Describing the health parameters of outpatients with schizophrenia

Relationships between physical fitness, physical activity, smoking and metabolic and mental health parameters in people with schizophrenia

Low physical fitness has been recognised as a prominent behavioural risk factor for cardiovascular diseases (CVD) and metabolic syndrome (MetS), and as an independent risk factor for all-cause mortality. No studies have systematically assessed physical fitness compared with a matched health control group in patients with schizophrenia. Eighty patients with schizophrenia and 40 age-, gender- and body mass index (BMI)-matched healthy volunteers were included. All participants performed an Eurofit test battery and filled out the International Physical Activity Questionnaire. Patients additionally had a fasting metabolic laboratory screening and were assessed for psychiatric symptoms. Patients with schizophrenia demonstrated significant differences from controls in whole body balance, explosive leg muscle strength, abdominal muscular endurance, and running speed. Inactive patients scored worse on most Eurofit items than patients walking for at least 30min per day. Low physical fitness was associated with illness duration, smoking, the presence of MetS and more severe negative, depressive and cognitive symptoms. Less physically active patients who smoke and suffer from high levels of negative, depressive and/or cognitive symptoms might benefit from specific rehabilitation interventions aimed at increasing physical fitness.

Psychological and physical self-management of people with schizophrenia in community psychiatric rehabilitation settings: a qualitative study

This study had three objectives: to explore the psychological and physical self-management behaviours of people with mental illness; to identify their motivations for their self-management behaviours; and to develop a framework to understand the generative processes of healthy vs. unhealthy conditions. The participants were eight persons with schizophrenia who were attending psychiatric rehabilitation centres. We conducted semi-structured interviews with the participants on their observations regarding public health nurses' counselling with them. The data were analysed qualitatively. Six categories of health self-management behaviours were identified. The primary motivations that led to the participants' behaviours were 'getting a job in the near future' or 'maintaining my current level of living'. The use of their own methods caused unhealthy conditions when health management was excessively strict or there was a discrepancy between their and care providers' recognition of the appropriate level of self-management.

Obesity in schizophrenia: screening, monitoring, and health promotion

PURPOSE

This paper reviews risks, assessments, antipsychotic medication choices, and lifestyle interventions for obesity in persons with schizophrenia.

CONCLUSIONS

Antipsychotic medication is the most important treatment choice. Simple diet teaching must take into account the cognitive limitations of clients with schizophrenia. After medical clearance is obtained, moderate exercise can be encouraged. Education about exercise benefits may increase motivation.

PRACTICE IMPLICATIONS

Nurses would be remiss to ignore the physical health effects of obesity in schizophrenia. Practitioners must choose psychiatric medications and provide health education, health promotion, and appropriate referrals to optimize quality of life for this group.