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Hui TT, Garvey L, Olasoji M. Perspectives of mental health clinicians on physical health of young people with early psychosis. Int J Ment Health Nurs 2024; 33:649-659. [PMID: 38012093 DOI: 10.1111/inm.13268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/31/2023] [Accepted: 11/15/2023] [Indexed: 11/29/2023]
Abstract
The aim of this study is to explore the views and understanding of youth mental health clinicians with regard to the physical health of young people with early psychosis and their perspectives on lifestyle interventions improving the health and well-being of young people with early psychosis. Physical health disparities leading to premature mortality among people with mental illness are well evident in the literature. Mental health and physical health are directly correlated. The risk of poor physical health often begins before the onset of mental ill health. Young people with early psychosis are highly susceptible to poor physical health. A co-designed integrated approach focusing on early prevention and intervention in overall well-being and health is imminent for this targeted population to prevent poor physical health trajectory across the lifespan. Ten clinicians were recruited and participated in this study through semi-structured interviews. Five themes were identified: (i) Impact of early psychosis, (ii) Focus of care, (iii) Conversations around physical health, (iv) Co-location of specialist roles and (v) Health literacy. The findings of this study confirm the dimensional impact of early psychosis on the well-being and health of young people through the vicious cycle of early psychosis. Promotion of health literacy along with social connectedness and elements of self-determination, as well as having a prime focus on the individuals' experience in the journey of health promotion through participation in lifestyle interventions, has been identified as critically prominent.
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Affiliation(s)
- Ting Ting Hui
- Federation University Australia, Berwick, Victoria, Australia
- Alfred Hospital, Melbourne, Victoria, Australia
| | - Loretta Garvey
- Federation University Australia, Berwick, Victoria, Australia
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology Australia, Hawthorn, Victoria, Australia
| | - Michael Olasoji
- Federation University Australia, Berwick, Victoria, Australia
- Alfred Hospital, Melbourne, Victoria, Australia
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Andersen MF, Roed K, Sørensen V, Riis A, Rafn BS, Ebdrup BH, Midtgaard J. Required elements for an educational programme for lay exercise instructors in charge of community-based exercise targeting young adults with schizophrenia spectrum disorders - A stakeholder focus group study. BMC Psychiatry 2024; 24:228. [PMID: 38532355 PMCID: PMC10967036 DOI: 10.1186/s12888-024-05648-9] [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: 08/10/2023] [Accepted: 02/28/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Exercise plays a crucial role in addressing the increased cardiometabolic morbidity and premature mortality in people with schizophrenia spectrum disorders. When delivered in community-based settings, exercise may also reduce loneliness, while promoting overall physical activity behaviours. Skilled instructors are essential to deliver effective community-based exercise; however, knowledge about their roles and required training is lacking. We aim to explore various stakeholders' perspectives regarding lay exercise instructors' roles, and the required elements in an educational programme supporting the delivery of community-based exercise for young adults with SSD. METHODS We used semi-structured homogeneous focus groups with representatives from different stakeholder groups (i.e., including representatives of clinical staff within mental health, physiotherapists, exercise instructors, young adults with schizophrenia spectrum disorders, and relatives of individuals with schizophrenia spectrum disorders) targeted or affected by a community-based exercise intervention. Data were analysed using qualitative content analysis. RESULTS We conducted six focus groups comprising a total of 30 individuals representing five different stakeholder groups The analysis identified three categories: (i) awareness and understanding of mental illness, i.e., providing basic knowledge to dispel common myths and stigma regarding mental illness (ii) protecting youth identity, i.e., supporting the feeling of being more than just a patient, and (iii) promoting exercise as a shared activity, i.e., a communal pursuit, fostering personal growth among participants, their peers and the instructors. CONCLUSIONS An educational programme for lay exercise instructors delivering community-based exercise targeting young adults with SSD should empower the instructors to assume the role of guardians of an inclusive exercise culture. Educational elements identified were adapted and integrated into an educational programme implemented and evaluated as a part of the Vega trial. Our results may be transferable to the education of lay workers in mental health care where the aim is to facilitate sustainable, recreational, community-based activities.
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Affiliation(s)
- Martin Færch Andersen
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark.
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark.
| | - Kickan Roed
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Victor Sørensen
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Allan Riis
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
- Center for General Practice, Aalborg University, Aalborg, Denmark
| | - Bolette Skjødt Rafn
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
- Late Effects Research Center (CASTLE), Department of Oncology, Danish Cancer Society National Cancer Survivorship, Copenhagen University Hospital- Rigshospitalet, Copenhagen, Denmark
| | - Bjørn Hylsebeck Ebdrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Faculty of Health and Medical Science, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Julie Midtgaard
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Science, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Damme KSF, Gupta T, Ristanovic I, Kimhy D, Bryan AD, Mittal VA. Exercise Intervention in Individuals at Clinical High Risk for Psychosis: Benefits to Fitness, Symptoms, Hippocampal Volumes, and Functional Connectivity. Schizophr Bull 2022; 48:1394-1405. [PMID: 35810336 PMCID: PMC9673264 DOI: 10.1093/schbul/sbac084] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS Individuals at clinical high risk for psychosis (CHR-p) are less fit than nonclinical peers and show hippocampal abnormalities that relate to clinical symptoms. Exercise generates hippocampal neurogenesis that may ameliorate these hippocampal abnormalities and related cognitive/clinical symptoms. This study examines the impact of exercise on deficits in fitness, cognitive deficits, attenuated psychotic symptoms, hippocampal volumes, and hippocampal connectivity in individuals at CHR-p. STUDY DESIGN In a randomized controlled trial, 32 individuals at CHR-p participated in either an exercise (n = 17) or waitlist (no exercise) (n = 15) condition. All participants were sedentary at use and absent of current antipsychotic medication, psychosis diagnoses, or a substance use disorder. The participants completed a series of fitness, cognitive tasks, clinical assessments, and an MRI session preintervention and postintervention. The exercise intervention included a high-intensity interval exercise (80% of VO2max) with 1-minute high-intensity intervals (95% of VO2max) every 10 minutes) protocol twice a week over 3 months. STUDY RESULTS The exercise intervention was well tolerated (83.78% retention; 81.25% completion). The exercising CHR-p group showed that improved fitness (pre/post-d = 0.53), increased in cognitive performance (pre/post-d = 0.49), decrease in positive symptoms (pre/post-d = 1.12) compared with the waitlist group. Exercising individuals showed stable hippocampal volumes; waitlist CHR-p individuals showed 3.57% decreased hippocampal subfield volume. Exercising individuals showed that increased exercise-related hippocampal connectivity compared to the waitlist individuals. CONCLUSIONS The exercise intervention had excellent adherence, and there were clear signs of mechanism engagement. Taken together, evidence suggests that high-intensity exercise can be a beneficial therapeutic tool in the psychosis risk period.
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Affiliation(s)
- Katherine S F Damme
- To whom correspondence should be addressed; Department of Psychology, Northwestern University, 2029 Sheridan Rd.Evanston, IL 60208, USA; tel: 402-890-3606, e-mail:
| | - Tina Gupta
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Ivanka Ristanovic
- Department of Psychology, Northwestern University, Evanston, IL, USA,Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL, USA
| | - David Kimhy
- Department of Psychology, Northwestern University, Evanston, IL, USA,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA,MIRECC, The James J. Peters VA Medical Center, Bronx, NY, USA
| | - Angela D Bryan
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA,Institute for Neuroscience, University of Colorado, Boulder, CO, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA,Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL, USA,Institute for Cognitive Science, University of Colorado, Boulder, CO, USA,Department of Psychiatry, Northwestern University, Chicago, IL, USA,Medical Social Sciences, Northwestern University, Chicago, IL, USA,Institute for Policy Research (IPR), Northwestern University, Chicago, IL, USA
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Fossati C, Torre G, Vasta S, Giombini A, Quaranta F, Papalia R, Pigozzi F. Physical Exercise and Mental Health: The Routes of a Reciprocal Relation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312364. [PMID: 34886090 PMCID: PMC8656946 DOI: 10.3390/ijerph182312364] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/15/2021] [Accepted: 11/22/2021] [Indexed: 01/18/2023]
Abstract
Sport participation and exercise practice are considered to be beneficial for mental status, yielding an improved mood and better quality of life. On the other hand, good mental fitness is thought to lead to better physical status and sport performance. The key aim of this narrative review is to provide an unstructured overview on the topic with special considerations on the role of mental and physical health to summarize the evidence on their reciprocal influence. While very few papers describe the role of mental health measures in affecting physical performance, more evidence is available concerning the effect of exercise and sport in improving mental health outcomes. Furthermore, there is a consistent role of depressive and anxiety symptoms in influencing the risk of sport injury in either recreational or elite athletes. Moreover, the importance of investigating mental health issues in elite and retired athletes is highlighted. On the basis of the available literature, several biases were found to affect the provided evidence mainly because of the complexity of a proper study design in this field.
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Affiliation(s)
- Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
| | - Guglielmo Torre
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (S.V.); (R.P.)
- Correspondence:
| | - Sebastiano Vasta
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (S.V.); (R.P.)
| | - Arrigo Giombini
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
| | - Federico Quaranta
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
| | - Rocco Papalia
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (S.V.); (R.P.)
| | - Fabio Pigozzi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
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Tong TK, Baker JS, Henriquez FL, Shi Q, Zhang H, Kong Z, Nie J. A Combined Approach for Health Assessment in Adolescent Endurance Runners. Healthcare (Basel) 2021; 9:healthcare9020163. [PMID: 33546247 PMCID: PMC7913343 DOI: 10.3390/healthcare9020163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/14/2021] [Accepted: 01/26/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND It has been shown that prolonged exhaustive exercise, such as half-marathon running, could lead to transient post-exercise elevation of cardiac troponins, increase in oxidative stress, and mild decline in renal function in adolescent athletes. With increases in sports participation involving young people, there has been much interest in pre and post health evaluations following exercise. Evaluations can be used to identify pre-existing health confounders and to examine any detrimental responses that may occur post exercise. Study purpose & Methods: The purpose of this study was to evaluate pre and post exercise measures of cardiac function, serum albumin, systemic immunoglobulin (Serum IgA and IgG), cortisol and testosterone in adolescent (age: 16.2 ± 0.6) male endurance runners performing in 21-km maximal run. RESULTS Results revealed that cortisol, IgA and IgG levels significantly decreased 2, 4, and 24 h post exercise compared to pre-exercise levels (p < 0.05). Testosterone levels reduced 4 h post exercise (p < 0.05) but were restored to baseline values following 24 h. There were no changes recorded for albumin levels post exercise (p > 0.05). ECG assessments did not show any abnormalities at the T wave axis, ST segments and Q wave pre or post exercise. CONCLUSIONS The findings from this study suggest that a single bout of prolonged maximum running is not likely to induce abnormal electrical activity in the heart, but does decrease serum immunoglobulin, and homeostasis of anabolic and catabolic hormones in trained adolescent endurance runners.
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Affiliation(s)
- Tomas K. Tong
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong 999077, China; (T.K.T.); (J.S.B.)
| | - Julien S. Baker
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong 999077, China; (T.K.T.); (J.S.B.)
| | - Fiona L. Henriquez
- Institute of Biomedical and Environmental Health, School of Science and Sport, University of the West of Scotland, Paisley PA1 2BE, UK;
| | - Qingde Shi
- School of Health Sciences and Sports, Macao Polytechnic Institute, Rua de Luis Gonzaga Gomes, Macao 999078, China;
| | - Haifeng Zhang
- College of Physical Education, Hebei Normal University, Shijiazhuang 050024, China;
| | - Zhaowei Kong
- Faculty of Education, University of Macau, Macao 999078, China;
| | - Jinlei Nie
- School of Health Sciences and Sports, Macao Polytechnic Institute, Rua de Luis Gonzaga Gomes, Macao 999078, China;
- Correspondence: ; Tel.: +853-8559-6832; Fax: +853-2851-8538
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