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Tous-Espelosin M, Crone D, Ruiz de Azua S, Iriarte-Yoller N, Sampedro A, Maldonado-Martín S. 'It Helped Me to Disconnect My Mind from the Problems': The Subjective Experiences of People with Schizophrenia Taking Part in a Concurrent Exercise Program. Issues Ment Health Nurs 2023; 44:717-725. [PMID: 37307587 DOI: 10.1080/01612840.2023.2212781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The aim of this study was to investigate the subjective experiences of a concurrent exercise program designed to improve both physical and mental health, through participation, for people with schizophrenia. Participants diagnosed with schizophrenia (n = 35, 41.6 ± 10.3 years) received an intensive concurrent exercise program for a 5-month duration, three times a week, at out-of-hospital facilities. Qualitative data was collected via individual, semi-structured interviews, organized, and analyzed with thematic analysis. The findings highlight the participants' perspective in supporting an out-of-hospital exercise program as an acceptable and beneficial adjunct to usual treatment in people with schizophrenia for holistic health improvements.
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Affiliation(s)
- Mikel Tous-Espelosin
- GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain
- Bioaraba Health Research Institute, Physical Activity, Exercise, and Health group, Vitoria-Gasteiz, Spain
| | - Diane Crone
- Centre for Health, Activity and Wellbeing Research, Cardiff Metropolitan University, Cardiff, UK
| | - Sonia Ruiz de Azua
- Department of Neuroscience, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Nagore Iriarte-Yoller
- Bioaraba, New Therapies in Mental Health Group, Vitoria-Gasteiz, Spain, Spain
- Osakidetza Basque Health Service. Araba Mental Health Network, Psychiatric Hospital of Alava, Vitoria-Gasteiz, Spain
- Department of Medicine, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Agurne Sampedro
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - Sara Maldonado-Martín
- GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain
- Bioaraba Health Research Institute, Physical Activity, Exercise, and Health group, Vitoria-Gasteiz, Spain
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2
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Newsome AM. Exercise Promotion Practices among Mental Health Professionals: A Scoping Review. Issues Ment Health Nurs 2023:1-11. [PMID: 37315310 DOI: 10.1080/01612840.2023.2212770] [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] [Indexed: 06/16/2023]
Abstract
Mental health professionals (MHPs) have a unique opportunity to integrate PA and exercise promotion into clinical care. This scoping review employed the information-motivation-behavioral Skills (IMB) model to examine the exercise promotion practices of MHP. An electronic search of four major databases from 2007 to August 2020 was conducted and results were reported using PRISMA. Seventeen studies were included where the variables of interest were knowledge, attitudes, and beliefs regarding exercise promotion. MHP expressed a need for additional training and the integration of exercise specialists to care for the physical health of patients. Practitioners need additional education to understand the guidelines for exercise prescription for individuals with SMI and the role exercise could have in improving the quality of life for their patients. Findings were conceptualized utilizing the IMB model to inform future quantitative measures and health behavior interventions.
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Affiliation(s)
- A'Naja M Newsome
- Department of Health Sciences, University of Central Florida, Orlando, Florida, USA
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3
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Healthy choices, healthy changes: A randomized trial of incentives to promote healthy eating and exercise in people with schizophrenia and other serious mental illnesses. Schizophr Res 2023; 255:1-8. [PMID: 36933290 DOI: 10.1016/j.schres.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 01/12/2023] [Accepted: 03/03/2023] [Indexed: 03/20/2023]
Abstract
INTRODUCTION People with schizophrenia and other serious mental illnesses (SMI) represent a concerning health disparity population, with 10-30 fewer years of life compared to the general population, mainly from high rates of cardiovascular disease (CVD). Preventing CVD is possible with exercise and diet interventions, but only 50 % of participants in clinical trials achieve reduction in CVD risk. This study assessed whether cash incentives improved weight loss, cardiovascular endurance, and/or mortality risk when added to one of four healthy lifestyle programs (gym membership, Weight Watchers membership, the InSHAPE program, InSHAPE + Weight Watchers). METHODS From 2012 to 2015, 1348 overweight or obese adults with SMI enrolled in a study using equipoise stratified randomization. Participants were randomly assigned to intervention, then to cash incentives, or not, for participation (gym and/or Weight Watchers), with baseline and quarterly assessments for 12 months. We examined effects of the interventions, key covariates, and incentives, using generalized linear models. RESULTS Main effects of randomization to receive cash incentives was not significant for any outcome; whereas total amount of incentives was significantly associated with all three primary outcomes (weight loss, cardiovascular endurance, mortality risk), mainly for participants in the InSHAPE+WW group who received additional cash incentives. CONCLUSIONS Incentives may be effective at preventing CVD and improving health outcomes for people with SMI, especially in the context of intensive support for healthy lifestyle behaviors. Policy changes are required to increase access to healthy lifestyle programming and more research is needed to establish the optimal amount of incentives for people with SMI. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02515981.
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4
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Çelik İnce S, Partlak Günüşen N. Effect of a nurse-led intervention program on the physical health and quality of life of individuals with severe mental illness. Perspect Psychiatr Care 2021; 57:1751-1764. [PMID: 33616211 DOI: 10.1111/ppc.12745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the effect of nurse-led intervention programs on patients' physical health, physical activities, healthy lifestyle behaviors, and quality of life. DESIGN AND METHODS The research was conducted with a quasi-experimental design. The sample consisted of 33 individuals with severe mental illness. Data were collected with the Healthy Lifestyle Behavior Scale II, the Short Form-36 Quality-of-Life Instrument, and pedometers. FINDINGS The individuals in the intervention group showed a statistically significant decrease in waist circumference and increases in the physical activity and nutrition dimensions of healthy lifestyle behaviors and the physical function of quality of life. No statistically significant changes were detected in anthropometric measurements, healthy lifestyle behaviors, or quality-of-life subscales in the control group. PRACTICE IMPLICATIONS Mental health nursing and psychiatric nurses should plan and implement interventions to encourage healthy eating and physical activity for patients.
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Affiliation(s)
- Sevecen Çelik İnce
- Psychiatric Nursing Department, Faculty of Health Science, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.,Psychiatric Nursing Department, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
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5
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Aschbrenner KA, Naslund JA, Reed JD, Fetter JC. Renewed call for lifestyle interventions to address obesity among individuals with serious mental illness in the COVID-19 era and beyond. Transl Behav Med 2021; 11:1359-1364. [PMID: 34160055 DOI: 10.1093/tbm/ibab076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Behavioral health has the opportunity to lead the way in using lifestyle interventions to address obesity and health disparities in people with serious mental illness (SMI) in the COVID-19 era. Evidence-based interventions for weight loss in individuals with SMI exist, and the field has developed strategies for implementing these interventions in real-world mental health care settings. In addition to promoting weight loss, lifestyle interventions have the potential to address social isolation and loneliness and other patient-centered outcomes among individuals with SMI, which will be especially valuable for mitigating the growing concerns about loneliness attributed to the COVID-19 pandemic restrictions on in-person encounters. In this commentary, we discuss practice, policy, and research implications related to using evidence-based lifestyle interventions for individuals with SMI during the COVID-19 pandemic and sustaining these programs in the long-term.
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Affiliation(s)
- Kelly A Aschbrenner
- Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
| | - John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Jeffrey D Reed
- Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
| | - Jeffrey C Fetter
- Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
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6
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Deenik J, Czosnek L, Teasdale SB, Stubbs B, Firth J, Schuch FB, Tenback DE, van Harten PN, Tak ECPM, Lederman O, Ward PB, Hendriksen IJM, Vancampfort D, Rosenbaum S. From impact factors to real impact: translating evidence on lifestyle interventions into routine mental health care. Transl Behav Med 2021; 10:1070-1073. [PMID: 31169897 PMCID: PMC7543082 DOI: 10.1093/tbm/ibz067] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The scandal of premature mortality in people with serious mental illness is well established. Despite an increase in studies evaluating the efficacy of lifestyle interventions, translating this evidence into routine clinical care and policies is challenging, in part due to limited effectiveness or implementation research. We highlight the challenge of implementation that is increasingly recognized in clinical practice, advocate for adopting implementation science to study the implementation and systematic update of effective interventions in practice and policy, and provide directions for future research.
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Affiliation(s)
- Jeroen Deenik
- Scientific Research Department, GGz Centraal, Amersfoort, The Netherlands.,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Louise Czosnek
- The Mary MacKillop Institute for Health Research, Melbourne, Australia
| | - Scott B Teasdale
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Sydney, Australia.,Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Felipe B Schuch
- Department of Methods and Sports Techniques, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Diederik E Tenback
- Center for Transcultural Psychiatry Veldzicht, Balkbrug, The Netherlands
| | - Peter N van Harten
- Scientific Research Department, GGz Centraal, Amersfoort, The Netherlands.,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | | | - Oscar Lederman
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | | | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,University Psychiatric Center, KU Leuven, Leuven, Belgium
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Black Dog Institute, Prince of Wales Hospital, Sydney, Australia
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7
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Farris SG, Abrantes AM. Mental health benefits from lifestyle physical activity interventions: A systematic review. Bull Menninger Clin 2020; 84:337-372. [PMID: 33779237 DOI: 10.1521/bumc.2020.84.4.337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Lifestyle physical activity (LPA) interventions are a promising alternative to structured exercise interventions for addressing mental health problems. The authors conducted a systematic review of the literature on LPA interventions in any population in order to determine (a) the extent to which mental health outcomes were examined and (b) whether benefits in mental health outcomes were observed. Mental health outcomes were defined as depression, anxiety, perceived stress, health-related quality of life, and psychological well-being. A total of 73 articles were identified as LPA intervention, of which 24.7% (n = 18) reported the effect of LPA intervention on mental health outcomes. The most commonly evaluated mental health outcome was depression, and to a lesser extent anxiety and perceived stress. Overall, findings point to promising effects of LPA interventions across common mental health problems. Key areas for future research are discussed in light of emergent limitations in existing published studies.
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Affiliation(s)
- Samantha G Farris
- Department of Psychology, Rutgers, the State University of New Jersey, Piscataway, New Jersey
| | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.,Behavioral Medicine and Addictions Research Unit, Butler Hospital, Providence, Rhode Island
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8
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Rosenbaum S, Morell R, Abdel-Baki A, Ahmadpanah M, Anilkumar TV, Baie L, Bauman A, Bender S, Boyan Han J, Brand S, Bratland-Sanda S, Bueno-Antequera J, Camaz Deslandes A, Carneiro L, Carraro A, Castañeda CP, Castro Monteiro F, Chapman J, Chau JY, Chen LJ, Chvatalova B, Chwastiak L, Corretti G, Dillon M, Douglas C, Egger ST, Gaughran F, Gerber M, Gobbi E, Gould K, Hatzinger M, Holsboer-Trachsler E, Hoodbhoy Z, Imboden C, Indu PS, Iqbal R, Jesus-Moraleida FR, Kondo S, Ku PW, Lederman O, Lee EHM, Malchow B, Matthews E, Mazur P, Meneghelli A, Mian A, Morseth B, Munguia-Izquierdo D, Nyboe L, O’Donoghue B, Perram A, Richards J, Romain AJ, Romaniuk M, Sadeghi Bahmani D, Sarno M, Schuch F, Schweinfurth N, Stubbs B, Uwakwe R, Van Damme T, Van Der Stouwe E, Vancampfort D, Vetter S, Waterreus A, Ward PB. Assessing physical activity in people with mental illness: 23-country reliability and validity of the simple physical activity questionnaire (SIMPAQ). BMC Psychiatry 2020; 20:108. [PMID: 32143714 PMCID: PMC7060599 DOI: 10.1186/s12888-020-2473-0] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 01/30/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness. METHODS The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Patients with a DSM or ICD mental illness diagnoses were recruited and completed the SIMPAQ on two occasions, one week apart. Participants wore an Actigraph accelerometer and completed brief cognitive and clinical assessments. RESULTS Evidence of SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1010 participants. The SIMPAQ had good test-retest reliability. Correlations for moderate-vigorous physical activity was comparable to studies conducted in general population samples. Evidence of validity for the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had stronger evidence of validity. This alternative method is recommended for use in future studies employing the SIMPAQ. CONCLUSIONS The SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals.
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Affiliation(s)
- S. Rosenbaum
- grid.1005.40000 0004 4902 0432School of Psychiatry, UNSW Sydney, Sydney, Australia
| | - R. Morell
- grid.1005.40000 0004 4902 0432School of Psychiatry, UNSW Sydney, Sydney, Australia
| | - A. Abdel-Baki
- grid.410559.c0000 0001 0743 2111Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Canada
| | - M. Ahmadpanah
- grid.411950.80000 0004 0611 9280Behavioral Disorders and Substances Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - T. V. Anilkumar
- grid.413226.00000 0004 1799 9930Department of Psychiatry, Government Medical College, Trivandrum, India
| | - L. Baie
- grid.16149.3b0000 0004 0551 4246Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
| | - A. Bauman
- grid.1013.30000 0004 1936 834XSchool of Public Health, University of Sydney, Sydney, Australia
| | - S. Bender
- LWL-Klinik Marsberg, Hospital for Psychiatry, Psychotherapy and Psychosomatics, Marsberg, Germany
| | - J. Boyan Han
- grid.253561.60000 0001 0806 2909California State University, Los Angeles, USA
| | - S. Brand
- grid.6612.30000 0004 1937 0642University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland ,grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino, Urbino, Italy ,grid.477714.60000 0004 0587 919XThe Sutherland Hospital, South Eastern Sydney Local Health District, Sydney, Australia
| | - S. Bratland-Sanda
- Department of Sport, Physical Education and Outdoor Studies, University of South-Eastern Norway, Bø, Notodden, Norway
| | - J. Bueno-Antequera
- grid.15449.3d0000 0001 2200 2355Physical Performance & Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain
| | - A. Camaz Deslandes
- grid.8536.80000 0001 2294 473XPsychiatry Institute, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - L. Carneiro
- Research Centre in Sports Sciences, Health Sciences and Human Development, CIDESD, GERON Research Community, Vila Real, Portugal
| | - A. Carraro
- grid.34988.3e0000 0001 1482 2038Faculty of Education, Free University of Bolzano, Bolzano, Italy
| | - C. P. Castañeda
- Early Intervention Program, JHorwitz Psychiatric Institute, Santiago, Chile
| | - F. Castro Monteiro
- grid.8532.c0000 0001 2200 7498Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - J. Chapman
- grid.1049.c0000 0001 2294 1395QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - J. Y. Chau
- grid.1013.30000 0004 1936 834XSchool of Public Health, University of Sydney, Sydney, Australia ,grid.1004.50000 0001 2158 5405Department of Health Systems and Populations, Macquarie University, Sydney, Australia
| | - L. J. Chen
- grid.445057.7Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan
| | - B. Chvatalova
- grid.447902.cNational Institute of Mental Health, Klecany, Czech Republic
| | - L. Chwastiak
- grid.34477.330000000122986657Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - G. Corretti
- Department of Mental Health, North-West Tuscany, Italy
| | - M. Dillon
- HSE Louth Meath Mental Health Services, Louth, Ireland
| | - C. Douglas
- South Coast Private Hospital, Wollongong, Australia
| | - S. T. Egger
- grid.10863.3c0000 0001 2164 6351Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain ,grid.7400.30000 0004 1937 0650Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - F. Gaughran
- grid.451052.70000 0004 0581 2008South London and Maudesley NHS Foundation Trust, London, UK
| | - M. Gerber
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino, Urbino, Italy
| | - E. Gobbi
- grid.6612.30000 0004 1937 0642Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, University of Basel, Basel, Switzerland
| | - K. Gould
- grid.460013.0St John of God Hospital, North Richmond, Australia
| | - M. Hatzinger
- Psychiatric Services Solothurn, Solothurn, Switzerland
| | - E. Holsboer-Trachsler
- grid.6612.30000 0004 1937 0642Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Z. Hoodbhoy
- grid.7147.50000 0001 0633 6224Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - C. Imboden
- Psychiatric Services Solothurn, Solothurn, Switzerland ,Private Clinic Wyss, Muenchenbuchsee, Switzerland
| | - P. S. Indu
- grid.413226.00000 0004 1799 9930Department of Community Medicine, Government Medical College, Trivandrum, India
| | - R. Iqbal
- grid.7147.50000 0001 0633 6224Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - F. R. Jesus-Moraleida
- grid.8395.70000 0001 2160 0329Department of Physical Therapy, Universidade Federal do Ceará, Fortaleza, Brazil
| | - S. Kondo
- grid.412708.80000 0004 1764 7572Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan
| | - P. W. Ku
- grid.412038.c0000 0000 9193 1222Graduate Institute of Sports and Health, National Changhua University of Education, Changhua, Taiwan
| | - O. Lederman
- grid.477714.60000 0004 0587 919XKeeping the Body In Mind, South Eastern Sydney Local Health District, Sydney, Australia
| | - E. H. M. Lee
- grid.194645.b0000000121742757Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | - B. Malchow
- grid.411984.10000 0001 0482 5331Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - E. Matthews
- grid.24349.380000000106807997School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - P. Mazur
- LWL-Klinik Marsberg, Hospital for Psychiatry, Psychotherapy and Psychosomatics, Marsberg, Germany
| | - A. Meneghelli
- Association of early intervention in mental disorders-Cambiare la Rotta-Onlus, Milano, Italy
| | - A. Mian
- grid.7147.50000 0001 0633 6224Department of Psychiatry, Aga Khan University, Karachi, Pakistan
| | - B. Morseth
- grid.10919.300000000122595234School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - D. Munguia-Izquierdo
- grid.15449.3d0000 0001 2200 2355Physical Performance & Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain
| | - L. Nyboe
- grid.154185.c0000 0004 0512 597XDepartment of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
| | - B. O’Donoghue
- grid.488501.0Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia
| | - A. Perram
- grid.267827.e0000 0001 2292 3111Faculty of Health, Victoria University Wellington, Wellington, New Zealand
| | - J. Richards
- grid.1013.30000 0004 1936 834XSchool of Public Health, University of Sydney, Sydney, Australia ,Gallipoli Medical Research Institute, Brisbane, Australia
| | - A. J. Romain
- grid.410559.c0000 0001 0743 2111Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Canada
| | - M. Romaniuk
- grid.412112.50000 0001 2012 5829Kermanshah University of Medical Sciences, Sleep Disorders and Substance Abuse Prevention Research Center, Kermanshah, Iran
| | - D. Sadeghi Bahmani
- grid.6612.30000 0004 1937 0642University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland ,grid.477714.60000 0004 0587 919XThe Sutherland Hospital, South Eastern Sydney Local Health District, Sydney, Australia
| | - M. Sarno
- Association of early intervention in mental disorders-Cambiare la Rotta-Onlus, Milano, Italy
| | - F. Schuch
- grid.411239.c0000 0001 2284 6531Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - N. Schweinfurth
- grid.6612.30000 0004 1937 0642University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland
| | - B. Stubbs
- grid.13097.3c0000 0001 2322 6764Department of Psychological Medicine, King’s College London, London, England
| | - R. Uwakwe
- grid.412207.20000 0001 0117 5863Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
| | - T. Van Damme
- grid.5596.f0000 0001 0668 7884Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - E. Van Der Stouwe
- grid.4494.d0000 0000 9558 4598University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Groningen, Netherlands
| | - D. Vancampfort
- grid.5596.f0000 0001 0668 7884Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - S. Vetter
- grid.7400.30000 0004 1937 0650Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - A. Waterreus
- grid.1012.20000 0004 1936 7910Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, University of Western Australia, Perth, Australia
| | - P. B. Ward
- grid.1005.40000 0004 4902 0432School of Psychiatry, UNSW Sydney, Sydney, Australia ,grid.429098.eSchizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, Australia
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9
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Guerin E, Dupuis JP, Jacob JD, Prud'homme D. [Physical activity programs and severe mental illness: A case study of an Assertive Community Treatment (ACT) team]. Rech Soins Infirm 2020; 138:29-42. [PMID: 31959239 DOI: 10.3917/rsi.138.0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Context : As a therapeutic intervention, physical activity has the potential to improve the quality of life of individuals with severe mental illnesses.Objectives : The goal of this case study was to conduct an in-depth examination of an individualized physical activity program for patients suffering from severe mental illnesses that was implemented by an Assertive Community Treatment (ACT) team in Ottawa, Canada.Method : Using a mixed-methods design, physical health parameters were measured over a nine-month period and semi-structured interviews were conducted with fourteen patients and five staff members.Results : The findings showed a significant reduction in weight following the evaluation period, as well as positive effects in terms of patients' self-esteem, autonomy, and socialization. The quality of the therapeutic relationship, the elimination of barriers, and the continued involvement of staff members were some of the key characteristics that led to the program's success.Discussion/conclusion : These promising results are an indication of the feasibility of this type of intervention among patients with severe mental illnesses as a therapeutic approach to improve their quality of life and support their recovery and social integration.
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10
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Deenik J, Tenback DE, Tak ECPM, Blanson Henkemans OA, Rosenbaum S, Hendriksen IJM, van Harten PN. Implementation barriers and facilitators of an integrated multidisciplinary lifestyle enhancing treatment for inpatients with severe mental illness: the MULTI study IV. BMC Health Serv Res 2019; 19:740. [PMID: 31640706 PMCID: PMC6806487 DOI: 10.1186/s12913-019-4608-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 10/03/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Despite an increase in studies showing the efficacy of lifestyle interventions in improving the poor health outcomes for people with severe mental illness (SMI), routine implementation remains ad hoc. Recently, a multidisciplinary lifestyle enhancing treatment for inpatients with SMI (MULTI) was implemented as part of routine care at a long-term inpatient facility in the Netherlands, resulting in significant health improvements after 18 months. The current study aimed to identify barriers and facilitators of its implementation. METHODS Determinants associated with the implementation of MULTI, related to the innovation, the users (patients, the healthcare professionals (HCPs)), and the organisational context, were assessed at the three wards that delivered MULTI. The evidence-based Measurement Instrument for Determinants of Innovations was used to assess determinants (29 items), each measured through a 5-point Likert scale and additional open-ended questions. We considered determinants to which ≥20% of the HCPs or patients responded negatively ("totally disagree/disagree", score < 3) as barriers and to which ≥80% of HCPs or patients responded positively ("agree/totally agree", score > 3) as facilitators. We included responses to open-ended questions if the topic was mentioned by ≥2 HCPs or patients. In total 50 HCPs (online questionnaire) and 46 patients (semi-structured interview) were invited to participate in the study. RESULTS Participating HCPs (n = 42) mentioned organisational factors as the strongest barriers (e.g. organisational changes and financial resources). Patients (n = 33) mentioned the complexity of participating in MULTI as the main barrier, which could partly be due to organisational factors (e.g. lack of time for nurses to improve tailoring). The implementation was facilitated by positive attitudes of HCPs and patients towards MULTI, including their own role in it. Open responses of HCPs and patients showed strong commitment, collaboration and ownership towards MULTI. CONCLUSIONS This is the first study analysing the implementation of a pragmatic lifestyle intervention targeting SMI inpatients in routine clinical care. Positive attitudes of both HCPs and patients towards such an approach facilitated the implementation of MULTI. We suggest that strategies addressing organisational implementation barriers are needed to further improve and maintain MULTI, to succeed in achieving positive health-related outcomes in inpatients with SMI.
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Affiliation(s)
- Jeroen Deenik
- GGz Centraal, Utrechtseweg 266, 3818EW Amersfoort, the Netherlands
- School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 5200MD Maastricht, the Netherlands
| | | | - Erwin C. P. M. Tak
- Tak Advies en Onderzoek, Hooigracht 38/K, 2312KV Leiden, the Netherlands
| | | | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Hospital Road, Randwick NSW, Sydney, 2031 Australia
- Black Dog Institute, Prince of Wales Hospital, Hospital Road, Randwick NSW, Sydney, 2031 Australia
| | | | - Peter N. van Harten
- GGz Centraal, Utrechtseweg 266, 3818EW Amersfoort, the Netherlands
- School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 5200MD Maastricht, the Netherlands
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11
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Ströhle A. Sports psychiatry: mental health and mental disorders in athletes and exercise treatment of mental disorders. Eur Arch Psychiatry Clin Neurosci 2019; 269:485-498. [PMID: 29564546 DOI: 10.1007/s00406-018-0891-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 03/19/2018] [Indexed: 12/11/2022]
Abstract
Sports psychiatry has developed for the past 3 decades as an emerging field within psychiatry and sports medicine. An International society has been established in 1994 and also national interest groups were implemented, mostly within the national organizations for psychiatry, some also containing the topic of exercise treatment of mental disorders. Where are we now 30 years later? We systematically but also selectively review the medical literature on exercise, sport, psychiatry, mental health and mental disorders and related topics. The number of publications in the field has increased exponentially. Most topics keep remaining on the agenda, e.g., head trauma and concussion, drug abuse and doping, performance enhancement, overtraining, ADHD or eating disorders. Supported by the growing literature, evidence-based recommendations have become available now in many clinical areas. A relatively new phenomenon is muscle dysmorphia, observed in weightlifters, bodybuilders but also in college students and gym users. Further, sports therapy of mental disorders has been studied by more and more high-quality randomized controlled clinical trials. Mostly as a complementary treatment, however, for some disorders already with a 1a evidence level, e.g., depression, dementia or MCI but also post-traumatic stress disorder. Being grown up and accepted nowadays, sports psychiatry still represents a fast-developing field. The reverse side of the coin, sport therapy of mental disorders has received a scientific basis now. Who else than sports psychiatry could advance sport therapy of mental disorders? We need this enthusiasm for sports and psychiatry for our patients with mental disorders and it is time now for a broadening of the scope. Optimized psychiatric prevention and treatment of athletes and ideal sport-related support for individuals with mental disorders should be our main purpose and goal.
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Affiliation(s)
- Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany.
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12
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Insights Following Implementation of an Exercise Intervention in Older Veterans with PTSD. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142630. [PMID: 31340588 PMCID: PMC6678353 DOI: 10.3390/ijerph16142630] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 07/16/2019] [Accepted: 07/19/2019] [Indexed: 12/23/2022]
Abstract
Individuals with post-traumatic stress disorder (PTSD) face numerous barriers to exercise. Little is known about behavioral strategies to promote participation in this population. This is a secondary analysis of individual barriers and goals, exercise prescription characteristics, and patient perceptions of a 12-week, community-based, randomized controlled exercise trial targeting older adults with PTSD, (N = 45; mean age = 68; male = 91%). The most common cited goals for participating included weight loss (65%) and increasing strength (65%). Exercise mode varied among those who completed the program (n = 37), with 14 (38%) using exclusively treadmill; eight (22%) using only bike, and 15 (41%) utilizing a combination. Patient-reported exercise duration and intensity progressively increased over the 12 weeks, and duration differed by mode of exercise. We observed high rates of attendance (84%) and completion (88%) to the program. Patient-reported barriers to attendance most often included health problems (62%) and medical appointments (55%). Participant responses to a program evaluation revealed high levels of satisfaction, preferences for group-based programs, and insights about the acceptability of the exercise environment (physical and social). This study is the first to report on goals, barriers, exercise prescription needs, and individual responses to supervised exercise training in a unique population, that is, older veterans with PTSD. Results of this study can inform future health promotion programs targeting older veterans with PTSD.
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13
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Pilot randomized controlled trial of exercise training for older veterans with PTSD. J Behav Med 2019; 43:648-659. [PMID: 31264055 DOI: 10.1007/s10865-019-00073-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 06/19/2019] [Indexed: 01/22/2023]
Abstract
Exercise training positively impacts mental health, yet remains untested in older adults with posttraumatic stress disorder (PTSD). We conducted a randomized controlled pilot trial to test the feasibility and acceptability of exercise training in older veterans with PTSD. Fifty-four veterans ≥ 60 years, with a DSM-V diagnosis of PTSD, were randomized to supervised exercise (n = 36) or wait-list (WL; n = 18). Primary outcomes included recruitment rates, attendance, satisfaction, and retention. Secondary outcomes included changes in PTSD symptoms, depression, health-related quality of life, and sleep quality; assessed at baseline and 12 weeks. There were no adverse events. Attrition was minimal (14%), and adherence to the exercise intervention was high (82%). Clinically significant improvements in PTSD and related conditions were observed following exercise (Cohen's d = 0.36-0.81). Exercise training is safe and acceptable in older adults with PTSD, may improve PTSD symptoms, and broadly impacts PTSD-related conditions. Future definitive trials are warranted.
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14
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Royes LFF, Gomez-Pinilla F. Making sense of gut feelings in the traumatic brain injury pathogenesis. Neurosci Biobehav Rev 2019; 102:345-361. [PMID: 31102601 DOI: 10.1016/j.neubiorev.2019.05.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 02/06/2023]
Abstract
Traumatic brain injury (TBI) is a devastating condition which often initiates a sequel of neurological disorders that can last throughout lifespan. From metabolic perspective, TBI also compromises systemic physiology including the function of body organs with subsequent malfunctions in metabolism. The emerging panorama is that the effects of TBI on the periphery strike back on the brain and exacerbate the overall TBI pathogenesis. An increasing number of clinical reports are alarming to show that metabolic dysfunction is associated with incidence of long-term neurological and psychiatric disorders. The autonomic nervous system, associated hypothalamic-pituitary axis, and the immune system are at the center of the interface between brain and body and are central to the regulation of overall homeostasis and disease. We review the strong association between mechanisms that regulate cell metabolism and inflammation which has important clinical implications for the communication between body and brain. We also discuss the integrative actions of lifestyle interventions such as diet and exercise on promoting brain and body health and cognition after TBI.
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Affiliation(s)
- Luiz Fernando Freire Royes
- Exercise Biochemistry Laboratory, Center of Physical Education and Sports, Federal University of Santa Maria - UFSM, Santa Maria, RS, Brazil
| | - Fernando Gomez-Pinilla
- Departments of Neurosurgery, and Integrative and Biology and Physiology, UCLA Brain Injury Research Center, University of California, Los Angeles, USA.
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15
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Çelik Ince S, Partlak Günüşen N. The views and habits of the individuals with mental illness about physical activity and nutrition. Perspect Psychiatr Care 2018; 54:586-595. [PMID: 29733428 DOI: 10.1111/ppc.12289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 04/04/2018] [Accepted: 04/14/2018] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study is to determine the views and habits of the individuals with mental illness on physical activities and nutrition behaviors. DESIGN AND METHODS This study was carried out descriptive qualitative method. The sample of the study consisted of 15 individuals with mental illness. The data were collected with Socio-Demographic Information Form and Semi-Structured Interview Form and analyzed by content analysis. FINDINGS Four main themes emerged as the result of the analysis of the data. These themes are the barriers, facilitators, habits, and the needs. PRACTICE IMPLICATIONS Mental health nurses should be aware of the barriers of individuals with mental illness. It is recommended that mental health nurses make interventions to encourage patients to have physical activity and healthy eating.
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Affiliation(s)
- Sevecen Çelik Ince
- Faculty of Nursing, Psychiatric Nursing Department, Dokuz Eylul University, Izmir, Turkey
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16
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The next step: a strategic focus on physical activity and sedentary behaviour in Irish mental health care. Ir J Psychol Med 2018; 38:6-8. [PMID: 33715644 DOI: 10.1017/ipm.2018.38] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
People with severe mental illnesses have dramatically reduced life expectancy compared with the general population, which is largely attributed to physical comorbidity. Physical activity and sedentary behaviour interventions offer a safe and viable therapeutic resource for multi-disciplinary mental health care teams. The accumulating evidence supporting the role of these interventions has changed the focus of mental health strategy in some countries, with new developing roles for certain mental health professionals in this field. However, in Ireland the absence of specialised exercise practitioners places a leadership role for mental health nurses in this regard. National mental health strategy in Ireland should prioritise physical activity and sedentary behaviour interventions, make recommendations for the integration of specialised exercise practitioners in all mental health multidisciplinary teams, and recommend the provision of training and awareness for mental health nurses and other multidisciplinary professionals who are already well placed to address this issue.
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17
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Buscemi J, Bennett GG, Gorin SS, Pagoto SL, Sallis JF, Wilson DK, Fitzgibbon ML. A 6-year update of the health policy and advocacy priorities of the Society of Behavioral Medicine. Transl Behav Med 2018; 7:903-911. [PMID: 28573355 DOI: 10.1007/s13142-017-0507-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Government policy affects virtually every topic of interest to health behavior researchers, from research funding to reimbursement for clinical services to application of evidence to impact health outcomes. This paper provides a 6-year update on the expansion of Society of Behavioral Medicine's (SBM) public policy and advocacy agenda and proposed future directions. SBM's Health Policy Council is responsible for ensuring coordination of the policy-related activities of the Health Policy Committee (HPC), the Civic and Public Engagement Committee (CPEC), and the Scientific and Professional Liaison Council (SPLC). These committees and councils have written letters to Congress, signed onto advocacy letters with hundreds of organizations, and developed and disseminated 15 health policy briefs, the majority of which have been presented to legislative staffers on Capitol Hill. With the assistance of the SPLC, SBM has collaborated on policy efforts with like-minded organizations to increase the impact of the Society's policy work. Moving forward, SBM plans to continue to increase efforts to disseminate policy work more broadly and develop long-term relationships with Congressional staffers. SBM leadership realizes that to remain relevant, demonstrate impact, and advance the role of behavioral medicine, we must advance a policy agenda that reflects our mission of better health through behavior change.
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18
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Vancampfort D, Stubbs B. Physical activity and metabolic disease among people with affective disorders: Prevention, management and implementation. J Affect Disord 2017; 224:87-94. [PMID: 27519365 DOI: 10.1016/j.jad.2016.07.042] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 06/24/2016] [Accepted: 07/10/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND One in ten and one in three of people with affective disorders experience diabetes and metabolic syndrome respectively. Physical activity (PA) and sedentary behaviour (SB) are key risk factors that can ameliorate the risk of metabolic disease among this population. However, PA is often seen as luxury and/or a secondary component within the management of people with affective disorders. METHODS The current article provides a non-systematic best-evidence synthesis of the available literature, detailing a number of suggestions for the implementation of PA into clinical practice. RESULTS Whilst the evidence is unequivocal for the efficacy of PA to prevent and manage metabolic disease in the general population, it is in its infancy in this patient group. Nonetheless, action must be taken now to ensure that PA and reducing SB are given a priority to prevent and manage metabolic diseases and improve wider health outcomes. PA should be treated as a vital sign and all people with affective disorders asked about their activity levels and if appropriate advised to increase this. There is a need for investment in qualified exercise specialists in clinical practice such as physiotherapists to undertake and oversee PA in practice. Behavioural strategies such as the self-determined theory should be employed to encourage adherence. Funding is required to develop the evidence base and elucidate the optimal intervention characteristics. CONCLUSION PA interventions should form an integral part of the multidisciplinary management of people with affective disorders and our article outlines the evidence and strategies to implement this in practice.
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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, Campus Kortenberg, 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 (IoPPN), King's College London, De Crespigny Park, London, UK.
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19
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Druss BG. Improving access to exercise training programs for patients with serious mental illness. Transl Behav Med 2017; 7:62-63. [PMID: 27550183 DOI: 10.1007/s13142-016-0435-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
In a recent issue of this journal, Pratt et al report on an important new position statement by the Society of Behavioral Medicine and the American College of Sports Medicine to improve access to exercise programming as a treatment for patients treated in community mental health settings. If implemented, these recommendations could greatly expand access to these services and improve outcomes for patients treated in community mental health settings.
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Affiliation(s)
- Benjamin G Druss
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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20
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Jerome GJ, Young DR, Dalcin AT, Wang NY, Gennusa J, Goldsholl S, Appel LJ, Daumit GL. Cardiorespiratory benefits of group exercise among adults with serious mental illness. Psychiatry Res 2017; 256:85-87. [PMID: 28624677 PMCID: PMC5603397 DOI: 10.1016/j.psychres.2017.06.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 04/04/2017] [Accepted: 06/09/2017] [Indexed: 11/27/2022]
Abstract
This study examined cardiorespiratory fitness (CRF) among adults with serious mental illness (SMI) participating in group exercise classes. Overweight and obese adults with SMI were randomized to either a control condition or a weight management condition with group exercise classes (n = 222). Submaximal bicycle ergometry was used to assess CRF at baseline, 6 and 18 months. Those with ≥ 66% participation in the exercise classes had a lower heart rate response at 6 and 18 month follow-up. Participation in group exercise classes was associated with improved short and long term cardiovascular fitness among adults with SMI.
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Affiliation(s)
- Gerald J Jerome
- Department of Kinesiology, Towson University Towson, 8000 York Road, Towson, MD 21252, USA; Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
| | - Deborah Rohm Young
- Kaiser Permanente Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Arlene T Dalcin
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Nae-Yuh Wang
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Joseph Gennusa
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Stacy Goldsholl
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Lawrence J Appel
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Gail L Daumit
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD 21287, USA
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21
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Vancampfort D, Firth J, Schuch FB, Rosenbaum S, Mugisha J, Hallgren M, Probst M, Ward PB, Gaughran F, De Hert M, Carvalho AF, Stubbs B. Sedentary behavior and physical activity levels in people with schizophrenia, bipolar disorder and major depressive disorder: a global systematic review and meta-analysis. World Psychiatry 2017; 16:308-315. [PMID: 28941119 PMCID: PMC5608847 DOI: 10.1002/wps.20458] [Citation(s) in RCA: 490] [Impact Index Per Article: 70.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
People with severe mental illness (schizophrenia, bipolar disorder or major depressive disorder) die up to 15 years prematurely due to chronic somatic comorbidities. Sedentary behavior and low physical activity are independent yet modifiable risk factors for cardiovascular disease and premature mortality in these people. A comprehensive meta-analysis exploring these risk factors is lacking in this vulnerable population. We conducted a meta-analysis investigating sedentary behavior and physical activity levels and their correlates in people with severe mental illness. Major electronic databases were searched from inception up to April 2017 for articles measuring sedentary behavior and/or physical activity with a self-report questionnaire or an objective measure (e.g., accelerometer). Random effects meta-analyses and meta-regression analyses were conducted. Sixty-nine studies were included (N=35,682; 39.5% male; mean age 43.0 years). People with severe mental illness spent on average 476.0 min per day (95% CI: 407.3-545.4) being sedentary during waking hours, and were significantly more sedentary than age- and gender-matched healthy controls (p=0.003). Their mean amount of moderate or vigorous physical activity was 38.4 min per day (95% CI: 32.0-44.8), being significantly lower than that of healthy controls (p=0.002 for moderate activity, p<0.001 for vigorous activity). People with severe mental illness were significantly less likely than matched healthy controls to meet physical activity guidelines (odds ratio = 1.5; 95% CI: 1.1-2.0, p<0.001, I2 =95.8). Lower physical activity levels and non-compliance with physical activity guidelines were associated with male gender, being single, unemployment, fewer years of education, higher body mass index, longer illness duration, antidepressant and antipsychotic medication use, lower cardiorespiratory fitness and a diagnosis of schizophrenia. People with bipolar disorder were the most physically active, yet spent most time being sedentary. Geographical differences were detected, and inpatients were more active than outpatients and those living in the community. Given the established health benefits of physical activity and its low levels in people with severe mental illness, future interventions specifically targeting the prevention of physical inactivity and sedentary behavior are warranted in this population.
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Affiliation(s)
- Davy Vancampfort
- Department of Rehabilitation SciencesKU Leuven, University of LeuvenLeuvenBelgium,University Psychiatric Centre, KU Leuven, University of LeuvenLeuven‐KortenbergBelgium
| | - Joseph Firth
- NICM, School of Science and HealthWestern Sidney UniversityCampbelltownAustralia,Division of Psychology and Mental Health, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - Felipe B. Schuch
- UnilasalleCanoasBrazil,Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do SulPorto AlegreBrazil,Hospital de Clínicas de Porto AlegrePorto AlegreBrazil
| | - Simon Rosenbaum
- School of PsychiatryUniversity of New South WalesSydneyAustralia,Black Dog Institute, Prince of Wales HospitalSydneyAustralia
| | - James Mugisha
- Kyambogo UniversityKampalaUganda,Butabika National Referral and Mental Health HospitalKampalaUganda
| | - Mats Hallgren
- Department of Public Health SciencesKarolinska InstituteStockholmSweden
| | - Michel Probst
- Department of Rehabilitation SciencesKU Leuven, University of LeuvenLeuvenBelgium
| | - Philip B. Ward
- School of PsychiatryUniversity of New South WalesSydneyAustralia,Schizophrenia Research Unit, Ingham Institute of Applied Medical ResearchLiverpool NSWSydneyAustralia
| | - Fiona Gaughran
- National Psychosis Unit, South London and Maudsley NHS Foundation Trust, and Department of Psychosis StudiesInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Marc De Hert
- University Psychiatric Centre, KU Leuven, University of LeuvenLeuven‐KortenbergBelgium
| | - André F. Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of MedicineFederal University of CearáFortalezaBrazil
| | - Brendon Stubbs
- Physiotherapy DepartmentSouth London and Maudsley NHS Foundation TrustLondonUK,Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
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22
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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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23
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Janssen EM, Jerome GJ, Dalcin AT, Gennusa JV, Goldsholl S, Frick KD, Wang NY, Appel LJ, Daumit GL. A cost analysis of implementing a behavioral weight loss intervention in community mental health settings: Results from the ACHIEVE trial. Obesity (Silver Spring) 2017; 25:1006-1013. [PMID: 28398006 PMCID: PMC5445002 DOI: 10.1002/oby.21836] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 03/01/2017] [Accepted: 03/08/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVE In the ACHIEVE randomized controlled trial, an 18-month behavioral intervention accomplished weight loss in persons with serious mental illness who attended community psychiatric rehabilitation programs. This analysis estimates costs for delivering the intervention during the study. It also estimates expected costs to implement the intervention more widely in a range of community mental health programs. METHODS Using empirical data, costs were calculated from the perspective of a community psychiatric rehabilitation program delivering the intervention. Personnel and travel costs were calculated using time sheet data. Rent and supply costs were calculated using rent per square foot and intervention records. A univariate sensitivity analysis and an expert-informed sensitivity analysis were conducted. RESULTS With 144 participants receiving the intervention and a mean weight loss of 3.4 kg, costs of $95 per participant per month and $501 per kilogram lost in the trial were calculated. In univariate sensitivity analysis, costs ranged from $402 to $725 per kilogram lost. Through expert-informed sensitivity analysis, it was estimated that rehabilitation programs could implement the intervention for $68 to $85 per client per month. CONCLUSIONS Costs of implementing the ACHIEVE intervention were in the range of other intensive behavioral weight loss interventions. Wider implementation of efficacious lifestyle interventions in community mental health settings will require adequate funding mechanisms.
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Affiliation(s)
- Ellen M. Janssen
- Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Gerald J. Jerome
- Towson University, Department of Kinesiology, Baltimore, Maryland, USA
- Johns Hopkins University School of Medicine, Division of General Internal Medicine, Baltimore, Maryland, USA
| | - Arlene T Dalcin
- Johns Hopkins University School of Medicine, Division of General Internal Medicine, Baltimore, Maryland, USA
- Johns Hopkins University, Welch Center for Prevention, Epidemiology, and Clinical Research Baltimore, Maryland, USA
| | - Joseph V. Gennusa
- Johns Hopkins University School of Medicine, Division of General Internal Medicine, Baltimore, Maryland, USA
| | - Stacy Goldsholl
- Johns Hopkins University School of Medicine, Division of General Internal Medicine, Baltimore, Maryland, USA
| | - Kevin D. Frick
- Johns Hopkins Carey Business School, Baltimore, Maryland, USA
| | - Nae-Yuh Wang
- Johns Hopkins University School of Medicine, Division of General Internal Medicine, Baltimore, Maryland, USA
- Johns Hopkins University, Welch Center for Prevention, Epidemiology, and Clinical Research Baltimore, Maryland, USA
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lawrence J. Appel
- Johns Hopkins University School of Medicine, Division of General Internal Medicine, Baltimore, Maryland, USA
- Johns Hopkins University, Welch Center for Prevention, Epidemiology, and Clinical Research Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Gail L. Daumit
- Johns Hopkins University School of Medicine, Division of General Internal Medicine, Baltimore, Maryland, USA
- Johns Hopkins University, Welch Center for Prevention, Epidemiology, and Clinical Research Baltimore, Maryland, USA
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Pillay AL. Is deinstitutionalisation a cheap alternative to chronic mental health care? SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2017. [DOI: 10.1177/0081246317709959] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Worldwide, there has been a dominant belief that the deinstitutionalisation of the mentally ill is a cost-saving approach, leading health authorities to embark on such initiatives without adequate community-based health and social service resources and supports. These have resulted in disaster, even in high-income countries, when insufficient planning and preparation have been effected. The recent experience in South Africa that saw the deaths of approximately 100 people with chronic mental illness within 1 year of being moved from a mental health facility is further evidence of the need for more concerted and deliberate planning and resourcing of mental health care services. The article examines various issues relating to deinstitutionalisation and urges authorities to re-examine their approach to mental health care and especially the priority accorded to this marginalised group.
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Affiliation(s)
- Anthony L Pillay
- Department of Behavioural Medicine, University of KwaZulu-Natal, South Africa
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