cross sectional international survey design of specialist mental health physiotherapists was undertaken. RESULTS Forty mental health physiotherapists provided in depth accounts of the four functional dimensions of social support (informational, tangible, esteem and emotional) and the one structural dimension (importance of group exercise). The results illustrate how these different dimensions of social support are used by physiotherapists to engage patients and identify the value of group work as a specific form of support. Specifically the importance of all types of support was reported and this helped to provide a detailed consideration to the skills that mental health physiotherapist have. CONCLUSION Providing social support is a significant part of the rehabilitation professionals' role. The current results advance the current understanding of how social support is provided to individuals with schizophrenia in rehabilitation settings.
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Affiliation(s)
- Andrew Soundy
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham , Birmingham , UK
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75
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Vancampfort D, Stubbs B, Mitchell AJ, De Hert M, Wampers M, Ward PB, Rosenbaum S, Correll CU. Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis. World Psychiatry 2015; 14:339-47. [PMID: 26407790 PMCID: PMC4592657 DOI: 10.1002/wps.20252] [Citation(s) in RCA: 761] [Impact Index Per Article: 84.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. The primary aim of this systematic review and meta-analysis was to assess the prevalence of MetS and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder, comparing subjects with different disorders and taking into account demographic variables and psychotropic medication use. The secondary aim was to compare the MetS prevalence in persons with any of the selected disorders versus matched general population controls. The pooled MetS prevalence in people with severe mental illness was 32.6% (95% CI: 30.8%-34.4%; N = 198; n = 52,678). Relative risk meta-analyses established that there was no significant difference in MetS prevalence in studies directly comparing schizophrenia versus bipolar disorder, and in those directly comparing bipolar disorder versus major depressive disorder. Only two studies directly compared people with schizophrenia and major depressive disorder, precluding meta-analytic calculations. Older age and a higher body mass index were significant moderators in the final demographic regression model (z = -3.6, p = 0.0003, r(2) = 0.19). People treated with all individual antipsychotic medications had a significantly (p<0.001) higher MetS risk compared to antipsychotic-naïve participants. MetS risk was significantly higher with clozapine and olanzapine (except vs. clozapine) than other antipsychotics, and significantly lower with aripiprazole than other antipsychotics (except vs. amisulpride). Compared with matched general population controls, people with severe mental illness had a significantly increased risk for MetS (RR = 1.58; 95% CI: 1.35-1.86; p<0.001) and all its components, except for hypertension (p = 0.07). These data suggest that the risk for MetS is similarly elevated in the diagnostic subgroups of severe mental illness. Routine screening and multidisciplinary management of medical and behavioral conditions is needed in these patients. Risks of individual antipsychotics should be considered when making treatment choices.
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Affiliation(s)
- Davy Vancampfort
- UPC KU Leuven, Campus Kortenberg, Department of Neurosciences, KU Leuven - University of LeuvenKortenberg, Belgium,Department of Rehabilitation Sciences, KU Leuven - University of LeuvenLeuven, Belgium
| | - Brendon Stubbs
- School of Health and Social Care, University of GreenwichEltham, London, UK
| | - Alex J Mitchell
- Department of Psycho-oncology, Leicestershire Partnership NHS TrustLeicester, UK,Department of Cancer and Molecular Medicine, University of LeicesterLeicester, UK
| | - Marc De Hert
- UPC KU Leuven, Campus Kortenberg, Department of Neurosciences, KU Leuven - University of LeuvenKortenberg, Belgium
| | - Martien Wampers
- UPC KU Leuven, Campus Kortenberg, Department of Neurosciences, KU Leuven - University of LeuvenKortenberg, Belgium
| | - Philip B Ward
- School of Psychiatry, University of New South WalesSydney, NSW, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South WalesSydney, NSW, Australia
| | - Christoph U Correll
- Zucker Hillside HospitalGlen Oaks, NY, USA,Hofstra North Shore LIJ School of MedicineHempstead, NY, USA
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76
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Vancampfort D, Guelinckx H, Probst M, Stubbs B, Rosenbaum S, Ward PB, De Hert M. Health-related quality of life and aerobic fitness in people with schizophrenia. Int J Ment Health Nurs 2015. [PMID: 26215311 DOI: 10.1111/inm.12145] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The purpose of this cross-sectional study was to investigate whether aerobic fitness contributes to the health-related quality of life (HRQoL) in people with schizophrenia, while adjusting for other previously-established contributory factors. Thirty-four male (34.1 ± 12.0 years) and 13 female (34.3 ± 9.2 years) participants performed a submaximal Astrand-Rhyming cycle ergometer test and completed the 36-item Short-Form Health Survey, the International Physical Activity Questionnaire, and the Psychosis Evaluation tool for Common Use by Caregivers. After controlling for age and sex, illness duration (12.4 ± 11.2 years, r(2) = 0.38, P < 0.001), fewer positive (9.3 ± 4.3, r(2) = 0.30, P = 0.006) and cognitive (8.4 ± 3.8, r(2) = 0.28, P = 0.011) symptoms, and higher aerobic fitness (34.5 ± 8.7 ml O2 min(-1) kg(-1), r(2) = 0.36, P = 0.001) were found to be independent significant predictors of physical HRQoL (mean score 66.6 ± 18.5). However, when all variables were included in the same regression model, only illness duration (P = 0.004) and positive symptoms (P = 0.045) remained significant predictors, while there was a trend (P < 0.10) for age and aerobic fitness. The final model explained 54% of the variability in physical HRQoL. No significant correlates for mental HRQoL (54.9 ± 18.5) were found. People with schizophrenia might improve their physical HRQoL by improving their aerobic fitness. Mental health nurses should assist in facilitating improvements in aerobic fitness through facilitating physical activity participation in patients with schizophrenia.
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Affiliation(s)
- Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium.,Department of Neurosciences, KU Leuven - University of Leuven, Kortenberg, Belgium
| | - Hannes Guelinckx
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Michel Probst
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium.,Department of Neurosciences, KU Leuven - University of Leuven, Kortenberg, Belgium
| | - Brendon Stubbs
- School of Health and Social Care, University of Greenwich, London, UK
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Schizophrenia Research Unit
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Schizophrenia Research Unit
| | - Marc De Hert
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium.,School of Health and Social Care, University of Greenwich, London, UK
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77
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Vancampfort D, Stubbs B, Ward PB, Teasdale S, Rosenbaum S. Integrating physical activity as medicine in the care of people with severe mental illness. Aust N Z J Psychiatry 2015; 49:681-2. [PMID: 26041791 DOI: 10.1177/0004867415590831] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Davy Vancampfort
- UPC KU Leuven, Kortenberg Campus, Department of Neurosciences, KU Leuven, Kortenberg, Belgium Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Brendon Stubbs
- School of Health and Social Care, University of Greenwich, London, UK
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Scott Teasdale
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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78
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Eskelinen S, Sailas E, Joutsenniemi K, Holi M, Suvisaari J. Clozapine use and sedentary lifestyle as determinants of metabolic syndrome in outpatients with schizophrenia. Nord J Psychiatry 2015; 69:339-45. [PMID: 25981178 DOI: 10.3109/08039488.2014.983544] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Schizophrenia patients are in danger of developing metabolic syndrome (MetS) and its outcomes type 2 diabetes and cardiovascular disease. Antipsychotic treatment and adverse lifestyle increase the burden of metabolic problems in schizophrenia, but little is known about the role of patients' current psychiatric problems and living arrangements in MetS. AIMS This study aims to evaluate correlations between MetS, severity of psychiatric symptoms, living arrangements, health behaviour and antipsychotic medication in outpatients with schizophrenia spectrum disorders. METHODS A general practitioner and psychiatric nurses performed a comprehensive health examination for all consenting patients with schizophrenia spectrum disorders treated in a psychosis outpatient clinic. Examination comprised of an interview, a questionnaire, measurements, laboratory tests and a general clinical examination. Diagnosis of MetS was made according to International Diabetes Federation (IDF) definition. Correlations were calculated and logistic regression analysis performed with SAS. RESULTS 276 patients (men n = 152, mean age ± standard deviation = 44.9 ± 12.6 years) participated in the study; 58.7% (n = 162) of them had MetS according to the IDF definition. Clozapine use doubled the risk of MetS (OR = 2.04, 95% CI 1.09-3.82, P = 0.03), whereas self-reported regular physical activity decreased the risk significantly (OR = 0.32, 95% CI 0.18-0.57, P < 0.001). We found no correlations between MetS and living arrangements or current severity of psychiatric symptoms. CONCLUSIONS MetS was alarmingly common in our sample. Even moderate physical activity was associated with decreased risk of MetS. Promotion of a physically active lifestyle should be one of the targets in treatment of schizophrenia, especially in patients using clozapine.
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Affiliation(s)
- Saana Eskelinen
- Saana Eskelinen, M.D., Hospital District of Helsinki and Uusimaa, Kellokoski Hospital , Tuusula, FIN-04500 Kellokoski , Finland
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79
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80
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Moons T, De Hert M, Kenis G, Viechtbauer W, van Os J, Gohlke H, Claes S, van Winkel R. No association between genetic or epigenetic variation in insulin growth factors and antipsychotic-induced metabolic disturbances in a cross-sectional sample. Pharmacogenomics 2015; 15:951-62. [PMID: 24956249 DOI: 10.2217/pgs.14.46] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
AIM Second-generation antipsychotics (SGA) are known to induce metabolic disturbances. Genetic pathways, such as the IGF pathway could be associated with increased metabolic syndrome (MetS). Additionally, IGF2 methylation varies as a function of environmental influences and is associated with schizophrenia and MetS. The current study aims to evaluate whether genetic and epigenetic variation in genes of the IGF pathway are associated with metabolic disturbances in patients under treatment with SGAs. METHODS Cross-sectional metabolic data from 438 patients with schizophrenia spectrum disorder was analyzed. Using the Sequenom MassARRAY iPLEX(TM) platform, 27 SNPs of the IGF1 and IGF2 genes and the IGF receptors IGF1R and IGF2R were genotyped. Methylation status of seven IGF2 CpG dinucleotides was evaluated using a Sequenom MALDI-TOF spectrometer. RESULTS & CONCLUSION There was a significant association between IGF2 methylation and genotype, but no significant association between genetic or epigenetic variability and metabolic parameters in the present study.
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Affiliation(s)
- Tim Moons
- GRASP Research Unit, University Psychiatric Centre Catholic University Leuven, Herestraat 49, 3000 Leuven, Belgium
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81
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Abstract
The primary aim was to determine whether the presence of metabolic syndrome (MetS) limits aerobic fitness in patients with schizophrenia. A secondary aim was to investigate the associations between aerobic fitness and MetS parameters. Aerobic fitness (expressed as predicted maximal oxygen uptake) was assessed using the Astrand-Rhyming test. Those with MetS (n = 19) were similar in age, sex, antipsychotic medication use, symptoms, and smoking behavior than those without (n = 31). Estimated maximal oxygen uptake was 21.4% lower (p = 0.001) in patients with MetS than in patients without MetS (29.5 ± 7.4 ml of O2/min/kg vs. 37.5 ± 8.2 ml of O2/min/kg, respectively). The estimated maximal oxygen uptake of the entire sample was correlated with waist circumference, the level of high-density lipoproteins, and fasting glucose. The current study demonstrates that the additive burden of MetS might place people with schizophrenia at increased risk for functional limitations in daily life activities.
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82
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Abstract
BACKGROUND Patients with schizophrenia have a substantially increased risk of cardiovascular disease and premature death compared with the general population. High prevalence of an unhealthy lifestyle contributes to the increased risk in these patients. Patients with schizophrenia are often physically inactive, and there is limited knowledge on the factors, such as barriers and incentives, that can influence physical activity in this patient group. OBJECTIVE The aim was to study the perception and experience of barriers to and incentives for physical activity in daily living in patients with schizophrenia, as reported by the patients themselves. DESIGN An explorative study applying conventional qualitative content analysis was conducted. METHODS A purposeful sample of 20 patients with schizophrenia or schizoaffective disorder (13 men, 7 women; 22-63 years of age) registered at 3 psychiatric outpatient clinics in Sweden were interviewed using semistructured interviews. RESULTS The analysis resulted in 3 main themes: (1) barriers-factors that complicate or obstruct physical activity, (2) reward-the motivation for physical activity, and (3) helpful strategies. LIMITATIONS The results may not reflect important factors related to physical activity in older patients (>65 years of age), newly diagnosed patients, or inpatients. CONCLUSIONS In accordance with patients' perceptions, there may be biopsychosocial determinants of physical activity behavior that are unique for this group of patients. Future studies should investigate whether physical activity interventions for patients with schizophrenia benefit from individual analyses of barriers and reward for physical activity in combination with the use of tailored strategies such as personal support and activity planning.
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83
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Soundy A, Muhamed A, Stubbs B, Probst M, Vancampfort D. The benefits of walking for individuals with schizophrenia spectrum disorders: A systematic review. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2014. [DOI: 10.12968/ijtr.2014.21.9.410] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Andrew Soundy
- a Lecturer in Physiotherapy at the School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | | | - Brendon Stubbs
- a Physiotherapist at the School of Health and Social Care, University of Greenwich, UK
| | - Michel Probst
- University Psychiatric Centre, KU Leuven, Kortenberg, Department of Neurosciences, KU Leuven, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, B-3001 Leuven, Belgium
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84
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Soundy A, Roskell C, Stubbs B, Vancampfort D. Selection, use and psychometric properties of physical activity measures to assess individuals with severe mental illness: a narrative synthesis. Arch Psychiatr Nurs 2014; 28:135-51. [PMID: 24673789 DOI: 10.1016/j.apnu.2013.12.002] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 11/21/2013] [Accepted: 12/14/2013] [Indexed: 12/13/2022]
Abstract
This research provides a critical consideration of the outcome measures used to assess physical activity in individuals with severe mental illness. A narrative synthesis was utilised to provide a simple juxtapose of the current research. A sensitive topic-based search strategy was conducted in order to identify studies that met the eligibility criteria. Fifty two studies met the inclusion criteria and 5 were identified specially as validation studies. The current research identified several methodological shortcomings. The justification and choice of outcome measure used is often weak and only five studies have validated a specific outcome measure of physical activity. Within these validation studies, the validation process often lacked a consideration of agreement between measures. Accelerometers have been most frequently used as a criterion measure, notably the RT3 tri-axial accelerometer. Objective based measures may be best placed to consider physical activity levels, although, methodological considerations for the utilization of such tools is required. Self-report questionnaires have benefits for use in this population but require further validation. Researchers and clinicians need to carefully consider what outcome measure they are using and be aware of the development, scope and purpose of that measure.
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Affiliation(s)
- Andrew Soundy
- School of Health and Population Sciences, College of Medicine and Dentistry, 52 Pritchatts Road, University of Birmingham, Edgbaston, Birmingham, UK.
| | - Carolyn Roskell
- School of Health and Population Sciences, College of Medicine and Dentistry, 52 Pritchatts Road, University of Birmingham, Edgbaston, Birmingham, UK.
| | - Brendon Stubbs
- School of Health and Social Care, University of Greenwich, Southwood Site, Avery Hill Road, Eltham, London, UK
| | - Davy Vancampfort
- University Psychiatric Center, Catholic University Leuven, Campus Kortenberg, Leuvensesteenweg 517, Kortenberg, Belgium.
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85
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Konarzewska B, Stefańska E, Wendołowicz A, Cwalina U, Golonko A, Małus A, Kowzan U, Szulc A, Rudzki L, Ostrowska L. Visceral obesity in normal-weight patients suffering from chronic schizophrenia. BMC Psychiatry 2014; 14:35. [PMID: 24506972 PMCID: PMC3922935 DOI: 10.1186/1471-244x-14-35] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Accepted: 02/05/2014] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND BMI (body mass index) can be misleading regarding the level of adiposity in a normal-weight individual. Recently, a bioelectrical impedance analysis (BIA) method was developed that can measure body composition variables. The main objectives of this study were to use BIA to compare the body composition variables between chronic non-diabetic schizophrenic patients with normal weight and healthy individuals. The secondary objective was to compare the nutritional pattern of schizophrenia patients with that of matched healthy subjects, and to identify possible relationships between the content of different components of their diet and visceral adiposity. METHODS The subjects were 52 normal-weight patients (33 males and 19 females) diagnosed with schizophrenia based on the DSM-IV and 45 (23 males and 22 females) BMI- matched controls. The patients had been receiving atypical or typical antipsychotic agents for at least one year before enrollment into the study but continuously for 3 months preceding the study and were psychiatrically stable. Body fat (kg), percent (%) body fat, fat-free mass, VAT (visceral adipose tissue) and SAT (subcutaneous adipose tissue) were measured using the bioelectrical impedance analysis (BIA) method. Daily food rations (DFR) were quantitatively evaluated by a 24-h dietary recall method covering 3 days preceding the examination. RESULTS In normal-weight patients schizophrenia was significantly linked with higher VAT, VAT/SAT ratio and lower fat- free mass. Men had over 5 times and women over 2 times as much VAT as BMI matched groups. In women with schizophrenia and in their controls, the amount of magnesium, niacin and vitamin B6 in their diet inversely correlated with VAT, while in men lower zinc and vitamin C intake was related to higher visceral adiposity. CONCLUSIONS Our study has shown that normal-weight patients with chronic schizophrenia have higher levels of visceral fat (VAT) than controls but similar volume of subcutaneous adipose tissue (SAT). Although no clear conclusion can be made regarding cause-and-effect relationships between the dietary content of food served to our patients and visceral obesity, we suggest that schizophrenia diet should be further investigated as a possible factor related to this type of obesity.
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Affiliation(s)
- Beata Konarzewska
- Department of Psychiatry, Medical University of Bialystok, Plac Brodowicza 1, Choroszcz 16-070, Poland.
| | - Ewa Stefańska
- Department of Dietetics and Clinical Nutrition, Medical University of Bialystok, Mieszka I-go 4B, Białystok 15-054, Poland
| | - Agnieszka Wendołowicz
- Department of Dietetics and Clinical Nutrition, Medical University of Bialystok, Mieszka I-go 4B, Białystok 15-054, Poland
| | - Urszula Cwalina
- Department of Statistics and Medical Informatics, Medical University of Bialystok, Szpitalna 37, Białystok 15-295, Poland
| | - Anna Golonko
- Department of Dietetics and Clinical Nutrition, Medical University of Bialystok, Mieszka I-go 4B, Białystok 15-054, Poland
| | - Aleksandra Małus
- Department of Psychiatry, Medical University of Bialystok, Plac Brodowicza 1, Choroszcz 16-070, Poland
| | - Urszula Kowzan
- Department of Psychiatry, Medical University of Bialystok, Plac Brodowicza 1, Choroszcz 16-070, Poland
| | - Agata Szulc
- Department of Psychiatry, Medical University of Bialystok, Plac Brodowicza 1, Choroszcz 16-070, Poland,Department of Psychiatry, Medical University of Warsaw, Faculty of Health Sciences, ul. Partyzantow 2/4, Pruszkow 05-802, Poland
| | - Leszek Rudzki
- Department of Psychiatry, Medical University of Bialystok, Plac Brodowicza 1, Choroszcz 16-070, Poland
| | - Lucyna Ostrowska
- Department of Dietetics and Clinical Nutrition, Medical University of Bialystok, Mieszka I-go 4B, Białystok 15-054, Poland
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86
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Sylvia LG, Bernstein EE, Hubbard JL, Keating L, Anderson EJ. Practical guide to measuring physical activity. J Acad Nutr Diet 2014; 114:199-208. [PMID: 24290836 PMCID: PMC3915355 DOI: 10.1016/j.jand.2013.09.018] [Citation(s) in RCA: 305] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 09/03/2013] [Indexed: 12/21/2022]
Affiliation(s)
- Louisa G. Sylvia
- Assistant Professor of Psychology; The Massachusetts General Hospital; Bipolar Clinic & Research Program, 50 Staniford Street, Suite 580, Boston, MA 02114; (phone) 617-643-4804 (fax) 617-726-6768
| | - Emily E. Bernstein
- Clinical Research Coordinator; The Massachusetts General Hospital; Bipolar Clinic & Research Program, 50 Staniford Street, Suite 580, Boston, MA 02114; (phone) 617-726-7591 (fax) 617-726-6768
| | - Jane L. Hubbard
- Dietician; Massachusetts General Hospital, Clinical Research Center, 55 Fruit St, Boston, MA 02114 (phone) (617) 724-2830; (617) 726-7563
| | - Leigh Keating
- Dietician, Brigham & Women’s Hospital; Clinical Center for Investigation, 221 Longwood Avenue, Boston MA 02115 (phone) 617-732-7783; (fax) 617-732-7900
| | - Ellen J. Anderson
- Bionutrition/MPC Director, Massachusetts General Hospital, Clinical Research Center, 55 Fruit St, Boston, MA 02114 (phone) (617) 724-2830; (617) 726-7563
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Ozbulut O, Genc A, Bagcioglu E, Coskun KS, Acar T, Alkoc OA, Karabacak H, Sener U, Ucok K. Evaluation of physical fitness parameters in patients with schizophrenia. Psychiatry Res 2013; 210:806-11. [PMID: 24113123 DOI: 10.1016/j.psychres.2013.09.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 09/09/2013] [Accepted: 09/15/2013] [Indexed: 10/26/2022]
Abstract
The aims of this study were to compare aerobic and anaerobic exercise capacities, pulmonary functions, body composition and fat distribution parameters in patients with schizophrenia and healthy controls and to investigate the associations among these parameters. Sixty (30 male, 30 female) patients with schizophrenia and 60 (30 male, 30 female) healthy controls were included in the study. Maximal aerobic capacity was estimated with the Astrand submaximal exercise protocol, and anaerobic performance was determined with a Wingate test. Body composition was established with a bioelectrical impedance analyzer. Pulmonary function tests, skinfold thickness and body circumference measurements were also carried out. Maximal aerobic capacity, maximal anaerobic power, anaerobic capacity and pulmonary function tests (forced vital capacity and maximal voluntary ventilation) were found to be lower in male and female schizophrenic groups as compared to the controls. Body fat percentage, waist and abdomen circumferences, and waist to hip ratio were found to be higher in female schizophrenic patients than in controls. We suggest that maximal aerobic capacity, maximal anaerobic power, and anaerobic capacity are poor in the schizophrenia patients as compared to healthy controls. Low cardiorespiratory fitness is related to reduced pulmonary function and impaired body composition in schizophrenia patients.
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Affiliation(s)
- Omer Ozbulut
- Department of Psychiatry, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
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Soundy A, Wampers M, Probst M, De Hert M, Stubbs B, Vancampfort D, Attux C, Leutwyler H, Ströhle A. Physical activity and sedentary behaviour in outpatients with schizophrenia: A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2013. [DOI: 10.12968/ijtr.2013.20.12.588] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
| | - Martien Wampers
- University Psychiatric Center, Catholic University Leuven, Campus Kortenberg, Belgium
| | - Michel Probst
- University Psychiatric Center, Catholic University Leuven, Campus Kortenberg, Belgium
| | - Marc De Hert
- University Psychiatric Center, Catholic University Leuven, Campus Kortenberg, Department of Neurosciences KU Leuven, Belgium
| | | | - Davy Vancampfort
- University Psychiatric Center, Catholic University Leuven, Campus Kortenberg, Belgium
| | - Cecelia Attux
- Department of Psychiatry, Universidade Federal de São Paulo, Brazil
| | - Heather Leutwyler
- Department of Physiological Nursing, University of California, San Francisco, USA
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Charité University of Medicine, Berlin, Germany
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Impact of physical activity on functioning of patients with first-episode psychosis--a 6 months prospective longitudinal study. Schizophr Res 2013; 150:538-41. [PMID: 24012460 DOI: 10.1016/j.schres.2013.08.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 08/13/2013] [Accepted: 08/21/2013] [Indexed: 11/22/2022]
Abstract
There has been increasing interest in studying the impact of physical activity on the psychological and physical well-being and functioning in patients with first-episode psychosis. The exploration of factors which contribute to physical activity in psychosis may open up opportunities for improvement of functional outcome. The purpose of this study was to examine the association between physical activity level and functioning in psychosis. A total of 283 patients with first-episode psychosis were recruited from a specialized early intervention service for adult-onset psychosis (Jockey Club Early Psychosis Project) in Hong Kong. The level of physical activity, sociodemographics and clinical characteristics was assessed at study entry. Functioning was assessed at 6-months period. Ninety-six (33.9%) patients were categorized as physically inactive, and 187 (66.1%) of them were physically active. Being physically inactive (β=0.163, P=0.003), having more positive and negative symptoms [SAPS total score (β=-0.161, P=0.005), and SANS total score (β=-0.202, P=0.001)], and having lower household income (β=0.207, P=0.001) at baseline predicted poorer functioning at 6months. Early intervention for psychosis should target to improve patients' physical activity level which may help subsequent functioning.
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Vancampfort D, Wampers M, Mitchell AJ, Correll CU, De Herdt A, Probst M, De Hert M. A meta-analysis of cardio-metabolic abnormalities in drug naïve, first-episode and multi-episode patients with schizophrenia versus general population controls. World Psychiatry 2013; 12:240-50. [PMID: 24096790 PMCID: PMC3799255 DOI: 10.1002/wps.20069] [Citation(s) in RCA: 197] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A meta-analysis was conducted to explore the risk for cardio-metabolic abnormalities in drug naïve, first-episode and multi-episode patients with schizophrenia and age- and gender- or cohort-matched general population controls. Our literature search generated 203 relevant studies, of which 136 were included. The final dataset comprised 185,606 unique patients with schizophrenia, and 28 studies provided data for age- and gender-matched or cohort-matched general population controls (n=3,898,739). We found that multi-episode patients with schizophrenia were at increased risk for abdominal obesity (OR=4.43; CI=2.52-7.82; p<0.001), hypertension (OR=1.36; CI=1.21-1.53; p<0.001), low high-density lipoprotein cholesterol (OR=2.35; CI=1.78-3.10; p<0.001), hypertriglyceridemia (OR=2.73; CI=1.95-3.83; p<0.001), metabolic syndrome (OR=2.35; CI=1.68-3.29; p<0.001), and diabetes (OR=1.99; CI=1.55-2.54; p<0.001), compared to controls. Multi-episode patients with schizophrenia were also at increased risk, compared to first-episode (p<0.001) and drug-naïve (p<0.001) patients, for the above abnormalities, with the exception of hypertension and diabetes. Our data provide further evidence supporting WPA recommendations on screening, follow-up, health education and lifestyle changes in people with schizophrenia.
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Affiliation(s)
- Davy Vancampfort
- University Psychiatric Centre KU Leuven, Campus Kortenberg, Leuvensesteenweg 517, 3070 Kortenberg, Belgium; KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
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91
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De Herdt A, Knapen J, Vancampfort D, De Hert M, Brunner E, Probst M. Social anxiety in physical activity participation in patients with mental illness: a cross-sectional multicenter study. Depress Anxiety 2013; 30:757-62. [PMID: 23532913 DOI: 10.1002/da.22059] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 12/10/2012] [Accepted: 12/21/2012] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Social anxiety (SA) is a frequent comorbid condition in patients with mental illness. However, no data exist regarding SA in physical activity (PA) situations. The aim of the present study was to measure the level of self-reported SA in PA participation in patients with mental illness compared to healthy controls. METHODS Six hundred ninety-three patients with mental illness and 2,888 controls aged between 18 and 65 years completed the Physical Activity and Sport Anxiety Scale (PASAS). Group and gender differences in PASAS scores were tested by ANOVA and Scheffé's post hoc test. RESULTS After controlling for gender (P < .05), the patient group (men 40.2 ± 14.4; women 49.2 ± 17) scored higher on the PASAS compared to control group (men 30.6 ± 12.2; women 37.3 ± 13.7). Within both groups, women reported higher levels of SA compared to men. CONCLUSIONS Our data indicate that patients with mental illness reported higher levels of SA in PA situations compared to healthy control subjects. Health professionals should consider SA when trying to improve outcome and adherence of patients with mental illness to PA interventions.
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Affiliation(s)
- Amber De Herdt
- Faculty of Rehabilitation Science and Physiotherapy, Catholic University of Leuven, Leuven, Belgium.
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Chang CC, Lai TJ. Variability of waist circumference and its relationship with cardiovascular risk factors in outpatients with schizophrenia. Psychiatry Res 2013; 208:191-3. [PMID: 23452756 DOI: 10.1016/j.psychres.2013.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 01/29/2013] [Accepted: 02/03/2013] [Indexed: 10/27/2022]
Abstract
The magnitude of waist circumference (WC) in schizophrenia patients was measured at three sites (above superior iliac crest, midpoint between lowest rib and iliac crest, and umbilical level), and correlated with lipid profiles, glucose, blood pressure and metabolic syndrome. The mean midpoint WC was significantly smaller than at the other sites.
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Affiliation(s)
- Cheng-Chen Chang
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
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93
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Hofmeister M. Schizophrenia patients: physical activity is and remains an organismic necessity. Singapore Med J 2013; 54:236-7. [DOI: 10.11622/smedj.2013081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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94
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Janney CA, Ganguli R, Richardson CR, Holleman RG, Tang G, Cauley JA, Kriska AM. Sedentary behavior and psychiatric symptoms in overweight and obese adults with schizophrenia and schizoaffective disorders (WAIST Study). Schizophr Res 2013; 145:63-8. [PMID: 23410710 PMCID: PMC3836608 DOI: 10.1016/j.schres.2013.01.010] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 01/14/2013] [Accepted: 01/16/2013] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Examine the association between sedentary behavior and psychiatric symptoms among overweight and obese adults with schizophrenia or schizoaffective disorders (SZO/SA). DESIGN Randomized clinical trial; Weight Assessment and Intervention in Schizophrenia Treatment (WAIST) Study: baseline data collected 2005-2008. SETTING University of Pittsburgh Medical Center, Pittsburgh, PA, USA. PARTICIPANTS Community-dwelling adults diagnosed with SZO/SA, with mild symptom severity [Positive and Negative Syndrome Scale (PANSS)<90], who were interested in losing weight, age 18-70years, BMI>27kg/m(2). MEASUREMENTS Objectively measured sedentary behavior by accelerometry, and psychopathology assessed by PANSS. Participants wore the actigraphs for 7 consecutive days during their waking hours. Sedentary behavior was defined as ≤100 counts per minute during wear-time and excluded sleep and non-wear time. RESULTS On average, 81% of the participant's monitoring time or 756min/day was classified as sedentary behavior using accelerometry. No association was observed between sedentary behaviors and PANSS psychiatric symptoms [total (p≥0.75), positive (p≥0.81), negative (p≥0.59) and general psychopathology (p≥0.65) subscales]. No association was observed between sedentary behaviors and age, race, gender and BMI. CONCLUSION From a clinical and public health perspective, the amount of time (approximately 13h) and percentage of time (81% excluding non-wear time associated with sleeping) engaged in sedentary behavior among overweight and obese adults in this population is alarming, and points to an urgent need for interventions to decrease sedentary behaviors. The lack of associations between sedentary behavior and psychiatric symptoms may be due to a ceiling effect for sedentary behavior.
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Affiliation(s)
- Carol A Janney
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
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Gordon PC, Xavier JC, Louzã MR. Weight gain, metabolic disturbances, and physical health care in a Brazilian sample of outpatients with schizophrenia. Neuropsychiatr Dis Treat 2013; 9:133-8. [PMID: 23355783 PMCID: PMC3552546 DOI: 10.2147/ndt.s37019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In the last few decades, a large number of studies have produced compelling evidence that patients with schizophrenia are at increased risk for developing several medical conditions and diseases, including obesity, metabolic disturbances, and cardiovascular diseases. Several protocols have been designed with the aim of reducing such risk. OBJECTIVE To investigate current physical health status in a population of outpatients with schizophrenia. METHODS A cross-sectional study was conducted in our outpatient clinic, selecting subjects who met DSM-IV diagnosis criteria for schizophrenia. Data were collected regarding clinical characteristics, lifestyle, medication in use, and biometric and laboratory parameters. RESULTS A total of 261 patients were included. We found a high prevalence of elevated body mass index (BMI . 25) (70%), dyslipidemia (73.2%), and metabolic syndrome (28.7%). Patients' ages were associated with worsened lipid profiles, but other variables, such as disorder duration or type of antipsychotic in use, were not associated with any metabolic disturbance. Despite the increased prevalence of these conditions, only a small portion of the sample was under regular medical treatment. CONCLUSION Outpatients with schizophrenia show signs of poor physical health conditions. These findings reinforce the need for an intensive and appropriate approach to assure that these patients receive adequate clinical referral and treatment.
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Affiliation(s)
- Pedro Caldana Gordon
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, Brazil ; Schizophrenia Research Program, Institute of Psychiatry, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brazil
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96
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Abbs B, Achalia RM, Adelufosi AO, Aktener AY, Beveridge NJ, Bhakta SG, Blackman RK, Bora E, Byun MS, Cabanis M, Carrion R, Castellani CA, Chow TJ, Dmitrzak-Weglarz M, Gayer-Anderson C, Gomes FV, Haut K, Hori H, Kantrowitz JT, Kishimoto T, Lee FHF, Lin A, Palaniyappan L, Quan M, Rubio MD, Ruiz de Azúa S, Sahoo S, Strauss GP, Szczepankiewicz A, Thompson AD, Trotta A, Tully LM, Uchida H, Velthorst E, Young JW, O’Shea A, DeLisi LE. The 3rd Schizophrenia International Research Society Conference, 14-18 April 2012, Florence, Italy: summaries of oral sessions. Schizophr Res 2012; 141:e1-e24. [PMID: 22910407 PMCID: PMC3877922 DOI: 10.1016/j.schres.2012.07.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 07/23/2012] [Indexed: 01/30/2023]
Abstract
The 3rd Schizophrenia International Research Society Conference was held in Florence, Italy, April 14-18, 2012 and this year had as its emphasis, "The Globalization of Research". Student travel awardees served as rapporteurs for each oral session and focused their summaries on the most significant findings that emerged and the discussions that followed. The following report is a composite of these summaries. We hope that it will provide an overview for those who were present, but could not participate in all sessions, and those who did not have the opportunity to attend, but who would be interested in an update on current investigations ongoing in the field of schizophrenia research.
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Affiliation(s)
- Brandon Abbs
- Brigham and Women’s Hospital, Department of Medicine, Connors Center for Women’s Health, Harvard Medical School, Department of Psychiatry, 1620 Tremont Street BC 3-34 Boston, MA 02120, Phone: 617-525-8641, Fax: 617-525-7900
| | - Rashmin M Achalia
- Department of Psychiatry, Government Medical College, Aurangabad, Maharashtra, India. Phone: + 91 9028851672, Fax: + 91 0240 2402418
| | - Adegoke O Adelufosi
- Dbepartment of Psychiatry, Ladoke Akintola University, Teaching Hospital (LAUTECH), Ogbomoso, Oyo State, Nigeria. P.O. Box 2210, Sapon, Abeokuta, Ogun State, Nigeria, Phone: +234 803 5988 054
| | - Ahmet Yiğit Aktener
- Göksun State Hospital, Göksun, Kahramanmaraş, Turkey, Phone: (0090) 532 4465832
| | - Natalie J Beveridge
- School of Biomedical Sciences & Pharmacy, Schizophrenia Research Institute, Room 616 Medical Sciences Building, University of Newcastle, Callaghan NSW 2308, Phone: (02) 4921 8748, Fax: (02) 4921 7903
| | - Savita G Bhakta
- Hofstra-NSLIJHS School of Medicine/The Zucker Hillside Hospital, address: 75 59 263rd street, Glen Oaks, NY-11004, Phone: 718-470-8232, Fax: 718-831-0368
| | - Rachael K Blackman
- University of Minnesota Medical Scientist Training Program (MD/PhD), University of Minnesota Neuroscience Department, and Brain Sciences Center VA Medical Center, Minneapolis, MN, University of Minnesota, Medical Scientist Training Program (MD/PhD), B681 Mayo, 420 Delaware St. SE, Minneapolis, MN 55455, Phone: 612-467-5077
| | - Emre Bora
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, VIC, Australia. Alan Gilbert Building NNF level 3 University of Melbourne, VIC, Australia, Phone: 61 3 8345 5611, Fax: 61 3 8345 5610
| | - MS Byun
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea, address: Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-no, Chongno-gu, Seoul 110-744, Republic of Korea. Phone: +82-2-2072-2457 Fax: +82-2-747-9063
| | - Maurice Cabanis
- Department of Psychiatry and Psychotherapy, Philipps-University, Rudolf-Bultmann-Straße 8, D-35039 Marburg, Germany, Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Rudolf-Bultmann-Str. 8, D-35039 Marburg, Germany Phone: +49(0)6421-58-66932, Fax: +49(0)6421-58-68939
| | - Ricardo Carrion
- Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore – Long Island Jewish Health System (NS-LIJHS), Glen Oaks, NY, USA, 2. Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, North Shore – Long Island Jewish Health System, Manhasset, New York, 11030, USA, Phone: 718-470-8878, Fax: 718-470-8131
| | - Christina A Castellani
- Molecular Genetics Unit, Department of Biology, The University of Western Ontario, London, Ontario, Canada, Phone: 519-661-2111 x86928, Fax: 519-661-3935
| | - Tze Jen Chow
- Universiti Tunku Abdul Rahman, Jalan Genting Kelang, Setapak 53300, Kuala Lumpur, Malaysia, Phone: +603-41079802
| | - M Dmitrzak-Weglarz
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Szpitalna St. 27/33, Poznan, 60-572, Poland, Phone: +48 618491311, Fax: +48 61484392
| | - Charlotte Gayer-Anderson
- Institute of Psychiatry, King’s College London, De Crespigny Park, London, United Kingdom, SE5 8AF, Phone: 0207 848 5060
| | - Felipe V Gomes
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto/SP 14049-900, Brazil
| | - Kristen Haut
- University of California, Los Angeles, 1285 Franz Hall, University of California, Los Angeles, CA, 90095, Phone: 310-794-9673, Fax: 310-794-9740
| | - Hiroaki Hori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, Japan, Phone: +81 42 341 2711, Fax: +81 42 346 1744
| | - Joshua T Kantrowitz
- New York State Psychiatric Institute/Nathan Kline Institute for Psychiatric Research 1051 Riverside Drive, Room 5807, New York, NY 10023, Phone: 212-543-6711, Fax: 212-543-1350
| | - Taishiro Kishimoto
- (1) The Zucker Hillside Hospital, Psychiatry Research, 75-59 263rd street, Glen Oaks, NY 11004 USA (2) Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, Japan, Phone: +1-718-470-8386, Fax: +718-343-1659
| | - Frankie HF Lee
- 1. Centre for Addiction and Mental Health, 250 College St. Toronto, Ontario, Canada, M5T 1R8, 2. Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada, M5S 1A8, Phone: +1416-535-8501 ext. 4084, Fax: +1416-979-4663
| | - Ashleigh Lin
- School of Psychology, University of Birmingham, Edgbaston, B152TT, United Kingdom, Phone: +44 121 414 6241, Fax: +44 121 414 4897
| | - Lena Palaniyappan
- Translational Neuroimaging, Division of Psychiatry, University of Nottingham address: C09, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, Phone: 01157430407, Fax: 01157430422
| | - Meina Quan
- 1. Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, 1249 Boylston Street, Boston, MA, 02215. 2. Laboratory of Neuroscience, Department of Psychiatry, VA Boston Healthcare System, Harvard Medical School, 940 Belmont Street, Brockton, MA, 02301, Phone: 617-525-6264, Fax: 617-525-6150
| | - Maria D Rubio
- University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, 1719 6th Ave S Rm 590, Birmingham, AL 35233, Phone: 205-996-6229
| | - Sonia Ruiz de Azúa
- CIBERSAM (Biomedical Research Center in Mental Health Net), University Hospital of Alava, University of the Basque Country, 29 Olaguibel St., 01004, Vitoria, Spain. Phone: 0034 945007664, Fax: 0034 945007664
| | - Saddichha Sahoo
- Clinical Fellow, Dept of Psychiatry, University of British Columbia, Vancouver, BC, Canada V6T1Z3
| | - Gregory P Strauss
- Department of Psychiatry, University of Maryland School of Medicine, Maryland Psychiatric Research Center, P.O. Box 21247, Baltimore, MD 21228, Phone: (410) 402-6104, Fax: (410) 402-7198
| | - Aleksandra Szczepankiewicz
- Laboratory of Molecular and Cell Biology, Department of Psychiatric Genetics, Poznan University of Medical Sciences, 27/33 Szpitalna St., 60-572 Poznan, Poland, Phone: +48-618491311, Fax: +48-61-8480111
| | - Andrew D Thompson
- Orygen Youth Health Research Centre, 35 Poplar Rd, Parkville, VIC 3052, Australia Phone: +61 3 93422800, Fax: +61 3 9342 2941
| | - Antonella Trotta
- Psychosis Studies, Institute of Psychiatry, King’s College London, United Kingdom, PO52 Psychosis Studies, Institute of Psychiatry, King’s College London, De Crespigny Park, London SE5 8AF, United Kingdom, Phone: +44 (0)743 5214863, Fax: +44 (0)20 7848 0287
| | - Laura M Tully
- Harvard University, Address: 33 Kirkland St., Cambridge MA 02138, Phone: 857-207-5509
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo, 160-8582, Japan, Phone: +81.3.3353.1211(x62454), Fax: +81.3.5379.0187
| | - Eva Velthorst
- Academic Medical Center, Department of Early Psychosis, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands, Phone: +31 (0)20 89 13671, Fax: +31 (0)20 89 13635
| | - Jared W Young
- University of California San Diego, Department of Psychiatry, 9500 Gilman Drive, La Jolla, CA, 92093-0804, Phone: 619 543 3582, Fax: 619 543 2493
| | - Anne O’Shea
- Coordinator of reports. Harvard Medical School, VA Boston Healthcare System, 940 Belmont Street, Brockton, MA 02301, Phone: 774-826-1374
| | - Lynn E. DeLisi
- Corresponding Author, VA Boston Healthcare System and Harvard Medical School, 940 Belmont Street, Brockton, MA 02301, Phone: 774-826-1355, Fax: 774-826-1758, Address all correspondence to Lynn E DeLisi, MD,
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Strassnig M, Brar JS, Ganguli R. Health-related quality of life, adiposity, and sedentary behavior in patients with early schizophrenia: preliminary study. Diabetes Metab Syndr Obes 2012; 5:389-94. [PMID: 23152691 PMCID: PMC3496370 DOI: 10.2147/dmso.s33619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To examine adiposity and sedentary behavior in relation to health-related quality of life (QoL) in patients with early schizophrenia. METHODS A cross-sectional study was used to assess adiposity by dual-energy X-ray absorptiometry scans, habitual physical activity and idle sitting time by the Short Form International Physical Activity Questionnaire, and health-related QoL by the RAND Medical Outcomes Study SF-36. QoL scores were compared with age-adjusted Canadian normative population data. RESULTS There were 36 participants with early schizophrenia, average age 25.1 (±3.6). Twenty-nine (72.5%) were males. Mean illness duration was 30 (±18) months, and mean body mass index was 28.3 (±5). Females had higher body fat content than males (30.8 ±6.9 vs 24.7 ± 10.6; t = -2.6, df = 34; P = 0.015). Total body fat (F = 14; P = 0.001), lean body mass (F = 10.2; P = 0.001), and sedentary behavior (F = 5; P = 0.013) significantly increased across body mass index categories. Total body fat was correlated with sedentary behavior (r = 0.62; P = 0.001), and total lean body mass was negatively correlated with sedentary behavior (r = 0.39; P = 0.03). Based on SF-36 scores, participants had significantly lower physical functioning (P = 0.0034), role physical (P = 0.0003), general health (P < 0.0001), vitality (P = 0.03), and physical component scores (P = 0.003) than Canadian population comparisons. Habitual sedentary behavior, more than activity or adiposity levels, was associated with health-related QoL in early schizophrenia. CONCLUSION Health-related QoL is lower in early schizophrenia and is predominantly experienced in the physical domain. QoL in early schizophrenia relates to sedentary behavior more than to activity and adiposity levels.
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Affiliation(s)
- Martin Strassnig
- Department of Psychiatry, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jaspreet S Brar
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rohan Ganguli
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
- Correspondence: Rohan Ganguli, Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, 1001 Queen Street West, Toronto, Ontario M6J 1H4, Canada, Tel +1 416 535 8501 ext 2102, Fax +1 416 260 4169, Email
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98
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Abstract
AbstractDespite 50 years of pharmacological and psychosocial interventions schizophrenia remains one of the leading causes of disability. The inability to function in everyday settings includes deficits in performance of social, occupational, and independent living activities. Schizophrenia is also a life-shortening illness, caused mainly by poor physical health and its complications. Dysfunctional lifestyles including sedentary behavior and lack of physical activity prevail, while treatment with adipogenic antipsychotic medication interacts with poor performance in screening, monitoring, and intervention that result in shortening of life expectancies by 25–30 years. Disability interferes with self-care and medical care, further worsening physical health to produce a vicious cycle of disability. Further, the neurobiological impact of obesity on brain functioning is substantial and relevant to schizophrenia. Decision making deficits that lead to choices resulting in obesity themselves have neurobiological determinants. Simultaneous treatment of cognitive deficits and related deficits in functional skills, ubiquitous determinants of everyday functioning in schizophrenia, and targeted interventions aimed at poor physical health, especially obesity and associated comorbidities, may lead to additive or even interactive gains in everyday functioning in patients with schizophrenia not previously realized with other interventions.
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