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Abstract
Schizophrenia and diabetes have been known to be linked disorders for decades. One reason is due to the fact that a major side effect of antipsychotic medication treatment is metabolic syndrome, which increases the risk of the patients developing type 2 diabetes and cardiovascular disorders. However, signs of metabolic syndrome in schizophrenia patients were identified more than 100 years ago, even before the development of antipsychotic drugs. This suggests that schizophrenia itself predisposes towards diabetes and, in turn, insulin resistance may be a risk factor for the development of schizophrenia. This review summarizes the findings surrounding this issue and places them into context with regards to increasing our understanding of the aetiology of schizophrenia and in support of biomarker and drug discovery efforts.
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Affiliation(s)
- Paul C Guest
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil.
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Tumiel E, Wichniak A, Jarema M, Lew-Starowicz M. Nonpharmacological Interventions for the Treatment of Cardiometabolic Risk Factors in People With Schizophrenia-A Systematic Review. Front Psychiatry 2019; 10:566. [PMID: 31481903 PMCID: PMC6709656 DOI: 10.3389/fpsyt.2019.00566] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 07/19/2019] [Indexed: 01/05/2023] Open
Abstract
Background: People suffering from schizophrenia are notably vulnerable to cardiometabolic risk factors (CMRF), such as obesity, high blood pressure, hyperglycemia and insulin resistance, high serum triglycerides, and low serum high-density lipoprotein (HDL), which are related to increased mortality and decreased quality of life. The increased risk of "metabolic syndrome" (MS) is related to low physical activity, an unhealthy diet, and side effects of antipsychotic drugs. Nonpharmacological interventions seem to be important in the prevention and therapy of MS. Aim: This paper provides an overview of published studies and a critical analysis of pilot programs involving nonpharmacological measures aimed at prevention and treatment of CMRF in patients with schizophrenia. Material and Method: We searched the PubMed, PsycARTICLES, and Cochrane Library databases to identify clinical trials. We included full-text studies that met the following criteria: age > 18 years, a diagnosis of schizophrenia or schizoaffective disorder, and monitored parameters associated with MS. Results: All 1,555 references were evaluated for inclusion in the review, and 20 met the inclusion criteria. Nonpharmacological interventions led to improvement in physical health and showed a promising potential for implementation in treatment programs dedicated to this particular group of patients. However, a critical analysis revealed limitations, which have implications for the direction of future research. Conclusions: Patients suffering from schizophrenia can benefit from nonpharmacological interventions aimed at counteracting CMRF, improving either metabolic parameters, cardiovascular fitness, or their health perception. Notwithstanding, to achieve long-term effects, future studies should comprise appropriate follow-up procedures.
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Affiliation(s)
- Ewa Tumiel
- III Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Adam Wichniak
- III Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Marek Jarema
- III Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Michał Lew-Starowicz
- III Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland.,Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland
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Gorczynski PF, Sitch M, Faulkner G. Examining methods, messengers and behavioural theories to disseminate physical activity information to individuals with a diagnosis of schizophrenia: a scoping review. J Ment Health 2017:1-10. [PMID: 28084841 DOI: 10.1080/09638237.2016.1276535] [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] [Received: 06/12/2016] [Revised: 11/05/2016] [Accepted: 12/20/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Many individuals with a diagnosis of schizophrenia are not active and lack the necessary knowledge and confidence to become and stay active. To develop effective physical activity promotion interventions, it is necessary to identify credible messengers and effective methods to disseminate physical activity information to this population. AIMS The purpose of this scoping review was to identify and examine knowledge mobilization theories, messengers and methods used to disseminate physical activity information to individuals with a diagnosis of schizophrenia. METHOD This scoping review followed the methodological framework proposed by Arksey and O'Malley. RESULTS In total, 43 studies and 7 reviews identified multiple messengers and methods used to disseminate physical activity information to individuals with a diagnosis of schizophrenia, but few attempts to structure information theoretically. Findings do not point to which messengers or methods are most effective or which theories should be used to construct information interventions. Studies show that physical activity information should be provided in an individualised manner from staff who could easily connect with patients. CONCLUSIONS Few researchers have addressed the physical activity information needs of individuals with a diagnosis of schizophrenia. Researchers need to examine and implement effective knowledge mobilization strategies for this population.
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Affiliation(s)
- Paul Filip Gorczynski
- a Department of Sport and Exercise Science , University of Portsmouth , Portsmouth , UK
| | - Matthew Sitch
- b Sport and Exercise Science, University of Chichester , Chichester , UK
| | - Guy Faulkner
- c Faculty of Physical Education and Health , University of Toronto , Toronto , ON , Canada , and
- d School of Kinesiology, University of British Columbia , and Vancouver , BC , Canada
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Calvo P, Fortuny JR, Guzmán S, Macías C, Bowen J, García ML, Orejas O, Molins F, Tvarijonaviciute A, Cerón JJ, Bulbena A, Fatjó J. Animal Assisted Therapy (AAT) Program As a Useful Adjunct to Conventional Psychosocial Rehabilitation for Patients with Schizophrenia: Results of a Small-scale Randomized Controlled Trial. Front Psychol 2016; 7:631. [PMID: 27199859 PMCID: PMC4858645 DOI: 10.3389/fpsyg.2016.00631] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 04/15/2016] [Indexed: 11/25/2022] Open
Abstract
Currently, one of the main objectives of human-animal interaction research is to demonstrate the benefits of animal assisted therapy (AAT) for specific profiles of patients or participants. The aim of this study is to assess the effect of an AAT program as an adjunct to a conventional 6-month psychosocial rehabilitation program for people with schizophrenia. Our hypothesis is that the inclusion of AAT into psychosocial rehabilitation would contribute positively to the impact of the overall program on symptomology and quality of life, and that AAT would be a positive experience for patients. To test these hypotheses, we compared pre-program with post-program scores for the Positive and Negative Syndrome Scale (PANSS) and the EuroQoL-5 dimensions questionnaire (EuroQol-5D), pre-session with post-session salivary cortisol and alpha-amylase for the last four AAT sessions, and adherence rates between different elements of the program. We conducted a randomized, controlled study in a psychiatric care center in Spain. Twenty-two institutionalized patients with chronic schizophrenia completed the 6-month rehabilitation program, which included individual psychotherapy, group therapy, a functional program (intended to improve daily functioning), a community program (intended to facilitate community reintegration) and a family program. Each member of the control group (n = 8) participated in one activity from a range of therapeutic activities that were part of the functional program. In place of this functional program activity, the AAT-treatment group (n = 14) participated in twice-weekly 1-h sessions of AAT. All participants received the same weekly total number of hours of rehabilitation. At the end of the program, both groups (control and AAT-treatment) showed significant improvements in positive and overall symptomatology, as measured with PANSS, but only the AAT-treatment group showed a significant improvement in negative symptomatology. Adherence to the AAT-treatment was significantly higher than overall adherence to the control group's functional rehabilitation activities. Cortisol level was significantly reduced after participating in an AAT session, which could indicate that interaction with the therapy dogs reduced stress. In conclusion, the results of this small-scale RCT suggest that AAT could be considered a useful adjunct to conventional psychosocial rehabilitation for people with schizophrenia.
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Affiliation(s)
- Paula Calvo
- Chair Affinity Foundation Animals and Health, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de BarcelonaBellaterra, Spain
- Hospital del Mar Medical Research InstituteBarcelona, Spain
| | - Joan R. Fortuny
- Centres Assistencials Emili Mira, Institut de Neuropsiquiatria i Addiccions, Parc de Salut MarSanta Coloma de Gramenet, Spain
| | - Sergio Guzmán
- Centres Assistencials Emili Mira, Institut de Neuropsiquiatria i Addiccions, Parc de Salut MarSanta Coloma de Gramenet, Spain
| | - Cristina Macías
- Centres Assistencials Emili Mira, Institut de Neuropsiquiatria i Addiccions, Parc de Salut MarSanta Coloma de Gramenet, Spain
| | - Jonathan Bowen
- Chair Affinity Foundation Animals and Health, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de BarcelonaBellaterra, Spain
- Queen Mother Hospital for Small Animals, The Royal Veterinary CollegeHertfordshire, UK
| | - María L. García
- Centres Assistencials Emili Mira, Institut de Neuropsiquiatria i Addiccions, Parc de Salut MarSanta Coloma de Gramenet, Spain
| | - Olivia Orejas
- Centres Assistencials Emili Mira, Institut de Neuropsiquiatria i Addiccions, Parc de Salut MarSanta Coloma de Gramenet, Spain
| | - Ferran Molins
- Centres Assistencials Emili Mira, Institut de Neuropsiquiatria i Addiccions, Parc de Salut MarSanta Coloma de Gramenet, Spain
| | - Asta Tvarijonaviciute
- Interlab-UMU, Campus de Excelencia Mare Nostrum, Universidad de MurciaMurcia, Spain
- Department of Medicine and Animal Surgery, Universitat Autònoma de BarcelonaBellaterra, Spain
| | - José J. Cerón
- Interlab-UMU, Campus de Excelencia Mare Nostrum, Universidad de MurciaMurcia, Spain
| | - Antoni Bulbena
- Chair Affinity Foundation Animals and Health, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de BarcelonaBellaterra, Spain
- Hospital del Mar Medical Research InstituteBarcelona, Spain
- Centres Assistencials Emili Mira, Institut de Neuropsiquiatria i Addiccions, Parc de Salut MarSanta Coloma de Gramenet, Spain
| | - Jaume Fatjó
- Chair Affinity Foundation Animals and Health, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de BarcelonaBellaterra, Spain
- Hospital del Mar Medical Research InstituteBarcelona, Spain
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Dauwan M, Begemann MJH, Heringa SM, Sommer IE. Exercise Improves Clinical Symptoms, Quality of Life, Global Functioning, and Depression in Schizophrenia: A Systematic Review and Meta-analysis. Schizophr Bull 2016; 42:588-99. [PMID: 26547223 PMCID: PMC4838091 DOI: 10.1093/schbul/sbv164] [Citation(s) in RCA: 234] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Physical exercise may be valuable for patients with schizophrenia spectrum disorders as it may have beneficial effect on clinical symptoms, quality of life and cognition. METHODS A systematic search was performed using PubMed (Medline), Embase, PsychInfo, and Cochrane Database of Systematic Reviews. Controlled and uncontrolled studies investigating the effect of any type of physical exercise interventions in schizophrenia spectrum disorders were included. Outcome measures were clinical symptoms, quality of life, global functioning, depression or cognition. Meta-analyses were performed using Comprehensive Meta-Analysis software. A random effects model was used to compute overall weighted effect sizes in Hedges' g. RESULTS Twenty-nine studies were included, examining 1109 patients. Exercise was superior to control conditions in improving total symptom severity (k = 14, n = 719: Hedges' g = .39, P < .001), positive (k = 15, n = 715: Hedges' g = .32, P < .01), negative (k = 18, n = 854: Hedges' g = .49, P < .001), and general (k = 10, n = 475: Hedges' g = .27, P < .05) symptoms, quality of life (k = 11, n = 770: Hedges' g = .55, P < .001), global functioning (k = 5, n = 342: Hedges' g = .32, P < .01), and depressive symptoms (k = 7, n = 337: Hedges' g = .71, P < .001). Yoga, specifically, improved the cognitive subdomain long-term memory (k = 2, n = 184: Hedges' g = .32, P < .05), while exercise in general or in any other form had no effect on cognition. CONCLUSION Physical exercise is a robust add-on treatment for improving clinical symptoms, quality of life, global functioning, and depressive symptoms in patients with schizophrenia. The effect on cognition is not demonstrated, but may be present for yoga.
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Affiliation(s)
- Meenakshi Dauwan
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Neurophysiology and MEG Center, Neuroscience Campus, VU University Medical Center, Amsterdam, The Netherlands
| | - Marieke J H Begemann
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sophie M Heringa
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Iris E Sommer
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
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Gross J, Vancampfort D, Stubbs B, Gorczynski P, Soundy A. A narrative synthesis investigating the use and value of social support to promote physical activity among individuals with schizophrenia. Disabil Rehabil 2015; 38:123-50. [PMID: 25786476 DOI: 10.3109/09638288.2015.1024343] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To review and synthesise the literature detailing the use of social support to facilitate physical activity participation in individuals with schizophrenia. METHOD A systematic review of major electronic databases was conducted to identify literature regarding the use of social support to promote physical activity among people with schizophrenia. A narrative synthesis was undertaken in four stages, including development of a theory, developing a preliminary synthesis, exploring relationships and assessing the robustness of the synthesis. RESULTS From a total of 110 studies, 23 met the inclusion criteria including 883 individuals with schizophrenia. Informational support was the most documented form of social support, followed by emotional, esteem and tangible. Providers included research personnel, healthcare professionals, family members and peers. Details of the content of the different dimensions of functional support are given. Social support appears to have an important role to help individuals with schizophrenia initiate, comply and adhere with exercise interventions. Social support may have an indirect benefit on weight maintenance. However, due to the limitations of the selected literature, it was difficult ascertain what the (in)direct benefit of social support are on health outcomes. CONCLUSIONS Social support appears to play a pivotal role in initiating physical activity as well as ensuring compliance and adherence to physical activity. Future research is required to investigate the optimal type and mode of delivery of social support on health outcomes. IMPLICATIONS FOR REHABILITATION Limited evidence is available that considers the role, value and use of social support within physical activity interventions for individuals with schizophrenia. Social support appears most likely to aid an individual's initiation, adherence and compliance to physical activity interventions. There may be an indirect benefit of social support on maintaining or enhancing health outcomes.
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Affiliation(s)
- Julia Gross
- a Department of Physiotherapy , School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham , Birmingham , UK
| | - Davy Vancampfort
- b Department of Neurosciences , University Psychiatric Centre, KU Leuven , Kortenberg , Belgium .,c Department of Rehabilitation Sciences , KU Leuven , Leuven , Belgium
| | - Brendon Stubbs
- d School of Health and Social Care, University of Greenwich , London , UK , and
| | - Paul Gorczynski
- e Department of Sport and Exercise Science , University of Portsmouth , Portsmouth , Hampshire , UK
| | - Andrew Soundy
- a Department of Physiotherapy , School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham , Birmingham , UK
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Sailer P, Wieber F, Pröpster K, Stoewer S, Nischk D, Volk F, Odenwald M. A brief intervention to improve exercising in patients with schizophrenia: a controlled pilot study with mental contrasting and implementation intentions (MCII). BMC Psychiatry 2015; 15:211. [PMID: 26335438 PMCID: PMC4557227 DOI: 10.1186/s12888-015-0513-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 05/29/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regular exercise can have positive effects on both the physical and mental health of individuals with schizophrenia. However, deficits in cognition, perception, affect, and volition make it especially difficult for people with schizophrenia to plan and follow through with their exercising intentions, as indicated by poor attendance and high drop-out rates in prior studies. Mental Contrasting and Implementation Intentions (MCII) is a well-established strategy to support the enactment of intended actions. This pilot study tests whether MCII helps people with schizophrenia in highly structured or autonomy-focused clinical hospital settings to translate their exercising intentions into action. METHODS Thirty-six inpatients (eleven women) with a mean age of 30.89 years (SD = 11.41) diagnosed with schizophrenia spectrum disorders from specialized highly structured or autonomy-focused wards were randomly assigned to two intervention groups. In the equal contact goal intention control condition, patients read an informative text about physical activity; they then set and wrote down the goal to attend jogging sessions. In the MCII experimental condition, patients read the same informative text and then worked through the MCII strategy. We hypothesized that MCII would increase attendance and persistence relative to the control condition over the course of four weeks and this will be especially be the case when applied in an autonomy-focused setting compared to when applied in a highly structured setting. RESULTS When applied in autonomy-focused settings, MCII increased attendance and persistence in jogging group sessions relative to the control condition. In the highly structured setting, no differences between conditions were found, most likely due to a ceiling effect. These results remained even when adjusting for group differences in the pre-intervention scores for the control variables depression (BDI), physical activity (IPAQ), weight (BMI), age, and education. Whereas commitment and physical activity apart from the jogging sessions remained stable over the course of the treatment, depression and negative symptoms were reduced. There were no differences in pre-post treatment changes between intervention groups. CONCLUSIONS The intervention in the present study provides initial support for the hypothesis that MCII helps patients to translate their exercising intentions into real-life behavior even in autonomously-focused settings without social control. TRIAL REGISTRATION ClinicalTrials.gov ID; URL: NCT01547026 Registered 3 March 2012.
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Affiliation(s)
- Pascal Sailer
- Department of Psychology, University of Konstanz, Universitätsstrasse 10, 78464, Konstanz, Germany.
| | - Frank Wieber
- Department of Psychology, University of Konstanz, Universitätsstrasse 10, 78464, Konstanz, Germany.
| | - Karl Pröpster
- Department of Psychology, University of Konstanz, Universitätsstrasse 10, 78464, Konstanz, Germany. .,Center for Psychiatry, Feursteinstrasse 55, 78479, Reichenau, Germany.
| | - Steffen Stoewer
- Thurgau Psychiatric Services, Seeblickstrasse 3, 8596, Münsterlingen, Switzerland.
| | - Daniel Nischk
- Center for Psychiatry, Feursteinstrasse 55, 78479, Reichenau, Germany.
| | - Franz Volk
- Center for Psychiatry, Feursteinstrasse 55, 78479, Reichenau, Germany.
| | - Michael Odenwald
- Department of Psychology, University of Konstanz, Universitätsstrasse 10, 78464, Konstanz, Germany. .,Center for Psychiatry, Feursteinstrasse 55, 78479, Reichenau, Germany.
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Stanton R, Reaburn P, Happell B. Barriers to exercise prescription and participation in people with mental illness: the perspectives of nurses working in mental health. J Psychiatr Ment Health Nurs 2015; 22:440-8. [PMID: 25855247 DOI: 10.1111/jpm.12205] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2015] [Indexed: 12/11/2022]
Abstract
ACCESSIBLE SUMMARY Exercise is valuable in the treatment of mental illness, yet personal and organizational barriers limit widespread implementation by nurses in mental health settings. Using a self-report questionnaire, we sought to identify how often nurses prescribe exercise and their level of agreement with previously identified barriers to exercise prescription and participation for mental health consumers. Nurses disagree that many of the previously identified barriers should impede exercise prescription for people with mental illness. Nurses agree that many of the barriers expressed by mental health consumers might prevent exercise participation. Our study provides valuable new insight into the role of nurses in the provision of exercise for people with mental illness; however, it is limited to a small sample. Confirmation of these findings in larger, geographically and professionally diverse groups is needed. ABSTRACT Evidence is mounting for the efficacy of exercise in the treatment of people with mental illness. Nurses working in mental health settings are well placed to provide exercise advice for people with mental illness. However, quantitative examinations of the barriers to exercise prescription experienced by nurses, or their views regarding the barriers to exercise participation experienced by people with mental illness, are lacking. In this study, 34 nurses completed the Exercise in Mental Illness Questionnaire-Health Professionals Version (EMIQ-HP). This survey examined the frequency of exercise prescription and the level of agreement with statements regarding barriers to exercise prescription for, and exercise participation by, people with mental illness. The level of agreement scores for statements for each section was summed, with a higher score indicating a higher level of agreement. Nurses disagree with many of the barriers to exercise prescription presented in the literature. The level of agreement scores did not differ between nurses who prescribe exercise 'Always', 'Most of the time', 'Occasionally' or 'Never'. We found a non-significant negative relationship between frequency of exercise prescription and summed level of agreement scores for barriers to exercise prescription. Consensus regarding barriers to exercise participation by mental health consumers is less clear. This study provides valuable new insight into the role of nurses in the provision of exercise for people with mental illness. Confirmation in larger samples is needed before translation of research to practice.
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Affiliation(s)
- R Stanton
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - P Reaburn
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - B Happell
- Research Centre for Nursing and Midwifery Practice, University of Canberra, Canberra, ACT, Australia.,Research Centre for Nursing and Midwifery Practice, ACT Health, Canberra, ACT, Australia
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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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Bernard P, Romain A, Esseul E, Artigusse M, Poy Y, Baghdadli A, Ninot G. Barrières et motivation à l’activité physique chez l’adulte atteint de schizophrénie : revue de littérature systématique. Sci Sports 2013. [DOI: 10.1016/j.scispo.2013.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Malchow B, Reich-Erkelenz D, Oertel-Knöchel V, Keller K, Hasan A, Schmitt A, Scheewe TW, Cahn W, Kahn RS, Falkai P. The effects of physical exercise in schizophrenia and affective disorders. Eur Arch Psychiatry Clin Neurosci 2013; 263:451-67. [PMID: 23873090 DOI: 10.1007/s00406-013-0423-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 07/08/2013] [Indexed: 01/23/2023]
Abstract
Affective and non-affective psychoses are severe and frequent psychiatric disorders. Amongst others, they not only have a profound impact on affected individuals through their symptomatology, but also regarding cognition, brain structure and function. Cognitive impairment influences patients' quality of life as well as their ability to work and being employed. While exercise therapy has been implemented in the treatment of psychiatric conditions since the days of Kraepelin and Bleuler, the underlying mechanisms have never been systematically studied. Since the early 1990s, studies emerged examining the effect of physical exercise in animal models, revealing stimulation of neurogenesis, synaptogenesis and neurotransmission. Based on that body of work, clinical studies have been carried out in both healthy humans and in patient populations. These studies differ with regard to homogenous study samples, sample size, type and duration of exercise, outcome variables and measurement techniques. Based on their review, we draw conclusions regarding recommendations for future research strategies showing that modern therapeutic approaches should include physical exercise as part of a multimodal intervention programme to improve psychopathology and cognitive symptoms in schizophrenia and affective disorders.
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Affiliation(s)
- Berend Malchow
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nußbaumstraße 7, 80336, Munich, Germany.
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Bredin SSD, Warburton DER, Lang DJ. The health benefits and challenges of exercise training in persons living with schizophrenia: a pilot study. Brain Sci 2013; 3:821-48. [PMID: 24961427 PMCID: PMC4061848 DOI: 10.3390/brainsci3020821] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 05/03/2013] [Accepted: 05/07/2013] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In addition to the hallmark cognitive and functional impairments mounting evidence indicates that schizophrenia is also associated with an increased risk for the development of secondary complications, in particular cardio-metabolic disease. This is thought to be the result of various factors including physical inactivity and the metabolic side effects of psychotropic medications. Therefore, non-pharmacological approaches to improving brain health, physical health, and overall well-being have been promoted increasingly. METHODS We report on the health-related physical fitness (body composition, blood pressure, heart rate, and aerobic fitness) and lipid profile of persons living with schizophrenia and effective means to address the challenges of exercise training in this population. RESULTS There was a markedly increased risk for cardio-metabolic disease in 13 persons living with schizophrenia (Age = 31 ± 7 years) including low aerobic fitness (76% ± 34% of predicted), reduced HDL (60% of cohort), elevated resting heart rate (80% of cohort), hypertension (40% of cohort), overweight and obesity (69% of cohort), and abdominal obesity (54% of cohort). Individualized exercise prescription (3 times/week) was well tolerated, with no incidence of adverse exercise-related events. The exercise adherence rate was 81% ± 21% (Range 48%-100%), and 69% of the participants were able to complete the entire exercise training program. Exercise training resulted in clinically important changes in physical activity, aerobic fitness, exercise tolerance, blood pressure, and body composition. CONCLUSION Persons living with schizophrenia appear to be at an increased risk for cardio-metabolic disease. An individualized exercise program has shown early promise for the treatment of schizophrenia and the various cognitive, functional, and physiological impairments that ultimately affect health and well-being.
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Affiliation(s)
- Shannon S D Bredin
- Cognitive and Functional Learning Laboratory, University of British Columbia, Vancouver V6T 1Z1, Canada.
| | - Darren E R Warburton
- Cognitive and Functional Learning Laboratory, University of British Columbia, Vancouver V6T 1Z1, Canada.
| | - Donna J Lang
- Department of Radiology, University of British Columbia, Vancouver V6T 1Z1, Canada.
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