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Venet-Kelma L, Morvan Y, Romain AJ, Mendy M, Meslier M, Thoisy I, Mulin E, Chirio-Espitalier M, Dadi G, Moualla M, Amado I, Kern L. Effect of an adapted physical activity program on stress, anxiety, depression in patients with schizophrenia: study protocol of a randomized-controlled trial. Eur Arch Psychiatry Clin Neurosci 2024; 274:891-902. [PMID: 37670161 DOI: 10.1007/s00406-023-01689-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/21/2023] [Indexed: 09/07/2023]
Abstract
Physical activity (PA) is recommended to optimize well-functioning in people with schizophrenia. PA has been found to improve quality of life, general symptomatology, depression, anxiety and stress symptoms, global and social functioning. In PA research, most of the interventions are based on one-on-one interventions but there is poor information about group-based PA interventions. Using a randomized controlled, clinician-blinded trial, subjects are randomized into two arms: the PA group or control group. Our first objective is about to evaluate the effects of a multimodal 6 week collective PA intervention on depression, anxiety, and stress symptoms in people with schizophrenia. Our second objective is about to evaluate these effects on secondary outcomes especially smoking, well-being, physical fitness and on care utilization. All participants are evaluated before and after the 6 week intervention period, and only participants in the PA group are called in a follow-up interview 3 and 6 months after the intervention.Trial registration Individual Protection Committee of Ile-de-France II, n ID RCB: 2018- A00583-52. Registered on 8 April 2018.
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Affiliation(s)
- Lucie Venet-Kelma
- University of Montreal, Montreal, QC, Canada. lucie.venet--
- Research Center of the University Institute of Mental Health of Montreal, Montreal, Canada. lucie.venet--
| | | | - Ahmed Jérôme Romain
- University of Montreal, Montreal, QC, Canada
- Research Center of the University Institute of Mental Health of Montreal, Montreal, Canada
| | - Mauricette Mendy
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Marjorie Meslier
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Isabelle Thoisy
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
| | - Emmanuel Mulin
- Korian Val du Fenouillet Psychiatric Clinic, La Crau, France
| | - Marion Chirio-Espitalier
- Reference Center for Therapeutic Education and Cognitive Remediation, University Hospital of Nantes, Nantes, France
| | - Ghita Dadi
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Mona Moualla
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Isabelle Amado
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Laurence Kern
- University of Paris Nanterre, Nanterre, France
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
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Domingue JL, Jager F, Lusk J, Ezeani C, Pryer B, Davis S. "The Person Gets Lost in the Whole Process": Access to Physical Healthcare for Patients Hospitalized in a Psychiatric Hospital. Res Theory Nurs Pract 2023; 37:214-230. [PMID: 37263635 DOI: 10.1891/rtnp-2022-0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Background and Purpose: Persons living with mental illnesses have unmet physical healthcare needs, leading to premature death. When they attempt to access physical health services, they are faced with numerous barriers that lead to delays in care. Although mental health nurses are identified as being essential actors in helping persons with mental illnesses navigate the complexities of the healthcare system, they also engage in conduct that further stigmatizes them. To complicate matters more, mental health nurses themselves face stigmatization when they help their patients living with mental illnesses access physical healthcare services. The aim of the study was to explore mental health nurses' experiences of associative stigma when accessing physical health services for their patients. Methods: To achieve this aim, we used an interpretive phenomenology methodology and a theoretical framework rooted in Erving Goffman's notion of associative stigma. Specifically, we conducted six interviews with mental health nurses working at an urban multisite psychiatric hospital to elicit accounts of their experiences of associative stigma when seeking physical healthcare for their patients and the meanings they make of these. Results: The results presented in this article illustrate some of the mechanisms by which stigmatization toward persons living with mental illnesses and mental health nurses cause delays in physical healthcare accessibility. Implications for Practice: In our discussion, we highlight the implications of these results for the practice of nurses and propose two structural solutions to improve access to physical healthcare and reduce stigmatizing experiences.
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Affiliation(s)
| | - Fiona Jager
- School of Baccalaureate Nursing, St. Lawrence College, Brockville, Ontario, Canada
| | - Jodi Lusk
- Royal Ottawa Health Care Group, Ottawa, Ontario, Canada
| | | | - Billie Pryer
- Royal Ottawa Health Care Group, Ottawa, Ontario, Canada
| | - Sascha Davis
- Royal Ottawa Health Care Group, Ottawa, Ontario, Canada
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3
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Wu H, Xue K, Peng A, Chai J, Zhao Y. Effectiveness and safety of Baduanjin for schizophrenia: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e32007. [PMID: 36482549 PMCID: PMC9726371 DOI: 10.1097/md.0000000000032007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The cause of schizophrenia is still unknown, the course of the disease is long and its onset is thought to be related to neurodevelopmental, genetic, and oxidative stress factors and so on. There is no means of cure. Typical drug therapy is effective in treating the acute stage of schizophrenia, while the impaired social and life functions of patients are often neglected. Baduanjin is a traditional Chinese physical and breathing exercise that not only strengthens the muscles, and moves the joints, but also exercises the will. Many studies have been reported in the study on the application of Baduanjin to schizophrenic patients to promote recovery, but no research systematically evaluates the therapeutic effects and safety of Baduanjin for schizophrenic patients. This study aims to systematically investigate the efficacy and safety of Baduanjin in the treatment of schizophrenic patients. METHODS Reports of randomized controlled trials (RCTs) on Baduanjin for schizophrenia will be searched in the following data sources, including 3 English databases(PubMed, EMBASE, Cochrane Library)and 4 Chinese databases(China National Knowledge Infrastructure, Chinese Biomedical Literature, Wanfang, and China Clinical Trials Registry Database), and their publication time is restricted from the establishment of the database to October 1, 2022. Two reviewers will independently perform study selection, data extraction, and quality assessment. RevMan V.5.4 software will be used for meta-analysis. The protocol will be performed according to preferred reporting items for systematic reviews and meta-analysis protocols (PRISMA-P) guidelines. RESULTS The results will provide a systematic overview of the current evidence on the use of Baduanjin to treat schizophrenia. CONCLUSION The conclusions of this study will help clarify whether Baduanjin is effective and safe for treating schizophrenia.
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Affiliation(s)
- Haiyuan Wu
- Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang Province, China
| | - Kaiyuan Xue
- Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang Province, China
| | - Aineng Peng
- Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang Province, China
| | - Jianbo Chai
- Department of Neurology, Heilongjiang Mental Hospital, Harbin, Heilongjiang Province, China
| | - Yonghou Zhao
- Department of Neurology, Heilongjiang Mental Hospital, Harbin, Heilongjiang Province, China
- * Correspondence: Yonghou Zhao, Department of Neurology, Heilongjiang Mental Hospital, Harbin, Heilongjiang Province 150000, China (e-mail: )
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Moon I, Han J. Moderating Effects of Physical Activity on the Relationship between Adverse Childhood Experiences and Health-Related Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:668. [PMID: 35055490 PMCID: PMC8775782 DOI: 10.3390/ijerph19020668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/01/2022] [Accepted: 01/05/2022] [Indexed: 11/16/2022]
Abstract
The effects of adverse childhood experiences (ACEs) on health-related quality of life (HRQOL) and their associations with physical activities (PA) are well-documented. However, the specific effects of different types of ACEs (e.g., child abuse and household dysfunction) on HRQOL and the role of PA are inconclusive. The purpose of this study is to find the buffering role of PA as a moderator that may reduce the negative impact of ACEs in general and the specific effects of different types of ACEs on HRQOL, perceived physical health, and mental health over time. The 2019 Behavioral Risk Fact Surveillance System (BRFSS), a state-based surveillance system supported by the CDC in the U.S., was used for this study. A total of 127,370 respondents from 17 states were selected for this study. First, descriptive statistics were generated and correlation analyses were conducted to find the association among variables and examine the possible predictors of HRQOL. Moderation models were then tested using Structural Equation Modeling (SEM). HRQOL in adults is negatively associated with ACEs, but is positively associated with PA. We found buffering effects of physical activity in the following relationships: (1) child abuse and HRQOL, (2) child abuse and perceived physical health, (3) ACEs and perceived mental health, (4) child abuse and perceived mental health, and (5) household dysfunction and perceived mental health. Our findings suggest that improvement of PA level is a significant predictor of improved HRQOL of adults with ACEs.
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Affiliation(s)
- Ingyu Moon
- School of Social Work, Nyack College, New York, NY 10004, USA
| | - Junghee Han
- Department of Social Work, University of Southern Indiana, Evansville, IN 47712, USA;
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5
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KOTA M, UEZONO S, ISHIBASHI Y, KURAMOCHI S, KITAKAZE S, KAGANOI S. Outcomes of Physiotherapy on Activities of Daily Living and Discharge to the Community in Psychiatric Long-term Care Ward Patients. Phys Ther Res 2022; 25:84-91. [DOI: 10.1298/ptr.e10159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/12/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Munetsugu KOTA
- Department of Health Sciences, Hiroshima Cosmopolitan University, Japan
| | - Sae UEZONO
- Department of Rehabilitation, Hirakawa Hospital, Japan
| | | | | | | | - Seiji KAGANOI
- Department of Rehabilitation, Geisei Hospital, Japan
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6
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Midtgaard J, Schnor H, Bjerre ED, Jespersen T, Jelsøe N, Frølund N, Seier S, Rønbøg JW, Nordsborg NB, Ebdrup BH. Exercise training complementary to specialised early intervention in patients with first-episode psychosis: a feasibility randomised trial. Pilot Feasibility Stud 2021; 7:162. [PMID: 34412705 PMCID: PMC8375206 DOI: 10.1186/s40814-021-00900-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 08/10/2021] [Indexed: 11/19/2022] Open
Abstract
Background The aim of this study was to examine feasibility of trial processes and group-based, structured exercise training in patients with first-episode psychosis. Methods Twenty-five patients with first-episode psychosis took part in a two-arm randomised feasibility trial. They were individually randomised (1:1) via a computer-generated randomisation sequence and allocated to either an exercise intervention group (INT) or a control group (CON). Patients allocated to INT completed a physical exercise training programme at moderate-to-vigorous intensity, 1 h three times weekly for 8 weeks. CON patients were encouraged to continue their usual level of activity and were offered the training programme after 8 weeks. Primary outcomes included screening rate, recruitment rate, retention rate, attendance and adverse events. Secondary outcomes included heart rate response during training, cardiovascular health (VO2max, resting heart rate, blood pressure), body composition (muscle mass, fat percentage), muscle strength (sit-to-stand, grip strength, jump height) and balance. Results Recruitment lasted 6 weeks and 86 out of 324 patients (27%) were screened, 71 of whom (83%) were deemed eligible. Twenty-five (35%) accepted inclusion (mean age 25.5; mean body mass index 25.1) and were subsequently randomised (INT = 13, CON = 12). Retention of patients was 76% and 52% at the 8-week and 16-week follow-up, respectively. Attendance was 43% (min. 9%, max. 96%). No significant changes were observed between groups in secondary physiological outcome measures. Conclusions Feasibility was challenged by limited recruitment and retention rates, suggesting that modifications are required if a large-scale randomised controlled trial is to be conducted. Recommendations for modifications are presented and discussed. Trial registration Clinicaltrials.gov, NCT03409393. Retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-021-00900-5.
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Affiliation(s)
- Julie Midtgaard
- Mental Health Centre Glostrup, University of Copenhagen, Nordstjernevej 41, DK-2600, Glostrup, Denmark. .,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark. .,The University Hospitals Centre for Health Research, Copenhagen University Hospital - Rigshospitalet, Department 9701, Blegdamsvej 9, DK-2100, Copenhagen Ø, Denmark.
| | - Helle Schnor
- Mental Health Centre Glostrup, University of Copenhagen, Nordstjernevej 41, DK-2600, Glostrup, Denmark.,University College Copenhagen, Tagensvej 86, DK-2200, Copenhagen N, Denmark
| | - Eik D Bjerre
- The University Hospitals Centre for Health Research, Copenhagen University Hospital - Rigshospitalet, Department 9701, Blegdamsvej 9, DK-2100, Copenhagen Ø, Denmark
| | - Tobias Jespersen
- Mental Health Centre Glostrup, University of Copenhagen, Nordstjernevej 41, DK-2600, Glostrup, Denmark
| | - Nina Jelsøe
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Alle 51, DK-2200, Copenhagen N, Denmark
| | - Nanna Frølund
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Alle 51, DK-2200, Copenhagen N, Denmark
| | - Søren Seier
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Alle 51, DK-2200, Copenhagen N, Denmark
| | - Jacob W Rønbøg
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Alle 51, DK-2200, Copenhagen N, Denmark
| | - Nikolai B Nordsborg
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Alle 51, DK-2200, Copenhagen N, Denmark
| | - Bjørn H Ebdrup
- Mental Health Centre Glostrup, University of Copenhagen, Nordstjernevej 41, DK-2600, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark.,Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Nordstjernevej 41, DK-2600, Glostrup, Denmark
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7
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Proteomic and metabolic profiling of chronic patients with schizophrenia induced by a physical activity program: Pilot study. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2021; 14:125-138. [PMID: 34384726 DOI: 10.1016/j.rpsmen.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 11/09/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Schizophrenia is a chronic illness often accompanied by metabolic disorders, diabetes, obesity and cardiovascular problems often associated with unhealthy lifestyles, as well as neuroendocrine problems caused by the disease itself. Lifestyle changes, such as regular physical exercise, have a positive effect on metabolic disorders and mental health, although the molecular changes that occur in this type of patient and how they explain the changes in their response are unknown. This study wants to analyze in a novel way the proteins and molecular pathways involved in critical plasmatic proteins in plasma to reveal the pathways involved in the implementation of physical exercise and the changes that occur among patients who participate in such programs with those who leave. METHODS Twenty-one patients with chronic schizophrenia underwent a daily, 6-month aerobic training program. We divided them into a group that completed the program (12 patients) and a second group that left the training program (9 patients). The biochemical and clinical data of each patient were analyzed and the proteomic profile of the plasma was studied using ESI-LC-MS/MS. RESULTS Proteomic analysis recognizes 21.165 proteins and peptides in each patient, of which we identified 1.812 proteins that varied between both groups linked to the metabolic and biological regulation pathways. After clinical analysis of each patient we found significant differences in weight, BMI, abdominal perimeter, diastolic blood pressure, and HDL cholesterol levels. The main change that vertebrates both groups is the Self-Assessment Anhedonia Scale, where we detected higher levels in the dropout group (no physical activity) compared to the active group. CONCLUSION The benefits of physical exercise are clear in chronic patients with schizophrenia, as it substantially improves their BMI, as well as their clinical and biochemical parameters. However, our study reveals the biological and molecular pathways that affect physical exercise in schizophrenia, such as important metabolic proteins such as ApoE and ApoC, proteins involved in neuronal regulation such as tenascin and neurotrophins, neuroinflammatory regulatory pathways such as lipocalin-2 and protein 14-3-3, as well as cytoskeleton proteins of cells such as spectrins and annexines. Understanding these molecular mechanisms opens the door to future therapies in the chronicity of schizophrenia.
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Lerbæk B, McCloughen A, Lauritsen MB, Aagaard J, Nordgaard J, Jørgensen R. Barriers and Possible Solutions to Providing Physical Health Care in Mental Health Care: A Qualitative Study of Danish Key Informants' Perspectives. Issues Ment Health Nurs 2021; 42:463-472. [PMID: 32990129 DOI: 10.1080/01612840.2020.1823537] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Provision of physical health care to people diagnosed with severe mental illness is widely reported as inadequate. This interview study explored perspectives of a group of key informants on current practices of providing physical health care within two mental health care settings in Denmark. Thematic analysis of their accounts provided insights into 1) barriers to the provision of physical health care in mental health settings, and 2) possible solutions to overcome existing barriers. Negative attitudes and limited specialist health care knowledge among mental health care professionals constituted serious barriers. To effectively address these barriers, mental health services need to be reoriented towards the prioritisation of physical health alongside mental health. This will require equipping mental health professionals with relevant knowledge and skills and organisational resources, to effectively work with people experiencing or at risk of physical comorbidities.
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Affiliation(s)
- Birgitte Lerbæk
- Clinic for Internal and Emergency Medicine, Aalborg University Hospital, Aalborg, Denmark.,Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Clinic Psychiatry South, Aalborg University Hospital, Psychiatry, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Andrea McCloughen
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Marlene Briciet Lauritsen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Psychiatry, Aalborg University Hospital, Aalborg, Denmark
| | | | - Julie Nordgaard
- Mental Health Center Amager, Copenhagen, Denmark.,University of Copenhagen, Copenhagen, Denmark
| | - Rikke Jørgensen
- Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Aalborg, Denmark
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9
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Proteomic and metabolic profiling of chronic patients with schizophrenia induced by a physical activity program: Pilot study. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2020. [PMID: 33264672 DOI: 10.1016/j.rpsm.2020.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Schizophrenia is a chronic illness often accompanied by metabolic disorders, diabetes, obesity and cardiovascular problems often associated with unhealthy lifestyles, as well as neuroendocrine problems caused by the disease itself. Lifestyle changes, such as regular physical exercise, have a positive effect on metabolic disorders and mental health, although the molecular changes that occur in this type of patient and how they explain the changes in their response are unknown. This study wants to analyze in a novel way the proteins and molecular pathways involved in critical plasmatic proteins in plasma to reveal the pathways involved in the implementation of physical exercise and the changes that occur among patients who participate in such programs with those who leave. METHODS Twenty-one patients with chronic schizophrenia underwent a daily, 6-month aerobic training program. We divided them into a group that completed the program (12 patients) and a second group that left the training program (9 patients). The biochemical and clinical data of each patient were analyzed and the proteomic profile of the plasma was studied using ESI-LC-MS/MS. RESULTS Proteomic analysis recognizes 21.165 proteins and peptides in each patient, of which we identified 1,812 proteins that varied between both groups linked to the metabolic and biological regulation pathways. After clinical analysis of each patient we found significant differences in weight, BMI, abdominal perimeter, diastolic blood pressure, and HDL cholesterol levels. The main change that vertebrates both groups is the Self-Assessment Anhedonia Scale, where we detected higher levels in the dropout group (no physical activity) compared to the active group. CONCLUSION The benefits of physical exercise are clear in chronic patients with schizophrenia, as it substantially improves their BMI, as well as their clinical and biochemical parameters. However, our study reveals the biological and molecular pathways that affect physical exercise in schizophrenia, such as important metabolic proteins such as ApoE and ApoC, proteins involved in neuronal regulation such as tenascin and neurotrophins, neuroinflammatory regulatory pathways such as lipocalin-2 and protein 14-3-3, as well as cytoskeleton proteins of cells such as spectrins and annexines. Understanding these molecular mechanisms opens the door to future therapies in the chronicity of schizophrenia.
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10
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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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van Aken BC, Bakia A, Wierdsma AI, Voskes Y, Van Weeghel J, van Bussel EMM, Hagestein C, Ruissen AM, Leendertse P, Sewbalak WV, van der Draai DA, Hammink A, Mandos ME, van der Gaag M, Bonebakker AE, Van Der Feltz-Cornelis CM, Mulder CL. UP'S: A Cohort Study on Recovery in Psychotic Disorder Patients: Design Protocol. Front Psychiatry 2020; 11:609530. [PMID: 33584375 PMCID: PMC7874019 DOI: 10.3389/fpsyt.2020.609530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/27/2020] [Indexed: 11/13/2022] Open
Abstract
Recovery is a multidimensional concept, including symptomatic, functional, social, as well as personal recovery. The present study aims at exploring psychosocial and biological determinants of personal recovery, and disentangling time-dependent relationships between personal recovery and the other domains of recovery in a sample of people with a psychotic disorder. A cohort study is conducted with a 10-year follow-up. Personal recovery is assessed using the Recovering Quality of Life Questionnaire (ReQoL) and the Individual Recovery Outcomes Counter (I.ROC). Other domains of recovery are assessed by the Positive and Negative Symptom Scale Remission (PANSS-R), the BRIEF-A and the Social Role Participation Questionnaire-Short version (SRPQ) to assess symptomatic, functional and societal recovery, respectively. In addition, multiple biological, psychological, and social determinants are assessed. This study aims to assess the course of personal recovery, and to find determinants and time-dependent relationships with symptomatic, functional and societal recovery in people with a psychotic disorder. Strengths of the study are the large number of participants, long duration of follow-up, multiple assessments over time, extending beyond the treatment trajectory, and the use of a broad range of biological, psychological, and social determinants.
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Affiliation(s)
- Bernice C van Aken
- Department of Psychiatry, Erasmus MC, Epidemiological and Social Psychiatric Research Institute, Rotterdam, Netherlands
| | - Ayuk Bakia
- Department of Psychiatry, Erasmus MC, Epidemiological and Social Psychiatric Research Institute, Rotterdam, Netherlands
| | - André I Wierdsma
- Department of Psychiatry, Erasmus MC, Epidemiological and Social Psychiatric Research Institute, Rotterdam, Netherlands
| | - Yolande Voskes
- Department of Ethics, Law and Humanities, Amsterdam UMC, Amsterdam, Netherlands.,GGz Breburg, Tilburg, Netherlands.,Phrenos Centre of Expertise, Utrecht, Netherlands
| | - Jaap Van Weeghel
- Phrenos Centre of Expertise, Utrecht, Netherlands.,Tranzo Department, Tilburg School of Behavioural and Social Sciences, Tilburg University, Tilburg, Netherlands.,Parnassia Psychosis Research, Den Haag, Netherlands
| | | | | | | | | | | | | | | | - M E Mandos
- Gemeente Rotterdam, Rotterdam, Netherlands
| | - Mark van der Gaag
- Parnassia Psychosis Research, Den Haag, Netherlands.,Department of Clinical Psychology, Vrije Universtiteit, Amsterdam, Netherlands
| | | | | | - Cornelis L Mulder
- Department of Psychiatry, Erasmus MC, Epidemiological and Social Psychiatric Research Institute, Rotterdam, Netherlands.,Bavo-Europoort Mental Health Care, Rotterdam, Netherlands
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12
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Lerbæk B, Jørgensen R, Aagaard J, Nordgaard J, Buus N. Mental health care professionals' accounts of actions and responsibilities related to managing physical health among people with severe mental illness. Arch Psychiatr Nurs 2019; 33:174-181. [PMID: 30927987 DOI: 10.1016/j.apnu.2018.11.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/11/2018] [Accepted: 11/17/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Life expectancy of people with severe mental illness (SMI) is greatly shortened compared to the general population, and despite extensive research, this issue is unsolved. Although it is widely recognised that people with SMI need support from health care services to manage health related issues, profound health inequalities exist within provision of health care. The aim of this study was to examine how mental health care professionals accounted for their actions and responsibilities related to managing physical health issues among people with SMI. METHODS Three focus groups were conducted with 22 mental health care professionals, employed at three mental health care locations. Participants' situated accounts were subjected to discourse analysis. RESULTS Participants accounted for actions and responsibilities in three typical ways; 1) by positioning people with SMI as difficult to motivate and actively resisting intervention, 2) by positioning people with SMI as so impaired that intervention was futile, and 3) by arguing they are undertreated for physical conditions and might have physical illnesses that staff are not aware of because of prominent mental illness. These discursive strategies seemed to legitimise situations where participants described not responding to physical health issues, and to downplay potential trouble in situations where participants described not succeeding in facilitating lifestyle changes or promoting compliance to treatment of physical conditions. DISCUSSION AND CONCLUSION Mental health care professionals need to increase their awareness of latent discriminating attitudes towards people with SMI. Such attitudes are suggested to reinforce barriers for people with SMI receiving physical health care.
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Affiliation(s)
- Birgitte Lerbæk
- Aalborg University Hospital, Psychiatry, Mølleparkvej 10, 9000 Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Søndre Skovvej 11, 9000 Aalborg, Denmark.
| | - Rikke Jørgensen
- Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Mølleparkvej 10, 9000 Aalborg, Denmark.
| | - Jørgen Aagaard
- Aalborg University Hospital, Psychiatry, Mølleparkvej 10, 9000 Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Søndre Skovvej 11, 9000 Aalborg, Denmark.
| | - Julie Nordgaard
- Mental Health Center Amager, Denmark; University of Copenhagen, Copenhagen, Denmark.
| | - Niels Buus
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia; St. Vincent's Private Hospital Sydney, Sydney, Australia; St. Vincent's Hospital Sydney, Sydney, Australia; Institute of Regional Health Research, University of Southern Denmark, Slagelse, Denmark.
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13
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Gardner A, Filia K, Killackey E, Cotton S. The social inclusion of young people with serious mental illness: A narrative review of the literature and suggested future directions. Aust N Z J Psychiatry 2019; 53:15-26. [PMID: 30309242 DOI: 10.1177/0004867418804065] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Social inclusion involves objective participatory (e.g. education/employment) and subjective (e.g. sense of belonging/acceptance) elements across multiple domains. It has been associated with enhanced physical and mental wellbeing yet is a novel construct in the empirical literature (i.e. measures have not been sufficiently developed). AIMS Young people with serious mental illness are reported to be socially excluded. It is unclear whether this is reflected in the social inclusion/exclusion literature. The aim of this narrative review is to determine whether such literature permits a comprehensive (i.e. multi-dimensional, objective and subjective) understanding of social inclusion among young people with serious mental illness. METHODS Searches to identify studies related to the social inclusion and/or exclusion of young people with serious mental illness were conducted on 16 February 2016, 24 August 2016, 16 February 2017, 24 August 2017 and 16 February 2018 in PsycINFO, MEDLINE, the Cochrane Library, SCOPUS, Open Grey, Web of Science, Google and Google Scholar. RESULTS There is a paucity of research in the explicit social inclusion literature involving young people either with or without serious mental illness as participants. Literatures exist in related independent areas of research (e.g. employment, social networks), but such studies employ heterogeneous methodologies. CONCLUSION Multi-dimensional measures of social inclusion incorporating objective and subjective indicators must be developed for young people with and without serious mental illness. This will enable the generation of normative and clinical data. Existing evidence for the social exclusion of young people with serious mental illness comes from objective indicators in isolated domains (e.g. unemployment). Subjective indicators continue to be under-researched. The above-described measures must be employed to further understanding of the apparent discrepancies between young people with serious mental illness and those without serious mental illness. This will elucidate the relationships between objective and subjective elements of social inclusion and the relationships between these elements and the psychological distress that young people with serious mental illness often experience. This has implications for intervention.
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Affiliation(s)
- Andrew Gardner
- 1 Department of Research and Translation at Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,2 School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Kate Filia
- 1 Department of Research and Translation at Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,3 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Eóin Killackey
- 1 Department of Research and Translation at Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,3 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sue Cotton
- 1 Department of Research and Translation at Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,3 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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14
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Duncan MJ, Arbour-Nicitopoulos K, Subramaniapillai M, Remington G, Faulkner G. Revisiting the International Physical Activity Questionnaire (IPAQ): Assessing sitting time among individuals with schizophrenia. Psychiatry Res 2019; 271:311-318. [PMID: 30529312 DOI: 10.1016/j.psychres.2018.11.063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/26/2018] [Accepted: 11/26/2018] [Indexed: 11/26/2022]
Abstract
While moderate to vigorous physical activity may be one method of addressing common physical morbidities in schizophrenia, reducing sedentary time may be a low intensity adjunct. In order to determine whether sedentary behaviour is associated with health outcomes, valid and reliable tools for assessing sedentary time are necessary. In order to characterize the validity and reliability of the International Physical Activity Questionnaire (IPAQ) for assessing sitting (sedentary) time, participants completed the IPAQ at baseline and 4 weeks later and wore accelerometers for 7 days before the final assessment. Bland-Altman analyses and intraclass correlation coefficients (ICC) were used to compare agreement between measurements. One-hundred thirteen individuals completed the study. Mean difference between the IPAQ and accelerometer was 26.8 min (95% Limits of Agreement: -458.7-512.3) and ICCA,1 was 0.23 (95% CI: 0.06-0.39). Week 1 and Week 4 administrations of the IPAQ differed by an average of 26.6 min, (95% Limits of Agreement: -510.9-564.2) and ICCA,1 was 0.41 (95% CI: 0.21-0.59). The "minutes" of sitting reported by the IPAQ do not reflect objective sedentary behaviour measurements and this current measure may be unsuitable for the population level assessment of sitting time among individuals with schizophrenia.
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Affiliation(s)
- Markus J Duncan
- School of Kinesiology, University of British Columbia, 2148 Health Sciences Mall, Room 4008, Vancouver, BC V6T 1Z8, Canada.
| | | | - Mehala Subramaniapillai
- Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Canada
| | - Gary Remington
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, 2148 Health Sciences Mall, Room 4008, Vancouver, BC V6T 1Z8, Canada
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15
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Wheeler AJ, Roennfeldt H, Slattery M, Krinks R, Stewart V. Codesigned recommendations for increasing engagement in structured physical activity for people with serious mental health problems in Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:860-870. [PMID: 30047608 DOI: 10.1111/hsc.12597] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/22/2018] [Accepted: 05/20/2018] [Indexed: 06/08/2023]
Abstract
People with mental health problems are at higher risk of physical health comorbidities and early mortality. A key risk factor for poor health outcomes is a lack of regular physical activity. Mental health services have typically responded by focusing on screening and promoting lifestyle programmes within secondary care mental health settings. The aim of this study was to better understand the barriers and enablers for Australian mental health consumers to participate in physical activity or exercise programmes from the perspectives of consumers and exercise practitioners. Interviews with 15 consumers experiencing serious mental health problems and five exercise practitioners were undertaken, followed by two focus groups (involving eight consumers and two exercise practitioners) to gain consensus on themes from the interviews, and codesign a set of recommendations for services to support and increase the engagement of mental health consumers in regular community-based exercise. Barriers that impacted on engagement in physical activity included: lack of social support, insufficient knowledge and information, difficulties with work/life balance, impact of physical and mental health issues, fear and lack of confidence, and financial cost. Enablers or motivators assisting engagement in community-based physical activity programmes included: social support, access to person-centred individualised exercise options, connection and a sense of belonging, and access to information and education. Recommendations and a checklist were developed to assist services to increase the involvement of mental health consumers in community-based exercise and to ensure that exercise practitioners and their employing organisations are adequately equipped to work with this population.
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Affiliation(s)
- Amanda J Wheeler
- Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Helena Roennfeldt
- Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia
| | - Maddy Slattery
- Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia
| | - Rachael Krinks
- Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia
| | - Victoria Stewart
- Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia
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16
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Waugh A, Crumlish N, Kelleher E, Forde C, Broderick J. A feasibility study of a physiotherapy-led motivational programme to increase physical activity and improve cardiometabolic risk in people with major mental illness. Gen Hosp Psychiatry 2018; 54:37-44. [PMID: 29678276 DOI: 10.1016/j.genhosppsych.2018.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 03/02/2018] [Accepted: 03/05/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Alice Waugh
- Department of Physiotherapy, St. James's Hospital, Dublin 8, Ireland.
| | - Niall Crumlish
- Department of Psychiatry, St. James's Hospital, Dublin 8, Ireland
| | - Eric Kelleher
- Department of Psychiatry, St. James's Hospital, Dublin 8, Ireland; Trinity College, The University of Dublin, Ireland
| | - Cuisle Forde
- Discipline of Physiotherapy, Trinity College, The University of Dublin, Ireland
| | - Julie Broderick
- Discipline of Physiotherapy, Trinity College, The University of Dublin, Ireland
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17
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Manderbacka K, Arffman M, Lumme S, Suvisaari J, Keskimäki I, Ahlgren-Rimpiläinen A, Malila N, Pukkala E. The effect of history of severe mental illness on mortality in colorectal cancer cases: a register-based cohort study. Acta Oncol 2018; 57:759-764. [PMID: 29363989 DOI: 10.1080/0284186x.2018.1429649] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND While the link between mental illness and cancer survival is well established, few studies have focused on colorectal cancer. We examined outcomes of colorectal cancer among persons with a history of severe mental illness (SMI). MATERIAL AND METHODS We identified patients with their first colorectal cancer diagnosis in 1990-2013 (n = 41,708) from the Finnish Cancer Registry, hospital admissions due to SMI preceding cancer diagnosis (n = 2382) from the Hospital Discharge Register and deaths from the Causes of Death statistics. Cox regression models were used to study the impact on SMI to mortality differences. RESULTS We found excess colorectal cancer mortality among persons with a history of psychosis and with substance use disorder. When controlling for age, comorbidity, stage at presentation and treatment, excess mortality risk among men with a history of psychosis was 1.72 (1.46-2.04) and women 1.37 (1.20-1.57). Among men with substance use disorder, the excess risk was 1.22 (1.09-1.37). CONCLUSION Understanding factors contributing to excess mortality among persons with a history of psychosis or substance use requires more detailed clinical studies and studies of care processes among these vulnerable patient groups. Collaboration between patients, mental health care and oncological teams is needed to improve outcomes of care.
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Affiliation(s)
- Kristiina Manderbacka
- Health and Social Systems Research Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Martti Arffman
- Health and Social Systems Research Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Sonja Lumme
- Health and Social Systems Research Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Suvisaari
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Ilmo Keskimäki
- Health and Social Systems Research Unit, National Institute for Health and Welfare, Helsinki, Finland
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | | | - Nea Malila
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
- Finnish Cancer Registry, Helsinki, Finland
| | - Eero Pukkala
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
- Finnish Cancer Registry, Helsinki, Finland
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18
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Huo T, Guo Y, Shenkman E, Muller K. Assessing the reliability of the short form 12 (SF-12) health survey in adults with mental health conditions: a report from the wellness incentive and navigation (WIN) study. Health Qual Life Outcomes 2018; 16:34. [PMID: 29439718 PMCID: PMC5811954 DOI: 10.1186/s12955-018-0858-2] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 02/05/2018] [Indexed: 12/11/2022] Open
Abstract
Background Although Short Form (SF)-12 × 2® has been extensively studied and used as a valid measure of health-related quality of life in a variety of population groups, no systematic studies have described the reliability of the measure in patients with behavioral conditions or serious mental illness (SMI). Methods and results We assessed the internal consistency, split-half reliability and annual test-retest correlations in a sample of 1587 participants with either a combination of physical and behavioral conditions or SMI. The Mosier’s alpha was 0.70 for the Physical Composite Scale (PCS) and 0.69 for the Mental Health Composite Scale (MCS), indicating good internal consistency. We observed strong correlations between physical functioning, physical role and body pain scales (r = 0.55–0.56), and between social functioning, emotional role, and mental health (r = 0.53–0.58). We calculated split-half reliabilities to be 0.74 for physical functioning, 0.75 for physical role, 0.73 for emotional role and 0.65 for mental health respectively. We assessed the annual test-retest correlation using intraclass correlation (ICC) and found an ICC of 0.61 for PCS and 0.57 for MCS composite scores, adjusting for age, sex, race/ethnicity, and CRG. We found no decline in the correlations between baseline and the following study years until year 3. Conclusions Our results encourage using SF-12v2® to assess health-related quality of life in the Medicaid population with combined physical and behavioral conditions or similar cohorts. Trial registration The WIN study was registered with clinicaltrials.gov on April 22, 2015. Trial registration number: NCT02440906. Retrospectively registered.
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Affiliation(s)
- Tianyao Huo
- Department of Health Outcomes and Biomedical Informatics, University of Florida, P.O. Box 100177, Gainesville, FL, 32610, USA.
| | - Yi Guo
- Department of Health Outcomes and Biomedical Informatics, University of Florida, P.O. Box 100177, Gainesville, FL, 32610, USA
| | - Elizabeth Shenkman
- Department of Health Outcomes and Biomedical Informatics, University of Florida, P.O. Box 100177, Gainesville, FL, 32610, USA
| | - Keith Muller
- Department of Health Outcomes and Biomedical Informatics, University of Florida, P.O. Box 100177, Gainesville, FL, 32610, USA
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19
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Evers SS, Boersma GJ, Tamashiro KL, Scheurink AJ, van Dijk G. Roman high and low avoidance rats differ in their response to chronic olanzapine treatment at the level of body weight regulation, glucose homeostasis, and cortico-mesolimbic gene expression. J Psychopharmacol 2017; 31:1437-1452. [PMID: 28892416 DOI: 10.1177/0269881117724749] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Olanzapine, an antipsychotic agent mainly used for treating schizophrenia, is frequently associated with body weight gain and diabetes mellitus. Nonetheless, studies have shown that not every individual is equally susceptible to olanzapine's weight-gaining effect. Therefore, Roman high and low avoidance rat strains were examined on their responsiveness to olanzapine treatment. The Roman high avoidance rat shares many behavioral and physiological characteristics with human schizophrenia, such as increased central dopaminergic sensitivity, whereas the Roman low avoidance rat has been shown to be prone to diet-induced obesity and insulin resistance. The data revealed that only the Roman high avoidance rats are susceptible to olanzapine-induced weight gain and attenuated glucose tolerance. Here it is suggested that the specific olanzapine-induced weight gain in Roman high avoidance rats could be related to augmented dopaminergic sensitivity at baseline through increased expression of prefrontal cortex dopamine receptor D1 mRNA and nucleus accumbens dopamine receptor D2 mRNA expression. Regression analyses revealed that olanzapine-induced weight gain in the Roman high avoidance rat is above all related to increased prolactin levels, whereas changes in glucose homeostasis is best explained by differences in central dopaminergic receptor expressions between strains and treatment. Our data indicates that individual differences in dopaminergic receptor expression in the cortico-mesolimbic system are related to susceptibility to olanzapine-induced weight gain.
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Affiliation(s)
- Simon S Evers
- 1 Department of Behavioral Neurosciences, University of Groningen, Nijenborgh, the Netherlands.,2 Department of Surgery, University of Michigan, Michigan, USA
| | - Gretha J Boersma
- 3 Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, USA.,4 Department of Medical Sciences, Clinical Diabetology and Metabolism, University of Uppsala, Uppsala, Sweden
| | - Kellie Lk Tamashiro
- 3 Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, USA
| | - Anton Jw Scheurink
- 1 Department of Behavioral Neurosciences, University of Groningen, Nijenborgh, the Netherlands
| | - Gertjan van Dijk
- 1 Department of Behavioral Neurosciences, University of Groningen, Nijenborgh, the Netherlands
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20
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Lloyd H, Lloyd J, Fitzpatrick R, Peters M. The role of life context and self-defined well-being in the outcomes that matter to people with a diagnosis of schizophrenia. Health Expect 2017; 20:1061-1072. [PMID: 28370942 PMCID: PMC5600238 DOI: 10.1111/hex.12548] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2017] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Conduct a deep exploration of the outcomes that matter to people with a diagnosis of schizophrenia and understand from their perspective how these outcomes can be achieved. SAMPLE AND METHODS In-depth qualitative interviews were conducted with 22 people with a diagnosis of schizophrenia. Interviews were analysed using thematic frameworks, and a realist informed theories of change approach. RESULTS Our study revealed the potential causal relationships between the context of a person's life, short-term goals and long-term outcomes. We provide a nuanced and detailed exploration of outcomes that matter for people with schizophrenia in relation to self-defined well-being. Achieving life milestones, feeling safe and outcomes related to improved physical health along with employment, a positive sense of self and psychosocial outcomes, were highly valued. For short- and long-term outcomes to be achieved, individuals required medication with minimal side-effects, cognitive behavioural therapy, family/social support and meaningful activities in their lives. Well-being was influenced by life context and short- and long-term outcomes, but in a circular nature also framed what short-term goals could be achieved. CONCLUSIONS Working with people with a diagnosis of schizophrenia to identify and achieve better outcomes will necessitate a person-centred approach. This will require an appreciation of the relationship between the statutory and non-statutory resources that are available and a consideration of an individual's current well-being status. This approach acknowledges personal strengths and encourages ownership of goals and supports self-management.
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Affiliation(s)
- Helen Lloyd
- Peninsula Medical SchoolPlymouth UniversityDevonUK
| | - Joanne Lloyd
- School of PsychologySport and ExerciseStaffordshire UniversityStoke on TrentUK
| | - Ray Fitzpatrick
- Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Michele Peters
- Nuffield Department of Population HealthUniversity of OxfordOxfordUK
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21
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Cameron IM, Hamilton RJ, Fernie G, MacGillivray SA. Obesity in individuals with schizophrenia: a case controlled study in Scotland. BJPsych Open 2017; 3:254-256. [PMID: 29093827 PMCID: PMC5643876 DOI: 10.1192/bjpo.bp.116.003640] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 08/11/2017] [Accepted: 09/24/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Despite extensive clinical concern about rates of obesity in patients with schizophrenia, there is little evidence of the extent of this problem at a population level. AIMS To estimate levels of obesity in a national population sample by comparing patients with schizophrenia with matched controls. METHOD We calculated levels of obesity for each patient with schizophrenia from the national Primary Care Clinical Informatics Unit database (n=4658) matched with age, gender and neighbourhood controls. RESULTS We demonstrated a significant increased obesity hazard for the schizophrenia group using Cox regression analysis, with odds ratio (OR) of 1.94 (95% CI 1.81-2.10) (under the assumption of missing body mass index (BMI) indicating non-obesity) and OR=1.68 (95% CI 1.55-1.81) where no assumptions were made for missing BMI data. CONCLUSIONS People with schizophrenia are at increased risk of being obese compared with controls matched by age, gender and practice attended. Priority should be given to research which aims to reduce weight and increase activity in those with schizophrenia. DECLARATION OF INTEREST None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.
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Affiliation(s)
| | - Ross J Hamilton
- , MBCHB, DRCOG, MRCGP, FRCPsych, Consultant Psychiatrist (retired), NHS Grampian, UK
| | - Gordon Fernie
- , PhD, Trial Manager, University of Aberdeen, Aberdeen, UK
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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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Progressive cortical reorganisation: A framework for investigating structural changes in schizophrenia. Neurosci Biobehav Rev 2017; 79:1-13. [DOI: 10.1016/j.neubiorev.2017.04.028] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 04/26/2017] [Accepted: 04/26/2017] [Indexed: 12/27/2022]
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24
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Jahrami HA, Faris MAIE, Saif ZQ, Hammad LH. Assessing dietary and lifestyle risk factors and their associations with disease comorbidities among patients with schizophrenia: A case-control study from Bahrain. Asian J Psychiatr 2017; 28:115-123. [PMID: 28784363 DOI: 10.1016/j.ajp.2017.03.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 03/18/2017] [Accepted: 03/27/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Acquired dietary habits and lifestyle behaviors of patients with schizophrenia may affect their life expectancy, disease complications and prognosis. The objectives of the current study were to assess the dietary habits and other lifestyle behaviors for Bahraini patients with schizophrenia, and to determine their associations with different medical comorbidities. METHOD A case-control study was conducted during the period of March to December 2016. A sample of 120 cases were recruited from the Psychiatric Hospital, Bahrain and age-sex-matched with 120 controls. Controls were recruited from primary health centres, and were free from serious mental illness. Dietary habits and lifestyle behaviors including smoking, alcohol intake and physical activity were assessed using a questionnaire. All medical records were reviewed retrospectively. Logistic regression analysis was used to identify dietary and lifestyle risk factors that are associated with one or more disease comorbidities. RESULTS Cases had higher prevalence of smoking and alcohol intake, excessive dietary intake, and decreased physical activity (all P<0.05) compared with controls. Cases appeared to be at higher risk for developing chronic medical conditions such as obesity, type 2 diabetes, hypertension, cardiovascular disease, and musculoskeletal disorders. Cases were three times more likely to have up to three or more medical comorbidities compared with controls. Excessive dietary intake and decreased physical activity were identified as the main risk factors. CONCLUSION Excessive caloric intake and decreased physical activity represent the main dietary and lifestyle risk factors associated with comorbidities among patients with schizophrenia in Bahrain.
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Affiliation(s)
- Haitham Ali Jahrami
- Psychiatric Hospital, Ministry of Health, Bahrain; College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Mo'ez Al-Islam Ezzat Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences/Sharjah Institute for Medical Research (SIMR), University of Sharjah, Sharjah, United Arab Emirates
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25
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Lloyd J, Lloyd H, Fitzpatrick R, Peters M. Treatment outcomes in schizophrenia: qualitative study of the views of family carers. BMC Psychiatry 2017; 17:266. [PMID: 28732482 PMCID: PMC5521073 DOI: 10.1186/s12888-017-1418-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 07/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schizophrenia is a complex, heterogeneous disorder, with highly variable treatment outcomes, and relatively little is known about what is important to patients. The aim of the study was to understand treatment outcomes informal carers perceive to be important to people with schizophrenia. METHOD Qualitative interview study with 34 individuals and 8 couples who care for a person with schizophrenia/schizoaffective disorder. Interviews were transcribed verbatim and analysed by a thematic framework based approach. RESULTS Carers described well-recognised outcomes of importance, alongside more novel outcomes relating to: Safety (of the patient/others); insight (e.g. into non-reality of psychotic phenomena); respite from fear, distress or pain; socially acceptable behaviour; getting out of the house; attainment of life milestones; changes in personality and/or temperament; reduction of vulnerability to stress; and several aspects of physical health. CONCLUSIONS These findings have the potential to inform the development of patient- or carer- focused outcome measures that take into account the full range of domains that carers feel are important for patients.
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Affiliation(s)
- Joanne Lloyd
- School of Psychology, Sport and Exercise, Staffordshire University, Stoke on Trent, UK
| | - Helen Lloyd
- Peninsula Medical School, Plymouth University, Plymouth, Devon UK
| | - Ray Fitzpatrick
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF UK
| | - Michele Peters
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF UK
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26
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Community Gardens as Health Promoters: Effects on Mental and Physical Stress Levels in Adults with and without Mental Disabilities. SUSTAINABILITY 2017. [DOI: 10.3390/su9010063] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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27
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Caris AV, Ysis W, Lemos VDA, Bottura R, Santos RVTD. Nutrition and exercise can attenuate inflammatory and psychobiological changes in hypoxia? Asian Pac J Trop Biomed 2017. [DOI: 10.1016/j.apjtb.2016.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Duncan MJ, Arbour-Nicitopoulos K, Subramanieapillai M, Remington G, Faulkner G. Revisiting the International Physical Activity Questionnaire (IPAQ): Assessing physical activity among individuals with schizophrenia. Schizophr Res 2017; 179:2-7. [PMID: 27623360 DOI: 10.1016/j.schres.2016.09.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 08/31/2016] [Accepted: 09/04/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Individuals with schizophrenia tend to have low levels of physical activity (PA) which contributes to high rates of physical comorbidities. Valid and reliable methods of assessing PA are essential for advancing health research. Ten years after initial validation of the Short-Form International Physical Activity Questionnaire (IPAQ), this study expands on the initial validation study by examining retest reliability over a 4-week period, assessing validity with a larger sample, and comparing validity of the IPAQ to a 24-hour recall alternative. METHODS Participants completed the IPAQ at baseline and 4weeks later, along with a 24-hour PA recall at week 4. At week 3 participants wore waist accelerometers for 7days. Spearman's correlation coefficients and Bland-Altman plots were calculated based on weekly minutes of moderate to vigorous PA (MVPA). RESULTS Test-retest reliability for the self-administered IPAQ was ρ=0.47, p<0.001 for MVPA. Correlation between IPAQ assessment and accelerometer-determined MVPA was ρ=0.30, p=0.003. The 24-hour recall correlated significantly with MVPA on the previous day ρ=0.27, p=0.012. A Bland-Altman plot indicated the IPAQ-SF underreported by -119.2min (-72%) on average compared to accelerometry (95% limits of agreement -1017.1 to 778.7min, -292% to 147%). CONCLUSION Compared to previous IPAQ validation work in this population, criterion validity was similar, but reliability was lower over a 4-week period. MVPA criterion validity of the 24-hour recall was comparable to the 7-day self-report IPAQ. Findings further support that the IPAQ is a suitable assessment tool for epidemiological studies. Objective measures of physical activity are recommended for intervention assessment.
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Affiliation(s)
| | | | | | - Gary Remington
- University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Guy Faulkner
- University of British Columbia, Vancouver, BC, Canada
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Firth J, Rosenbaum S, Stubbs B, Gorczynski P, Yung AR, Vancampfort D. Motivating factors and barriers towards exercise in severe mental illness: a systematic review and meta-analysis. Psychol Med 2016; 46:2869-2881. [PMID: 27502153 PMCID: PMC5080671 DOI: 10.1017/s0033291716001732] [Citation(s) in RCA: 254] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 06/23/2016] [Accepted: 06/24/2016] [Indexed: 12/23/2022]
Abstract
Exercise can improve clinical outcomes in people with severe mental illness (SMI). However, this population typically engages in low levels of physical activity with poor adherence to exercise interventions. Understanding the motivating factors and barriers towards exercise for people with SMI would help to maximize exercise participation. A search of major electronic databases was conducted from inception until May 2016. Quantitative studies providing proportional data on the motivating factors and/or barriers towards exercise among patients with SMI were eligible. Random-effects meta-analyses were undertaken to calculate proportional data and 95% confidence intervals (CI) for motivating factors and barriers toward exercise. From 1468 studies, 12 independent studies of 6431 psychiatric patients were eligible for inclusion. Meta-analyses showed that 91% of people with SMI endorsed 'improving health' as a reason for exercise (N = 6, n = 790, 95% CI 80-94). Among specific aspects of health and well-being, the most common motivations were 'losing weight' (83% of patients), 'improving mood' (81%) and 'reducing stress' (78%). However, low mood and stress were also identified as the most prevalent barriers towards exercise (61% of patients), followed by 'lack of support' (50%). Many of the desirable outcomes of exercise for people with SMI, such as mood improvement, stress reduction and increased energy, are inversely related to the barriers of depression, stress and fatigue which frequently restrict their participation in exercise. Providing patients with professional support to identify and achieve their exercise goals may enable them to overcome psychological barriers, and maintain motivation towards regular physical activity.
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Affiliation(s)
- J. Firth
- Institute of Brain, Behaviour and Mental
Health, University of Manchester,
UK
| | - S. Rosenbaum
- Department of Exercise Physiology,
School of Medical Sciences, Faculty of
Medicine, University of New South Wales,
Australia
| | - B. Stubbs
- Physiotherapy Department,
South London and Maudsley NHS Foundation Trust,
UK
- Health Service and Population Research
Department, Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
UK
| | - P. Gorczynski
- Department of Sport and Exercise
Science, University of Portsmouth,
UK
| | - A. R. Yung
- Institute of Brain, Behaviour and Mental
Health, University of Manchester,
UK
- Orygen Youth Health Research Centre,
University of Melbourne, Australia
| | - D. Vancampfort
- KU Leuven Department of Rehabilitation
Sciences, Leuven, Belgium
- KU Leuven Department of Neurosciences,
UPC KU Leuven, Belgium
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McCloughen A, Foster K, Kerley D, Delgado C, Turnell A. Physical health and well-being: Experiences and perspectives of young adult mental health consumers. Int J Ment Health Nurs 2016; 25:299-307. [PMID: 26856981 DOI: 10.1111/inm.12189] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 09/04/2015] [Accepted: 09/10/2015] [Indexed: 11/29/2022]
Abstract
Compromised physical health and raised levels of morbidity and mortality are experienced by young people (16-24 years) with mental illness, and are compounded by psychotropic medication. How this group conceives and experiences physical health is not well understood. We investigated the meanings, beliefs, and endeavours of young people that impact their physical health understandings and behaviours. The present study formed the qualitative phase of a sequential mixed-methods study, and incorporated semistructured interviews with 12 hospitalized young people. Qualitative content analysis was used to analyse data. Participants held a holistic ideal of physical health that they did not meet. Weight change, poor sleep, and limited exercise adversely impacted their lives and self-image. Sedentary behaviour, reduced energy, and limited health literacy compromised effective management of physical health. Young people needed structure and support to assist them in addressing their physical health needs when amotivation overwhelmed their internal resources. Nurses are well placed to help young people increase their competency for health management. Individualized information and methods to promote good physical health are required for this group in jeopardy from physical morbidity and mortality.
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Affiliation(s)
| | - Kim Foster
- Disciplines of Nursing and Midwifery, University of Canberra
| | - David Kerley
- Mental Health Service, Sydney Local Health District
| | - Cynthia Delgado
- Sydney Nursing School.,Sydney Local Health District, Sydney, New South Wales
| | - Adrienne Turnell
- School of Psychology, University of Sydney.,School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
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Trainor K, Leavey G. Barriers and Facilitators to Smoking Cessation Among People With Severe Mental Illness: A Critical Appraisal of Qualitative Studies. Nicotine Tob Res 2016; 19:14-23. [PMID: 27613905 DOI: 10.1093/ntr/ntw183] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 07/12/2016] [Indexed: 11/13/2022]
Abstract
BACKGROUND People with severe mental illness (PWSMI) die 15-20 years earlier than people in the general population and this is often due to preventable smoking-related health conditions. Studies that identify barriers and facilitators to smoking cessation are crucial for policy makers and health care professionals. AIMS This appraisal aims to identify and critically appraise qualitative studies which explore smoking experiences and barriers to smoking cessation among PWSMI. METHOD Articles were retrieved from electronic health related databases including Web of Science, Scopus, PubMed, Sage, Biomed, Medline, Embase, and electronic hand searches of bibliographies from key articles. RESULTS Eleven papers were identified. Although the overall quality of studies were sufficient, most had limited information relating to trustworthiness and sociodemographic details. Cost savings and health benefits were frequently cited as facilitators to quitting, however may be of limited impact as smoking for existential purposes, social inclusion, and mental health management appear to be considered highly important among PWSMI. CONCLUSIONS Findings were restricted to predominantly individual barriers to smoking cessation which may be more resistant to change as service users rely on smoking to manage their mental health and smoking is embedded in the culture of mental health settings. IMPLICATIONS This critical appraisal identifies qualitative evidence regarding which factors facilitate or prevent individuals with severe mental illness from engaging with smoking cessation. Healthcare professionals and policy makers should address external barriers to quitting smoking as this may increase participation in intervention studies, inform policy and assist in the development of a feasible and acceptable smoking cessation intervention among PWSMI. Methodological considerations highlight that future research should include sociodemographic and contextual factors to improve utility and applicability of findings.
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Affiliation(s)
- Katie Trainor
- Department of Health and Life Sciences, University of Ulster, Faculty of Life and Health Sciences, Coleraine, UK; .,The Bamford Centre for Mental Health and Wellbeing, University of Ulster Faculty of Life and Health Sciences, Coleraine, UK
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Investigating causality in the association between 25(OH)D and schizophrenia. Sci Rep 2016; 6:26496. [PMID: 27215954 PMCID: PMC4877705 DOI: 10.1038/srep26496] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 05/03/2016] [Indexed: 01/08/2023] Open
Abstract
Vitamin D deficiency is associated with increased risk of schizophrenia. However, it is not known whether this association is causal or what the direction of causality is. We performed two sample bidirectional Mendelian randomization analysis using single nucleotide polymorphisms (SNPs) robustly associated with serum 25(OH)D to investigate the causal effect of 25(OH)D on risk of schizophrenia, and SNPs robustly associated with schizophrenia to investigate the causal effect of schizophrenia on 25(OH)D. We used summary data from genome-wide association studies and meta-analyses of schizophrenia and 25(OH)D to obtain betas and standard errors for the SNP-exposure and SNP-outcome associations. These were combined using inverse variance weighted fixed effects meta-analyses. In 34,241 schizophrenia cases and 45,604 controls, there was no clear evidence for a causal effect of 25(OH)D on schizophrenia risk. The odds ratio for schizophrenia per 10% increase in 25(OH)D conferred by the four 25(OH)D increasing SNPs was 0.992 (95% CI: 0.969 to 1.015). In up to 16,125 individuals with measured serum 25(OH)D, there was no clear evidence that genetic risk for schizophrenia causally lowers serum 25(OH)D. These findings suggest that associations between schizophrenia and serum 25(OH)D may not be causal. Therefore, vitamin D supplementation may not prevent schizophrenia.
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Efficacy of Baduanjin Exercise and Feasibility of Mobile Text Reminders on Follow-up Participation in People With Severe Mental Illness: An Exploratory Study. J Psychiatr Pract 2016; 22:241-9. [PMID: 27123805 DOI: 10.1097/pra.0000000000000158] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND People with severe mental illness (SMI) frequently have poor physical health, which can in part be related to a low level of physical activity. The goal of this exploratory study was to examine the efficacy of a group participating in Baduanjin (a type of traditional Chinese exercise) on the health of individuals with SMI and the feasibility/acceptability of using short message service (SMS) reminder strategies to prompt continued exercise during a follow-up period. METHOD Participants (N=11) participated in a Baduanjin group session for 8 weeks and then maintained home-based Baduanjin with SMS reminders for another 8 weeks. Physical and psychological tests were administered to participants. RESULTS Significant improvements were found in balance and processing speed and in some domains of the 36-Item Short Form Health Survey (SF-36) after the Baduanjin program. Participants were able to maintain engagement in 80% of the expected practice time during the follow-up period. The acceptability of strategies to support home-based exercise, including SMS reminders, was high. CONCLUSIONS This preliminary study suggested the efficacy of Baduanjin and the feasibility of SMS reminders in maintaining follow-up participation in people with SMI. Future studies using a larger sample size and a control group are needed to confirm the findings.
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Vera-Garcia E, Mayoral-Cleries F, Vancampfort D, Stubbs B, Cuesta-Vargas AI. A systematic review of the benefits of physical therapy within a multidisciplinary care approach for people with schizophrenia: An update. Psychiatry Res 2015; 229:828-39. [PMID: 26254795 DOI: 10.1016/j.psychres.2015.07.083] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 06/15/2015] [Accepted: 07/30/2015] [Indexed: 11/25/2022]
Abstract
This systematic review summarizes the most recent evidence from randomized controlled trials (RCTs) considering the effectiveness of physical therapy interventions (aerobic exercises, strength exercises, relaxation training, basic body awareness exercises, or a combination of these) within the multidisciplinary management of schizophrenia. Two authors searched PubMed, PsycINFO, EMBASE, Web of Science, Physiotherapy Evidence Database (PEDro), and the Cochrane Library considering RCTs published from July 1, 2011-October 1, 2014. Thirteen RCTs representing 549 participants met the inclusion criteria. Overall, the results demonstrate that aerobic exercise significantly reduces psychiatric symptoms, potentially improves mental and physical quality of life and reduces metabolic risk and weight. Specifically, yoga reduces psychiatric symptoms, whilst Tai-chi and progressive muscle relaxation may also have benefits to patients. Two RCTs reported on adverse events. No adverse event was observed supporting the notion that physical therapy is safe in people with schizophrenia. There was considerable heterogeneity in the design, implementation and outcomes in the included studies precluding a meaningful meta-analysis. In general, the quality of physical therapy RCTS is improving and current research demonstrates that physical therapy approaches are valuable interventions and can help improve the psychiatric, physical and quality of life of people with schizophrenia.
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Affiliation(s)
- Elisa Vera-Garcia
- Hospital Regional Universitario de Malaga, Departamento de Salud Mental, Malaga Spain. Instituto de Biomedicina de Málaga (IBIMA), Spain; Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Cátedra de Fisioterapia y Discapacidad, Instituto de Biomedicina de Málaga (IBIMA), Grupo de Clinimetria (FE-14), Spain
| | - Fermín Mayoral-Cleries
- Hospital Regional Universitario de Malaga, Departamento de Salud Mental, Malaga Spain. Instituto de Biomedicina de Málaga (IBIMA), Spain
| | - Davy Vancampfort
- University of Leuven, Department of Rehabilitation Sciences, Belgium
| | - Brendon Stubbs
- University of Greenwich, School of Health and Social Care, UK
| | - Antonio I Cuesta-Vargas
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Cátedra de Fisioterapia y Discapacidad, Instituto de Biomedicina de Málaga (IBIMA), Grupo de Clinimetria (FE-14), Spain.
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Firth J, Cotter J, Elliott R, French P, Yung AR. A systematic review and meta-analysis of exercise interventions in schizophrenia patients. Psychol Med 2015; 45:1343-1361. [PMID: 25650668 DOI: 10.1017/s0033291714003110] [Citation(s) in RCA: 350] [Impact Index Per Article: 38.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The typically poor outcomes of schizophrenia could be improved through interventions that reduce cardiometabolic risk, negative symptoms and cognitive deficits; aspects of the illness which often go untreated. The present review and meta-analysis aimed to establish the effectiveness of exercise for improving both physical and mental health outcomes in schizophrenia patients. METHOD We conducted a systematic literature search to identify all studies that examined the physical or mental effects of exercise interventions in non-affective psychotic disorders. Of 1581 references, 20 eligible studies were identified. Data on study design, sample characteristics, outcomes and feasibility were extracted from all studies and systematically reviewed. Meta-analyses were also conducted on the physical and mental health outcomes of randomized controlled trials. RESULTS Exercise interventions had no significant effect on body mass index, but can improve physical fitness and other cardiometabolic risk factors. Psychiatric symptoms were significantly reduced by interventions using around 90 min of moderate-to-vigorous exercise per week (standardized mean difference: 0.72, 95% confidence interval -1.14 to -0.29). This amount of exercise was also reported to significantly improve functioning, co-morbid disorders and neurocognition. CONCLUSIONS Interventions that implement a sufficient dose of exercise, in supervised or group settings, can be feasible and effective interventions for schizophrenia.
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Affiliation(s)
- J Firth
- Institute of Brain, Behaviour and Mental Health, University of Manchester,UK
| | - J Cotter
- Institute of Brain, Behaviour and Mental Health, University of Manchester,UK
| | - R Elliott
- Institute of Brain, Behaviour and Mental Health, University of Manchester,UK
| | - P French
- Psychosis Research Unit, Greater Manchester West NHS Mental Health Trust,UK
| | - A R Yung
- Institute of Brain, Behaviour and Mental Health, University of Manchester,UK
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36
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McCloughen A, Foster K, Marabong N, Miu D, Fethney J. Physical Health Risk Behaviours in Young People with Mental Illness. Issues Ment Health Nurs 2015; 36:781-90. [PMID: 26514256 DOI: 10.3109/01612840.2015.1036480] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Comorbid physical health conditions, commonly associated with mental illness, contribute to increased morbidity and reduced life expectancy. The trajectory to poorer health begins with the onset of mental illness. For young people with mental illness, health risk behaviours and poor physical health can progress to adulthood with long-term detrimental impacts. Using a cross-sectional survey design, self-reported health risk behaviours were gathered from 56 young (16-25 years) Australians who had been hospitalised for mental illness and taking psychotropic medication. Smoking, alcohol use, minimal physical activity, and lack of primary health care were evident. While these behaviours are typical of many young people, those with mental illness have substantially increased vulnerability to poor health and reduced life expectancy. Priority needs to be given to targeted health promotion strategies for young people with mental illness to modify their risky long-term health behaviours and improve morbidity and mortality outcomes. Nurses in mental health settings play a vital role in promoting young peoples' well-being and preventing poorer physical health outcomes. Implementation of a cardiometabolic health nurse role in inpatient settings for young people with mental illness could facilitate prevention and early intervention for health risk behaviours.
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Affiliation(s)
| | - Kim Foster
- b University of Canberra, Faculty of Health, Disciplines of Nursing and Midwifery , Canberra , Australia
| | - Nikka Marabong
- c South Western Sydney Local Health District, Campbelltown Hospital , Sydney , Australia
| | - David Miu
- c South Western Sydney Local Health District, Campbelltown Hospital , Sydney , Australia
| | - Judith Fethney
- a University of Sydney, School of Nursing , Sydney , Australia
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Behan C, Doyle R, Masterson S, Shiers D, Clarke M. A double-edged sword: review of the interplay between physical health and mental health. Ir J Med Sci 2014; 184:107-12. [PMID: 25342160 DOI: 10.1007/s11845-014-1205-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 09/27/2014] [Indexed: 01/22/2023]
Abstract
It is widely acknowledged that there is interplay between physical and mental health, with causality in both directions. A common theme across countries is the uncertainty surrounding who should act as gatekeeper for physical health matters in psychiatry. Much of the metabolic monitoring is carried out by psychiatrists who often feel ill equipped to treat medical problems such as abnormal cholesterol or disturbances of glucose metabolism. However many patients do not attend primary care on a regular basis and may not be likely to follow through on referral to primary care. This review aims to examine the interplay between co-morbid physical and mental health conditions, identify the physical health conditions particularly associated with severe affective and psychotic illness and briefly discuss interventions and recommendations in this area. As people with severe mental illness die 10-20 years younger than their peers, with much of this premature mortality due to cardiovascular disease, this topic is emerging as one of great importance amongst clinicians and policymakers internationally.
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Affiliation(s)
- C Behan
- DETECT Early Intervention Service in Psychosis, Dublin, Ireland,
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38
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Wearden A. Health behaviour interventions should not neglect people with serious mental health problems. Br J Health Psychol 2014; 19:683-7. [PMID: 25293830 DOI: 10.1111/bjhp.12117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Alison Wearden
- School of Psychological Sciences and Manchester Centre for Health Psychology, University of Manchester, UK
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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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Stubbs B, Soundy A, Probst M, Parker A, Skjaerven LH, Lundvik Gyllensten A, Vancampfort D. Addressing the disparity in physical health provision for people with schizophrenia: an important role for physiotherapists. Physiotherapy 2014; 100:185-6. [DOI: 10.1016/j.physio.2013.11.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 11/08/2013] [Indexed: 12/23/2022]
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Stubbs B, Probst M, Soundy A, Parker A, De Herdt A, De Hert M, Mitchell AJ, Vancampfort D. Physiotherapists can help implement physical activity programmes in clinical practice. Br J Psychiatry 2014; 204:164. [PMID: 24493657 DOI: 10.1192/bjp.204.2.164] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Arbour-Nicitopoulos KP, Duncan M, Remington G, Cairney J, Faulkner GE. Development and Reliability Testing of a Health Action Process Approach Inventory for Physical Activity Participation among Individuals with Schizophrenia. Front Psychiatry 2014; 5:68. [PMID: 24959152 PMCID: PMC4051131 DOI: 10.3389/fpsyt.2014.00068] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 05/26/2014] [Indexed: 11/25/2022] Open
Abstract
Individuals with schizophrenia tend to have high levels of cardiovascular disease and lower physical activity (PA) levels than the general population. Research is urgently required in developing evidence-based behavioral interventions for increasing PA in this population. One model that has been increasingly used to understand the mechanisms underlying PA is the health action process approach (HAPA). The purpose of this study was to adapt and pilot-test a HAPA-based inventory that reliably captures salient, modifiable PA determinants for individuals with schizophrenia. Initially, 12 outpatients with schizophrenia reviewed the inventory and provided verbal feedback regarding comprehension, item relevance, and potential new content. A content analysis framework was used to inform modifications to the inventory. The resultant inventory underwent a quantitative assessment of internal consistency and test-retest reliability. Twenty-five outpatients (M age = 41.5 ± 13.5 years; 64% male) completed the inventory on two separate occasions, 1 week apart. All but two scales showed good internal consistency (Cronbach's α = 0.62-0.98) and test-retest correlations (rs = 0.21-0.96). Preliminary assessment of criterion validity of the HAPA inventory showed significant, large-sized correlations between behavioral intentions and both affective outcome expectancies and task self-efficacy, and small to moderate correlations between self-reported minutes of moderate-to-vigorous PA and the volitional constructs of the HAPA model. These findings provide preliminary support for the reliability and validity of the first-ever inventory for examining theory-based predictors of moderate-to-vigorous PA intentions and behavior among individuals with schizophrenia. Further validation research with this inventory using an objective measure of PA behavior will provide additional support for its psychometric properties within the schizophrenia population.
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Affiliation(s)
- Kelly P Arbour-Nicitopoulos
- Faculty of Kinesiology and Physical Education, University of Toronto , Toronto, ON , Canada ; Bloorview Research Institute , Toronto, ON , Canada
| | - Markus Duncan
- Faculty of Kinesiology and Physical Education, University of Toronto , Toronto, ON , Canada
| | - Gary Remington
- Schizophrenia Program, Centre for Addiction and Mental Health , Toronto, ON , Canada ; Faculty of Medicine, University of Toronto , Toronto, ON , Canada
| | - John Cairney
- Department of Medicine, McMaster University , Hamilton, ON , Canada ; Department of Psychiatry and Behavioural Neuroscience, McMaster University , Hamilton, ON , Canada
| | - Guy E Faulkner
- Faculty of Kinesiology and Physical Education, University of Toronto , Toronto, ON , Canada ; Schizophrenia Program, Centre for Addiction and Mental Health , Toronto, ON , Canada
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