1
|
Korman N, Stanton R, Vecchio A, Chapman J, Parker S, Martland R, Siskind D, Firth J. The effect of exercise on global, social, daily living and occupational functioning in people living with schizophrenia: A systematic review and meta-analysis. Schizophr Res 2023; 256:98-111. [PMID: 37209456 DOI: 10.1016/j.schres.2023.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 03/28/2023] [Accepted: 04/19/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Schizophrenia is associated with high rates of global, social and occupational functional impairments. While prior meta-analyses have extensively examined the impact of exercise on physical and mental health, the impact on functioning in schizophrenia have yet to be fully established. This review aimed to update the evidence base regarding the impact of exercise on functioning in schizophrenia, and explore moderators of effect. METHODS A systematic search was conducted to identify randomized controlled trials (RCTs) of exercise evaluating global functioning versus any comparator in people with schizophrenia; between group meta-analyses of global functioning (and secondary - social, living skills, occupational, adverse events) were computed using a random effects model. Subgroup analyses based on diagnosis and aspects of the intervention were conducted. RESULTS 18 full text articles were included, involving 734 participants. A moderate impact of exercise on global functioning was found (g = 0.40, 95 % C·I. = 0.12 to 0.69, p = 0.006), with a moderate impact of exercise on social (N = 5, g = 0.54 95 % C.I = 0.16 to 0.9 p = 0.005), and daily living functioning (N = 3, g = 0.65, 95 % C.I. = 0.07 to 1.22, p = 0.005). CONCLUSIONS There is good evidence that exercise can improve the global functioning of people with schizophrenia, with preliminary evidence for social and daily living skills; exercise should be considered an important adjunct to usual care. Higher impacts on global functioning were seen in aerobic interventions and of at least moderate to vigorous intensity. More research is required into resistance training, in early psychosis cohorts and to evaluate the comparison of exercise with other established psychosocial therapies.
Collapse
Affiliation(s)
- Nicole Korman
- Addiction and Mental Health Services, Metro South Health Services, Australia; School of Medicine, University of Queensland, Brisbane, Australia.
| | - Robert Stanton
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Anna Vecchio
- Addiction and Mental Health Services, Metro South Health Services, Australia
| | - Justin Chapman
- Addiction and Mental Health Services, Metro South Health Services, Australia; Queensland Institute of Medical Research, Brisbane, Australia
| | - Stephen Parker
- Addiction and Mental Health Services, Metro South Health Services, Australia; School of Medicine, University of Queensland, Brisbane, Australia; The Prince Charles Hospital, Metro North Mental Health Services, Australia
| | - Rebecca Martland
- Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Dan Siskind
- Addiction and Mental Health Services, Metro South Health Services, Australia; School of Medicine, University of Queensland, Brisbane, Australia
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| |
Collapse
|
2
|
Bailey R, Bartlett YK, Hassan L, Armitage CJ, Stockton-Powdrell C, Machin M, Lewis S, Epton T. Acceptability of reducing sedentariness using a mobile-phone application based on 'if then' plans for people with psychosis: A focus-group study conducted in North West England, UK. Int J Soc Psychiatry 2022; 68:1100-1107. [PMID: 35670446 PMCID: PMC9310137 DOI: 10.1177/00207640221102733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To understand the acceptability of (a) reducing sedentary-behaviour in people with psychosis using 'if-then' plans and (b) the proposed app content. DESIGN Qualitative acceptability study. METHOD Three structured focus-groups and an interview were conducted with eight participants who had experience of a psychotic episode. They discussed sedentary-behaviour, being more active, critical situations in which they may be tempted to be sedentary and solutions to these (the if-then plans), and a mock-up of the mobile application. The Theoretical Framework of Acceptability (TFA) was used to analyse qualitatively the transcripts. RESULTS All TFA constructs were coded in each of the transcripts. The idea of reducing sedentary-behaviour was acceptable to people with psychosis, participants knew the importance of being more active, however it is not always their main priority. Likewise, the proposed content of the app was found to be acceptable, with participants already using some of the proposed solutions. CONCLUSION This was the first study to use the TFA framework to assess the acceptability of an app that uses critical situations and solutions ('if-then plans') to help reduce sedentary behaviour for people with psychosis. In this sample (male, English speaking mainly white people), participants understood the benefits of being more active. However, reducing sedentary-behaviour is not the main priority of this population and being sedentary has benefits when their mental-health is bad.
Collapse
Affiliation(s)
- Rachel Bailey
- Division of Psychology & Mental Health, Manchester Centre for Health Psychology, University of Manchester, Manchester, Greater Manchester, UK
| | - Y Kiera Bartlett
- Division of Psychology & Mental Health, Manchester Centre for Health Psychology, University of Manchester, Manchester, Greater Manchester, UK
| | - Lamiece Hassan
- Division of Psychology & Mental Health, University of Manchester, Manchester, Greater Manchester, UK
| | - Christopher J Armitage
- Division of Psychology & Mental Health, Manchester Centre for Health Psychology, University of Manchester, Manchester, Greater Manchester, UK.,Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, Greater Manchester, UK.,NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, Greater Manchester, UK
| | - Charlotte Stockton-Powdrell
- Division of Informatics, Imaging & Data Sciences, Centre for Health Informatics, University of Manchester, Manchester, Greater Manchester, UK
| | - Matthew Machin
- Division of Informatics, Imaging & Data Sciences, Centre for Health Informatics, University of Manchester, Manchester, Greater Manchester, UK
| | - Shon Lewis
- Greater Manchester Mental Health NHS Foundation Trust, Prestwich, Manchester, UK
| | - Tracy Epton
- Division of Psychology & Mental Health, Manchester Centre for Health Psychology, University of Manchester, Manchester, Greater Manchester, UK
| |
Collapse
|
3
|
Maharaj SS, Nuhu JM. Effect of treadmill walking for anxiety, depression and social well-being in women with diabetes type 2: A randomized controlled trial. Health Care Women Int 2022; 44:734-752. [PMID: 35763045 DOI: 10.1080/07399332.2022.2090566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Anxiety and depression are higher in persons with diabetes leading to poor glycaemic control and diabetes-related emotional distress. Some diabetic women do not engage in exercises perceiving it to make their diabetes worse. The researchers' objective of this treadmill walking program was to determine its effect on anxiety, depression and social well-being in women with diabetes type 2 (DT2). We randomized 49 sedentary women with DT2 into treadmill walking at moderate intensity of 40-60% of their age-adjusted maximal heart rate, three times per week on alternate days for 12 weeks. The control attended electronic lectures on diet, diabetes and mental health. The treadmill group had no adverse effects and their anxiety, depression and social well-being scores improved with no significant changes for the control. We offer women with DT2 an easy, safe indoors exercise preventing them from abuse from men, erratic drivers and extreme weather conditions with positive physiological responses.
Collapse
Affiliation(s)
- Sonill S. Maharaj
- Department of Physiotherapy, University of KwaZulu-Natal, Durban, South Africa
| | - Jibril M. Nuhu
- UKZN and Faculty of Allied Health Sciences, Department of Physiotherapy, Bayero University, Kano, Nigeria
| |
Collapse
|
4
|
Gyasi RM, Peprah P, Abass K, Pokua Siaw L, Dodzi Ami Adjakloe Y, Kofi Garsonu E, Phillips DR. Loneliness and physical function impairment: Perceived health status as an effect modifier in community-dwelling older adults in Ghana. Prev Med Rep 2022; 26:101721. [PMID: 35141124 PMCID: PMC8814641 DOI: 10.1016/j.pmedr.2022.101721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/03/2022] [Accepted: 01/23/2022] [Indexed: 11/01/2022] Open
Abstract
Background Methods Results Conclusions
Collapse
|
5
|
Abstract
OBJECTIVE While there is considerable current emphasis on youth and early psychosis, relatively little is known about the lives of people who live with psychotic disorders into middle age and beyond. We investigated social functioning, physical health status, substance use and psychiatric symptom profile in people with psychotic disorders aged between 50 and 65 years. METHODS Data were collected as part of the Survey of High Impact Psychosis, a population-based survey of Australians aged 18-65 years with a psychotic disorder. We compared those aged 50-65 years (N = 347) with those aged 18-49 years (N = 1478) across a range of measures. RESULTS The older group contained more women and more people with affective psychoses compared to the younger group. They were also more likely to have had a later onset and a chronic course of illness. The older group were more likely to have negative symptoms but less likely to exhibit positive symptoms; they also had lower current cognition, compared to the younger group. Compared to the younger group, the older group were more likely to be divorced/separated, to be living alone and to be unemployed. They had substantially lower lifetime use of alcohol and illicit substances, but rates of obesity, metabolic syndrome and diabetes mellitus were higher. CONCLUSION Our findings suggest that the characteristics of people with psychosis change significantly as they progress into the middle age and beyond. A better understanding of these differences is important in informing targeted treatment strategies for older people living with psychosis.
Collapse
Affiliation(s)
- Cherrie Galletly
- Interim Dean and Discipline of Psychiatry, Department of Medical Specialties, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Northern Adelaide Local Health Network (NALHN), Lyell McEwin Hospital, Adelaide, SA, Australia
- Ramsay Health Care (SA) Mental Health Services, The Adelaide Clinic, Gilberton, Australia
| | - Shuichi Suetani
- Physical and Mental Health Stream, Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia
- Metro South Addiction and Mental Health Services, Woolloongabba, QLD, Australia
- Department of Medicine, Griffith University, Nathan, QLD, Australia
| | - Lisa Hahn
- Ramsay Health Care (SA) Mental Health Services, The Adelaide Clinic, Gilberton, Australia
| | - Duncan McKellar
- Northern Adelaide Local Health Network (NALHN), Lyell McEwin Hospital, Adelaide, SA, Australia
- Office of the Chief Psychiatrist, SA Department of Health and Wellbeing, Adelaide, SA, Australia
| | - David Castle
- The University of Melbourne, Department of Psychiatry Melbourne, VIC, Australia
- St Vincent's Health Australia, Melbourne, VIC, Australia
- Scientific Director, Centre for Complex Interventions, Centre for Addictions and Mental Health; and Professor, Department of Psychiatry, University of Toronto, Toronto, Canada
| |
Collapse
|
6
|
Loneliness: An Immunometabolic Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212162. [PMID: 34831917 PMCID: PMC8618012 DOI: 10.3390/ijerph182212162] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 11/11/2021] [Accepted: 11/16/2021] [Indexed: 12/12/2022]
Abstract
Loneliness has been defined as an agonizing encounter, experienced when the need for human intimacy is not met adequately, or when a person’s social network does not match their preference, either in number or attributes. This definition helps us realize that the cause of loneliness is not merely being alone, but rather not being in the company we desire. With loneliness being introduced as a measurable, distinct psychological experience, it has been found to be associated with poor health behaviors, heightened stress response, and inadequate physiological repairing activity. With these three major pathways of pathogenesis, loneliness can do much harm; as it impacts both immune and metabolic regulation, altering the levels of inflammatory cytokines, growth factors, acute-phase reactants, chemokines, immunoglobulins, antibody response against viruses and vaccines, and immune cell activity; and affecting stress circuitry, glycemic control, lipid metabolism, body composition, metabolic syndrome, cardiovascular function, cognitive function and mental health, respectively. Taken together, there are too many immunologic and metabolic manifestations associated with the construct of loneliness, and with previous literature showcasing loneliness as a distinct psychological experience and a health determinant, we propose that loneliness, in and of itself, is not just a psychosocial phenomenon. It is also an all-encompassing complex of systemic alterations that occur with it, expanding it into a syndrome of events, linked through a shared network of immunometabolic pathology. This review aims to portray a detailed picture of loneliness as an “immunometabolic syndrome”, with its multifaceted pathology.
Collapse
|
7
|
Szortyka MF, Batista Cristiano V, Belmonte-de-Abreu P. Differential Physical and Mental Benefits of Physiotherapy Program Among Patients With Schizophrenia and Healthy Controls Suggesting Different Physical Characteristics and Needs. Front Psychiatry 2021; 12:536767. [PMID: 33633600 PMCID: PMC7900508 DOI: 10.3389/fpsyt.2021.536767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 01/15/2021] [Indexed: 11/18/2022] Open
Abstract
In contrast to several other severe illnesses marked by inflammation and autoimmunity that now have potent and efficient treatments and even cures, schizophrenia (SCZ) is a disease still associated with poor outcome, incapacity, and social burden. Even after decades of research on the brain and behavior, this illness is still associated with profound effects on both mental health and physical health, with recent studies showing that treatment is more efficient when associating drugs with psychological and physical treatments. Most of the studies measured the effects of physical intervention compared with usual care and demonstrated a positive effect as an add-on treatment. What remains unclear is the different effects of the same intervention in normal subjects in a sample of patients with the illness. The study aimed to evaluate the effects of physical intervention over motor functional capacity and mental health in patients with SCZ compared with healthy controls (HC). The outcomes were (a) functional capacity [by 6-min walk test (6MWT)], (b) body flexibility index (Wells' bench), (c) disease severity [by Brief Psychiatric Rating Scale (BPRS)], (d) quality of life [by 36-Item Short Form (SF-36) questionnaire], and (e) physical activity [Simple Physical Activity Questionnaire (SIMPAQ)]. The intervention was associated with significant decrease of body mass index (BMI), blood pressure, disease severity, and improvement in daily life activities. Unexpectedly, it was observed that schizophrenics, compared with matched HC, were at a lower level of performance in the beginning, remained below HC over the studied time despite similar physical intervention, and had different changes. The intervention had lower effects over physical capacity and better effects over quality of life and disease severity. The results confirm previous studies comparing patients receiving physical intervention but suggest that they may receive different types of intervention, suited for their different baseline fitness, motivation, and capacity to engage in physical effort over sustained time. Additionally, they point to extended time of intervention of multidisciplinary treatment (physical and psychological-cognitive techniques) to improve outcomes in SCZ.
Collapse
Affiliation(s)
- Michele Fonseca Szortyka
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil.,Schizophrenia Program of Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Viviane Batista Cristiano
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil.,Schizophrenia Program of Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Paulo Belmonte-de-Abreu
- Department of Psychiatry, Schizophrenia Program of the Federal University of Rio Grande Do Sul Medical School, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| |
Collapse
|
8
|
Badcock JC, Adery LH, Park S. Loneliness in psychosis: A practical review and critique for clinicians. ACTA ACUST UNITED AC 2020. [DOI: 10.1111/cpsp.12345] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
9
|
Madden DR, Lam CN, Redline B, Dzubur E, Rhoades H, Intille SS, Dunton GF, Henwood B. Real-Time Data Collection to Examine Relations Between Physical Activity and Affect in Adults With Mental Illness. JOURNAL OF SPORT & EXERCISE PSYCHOLOGY 2020; 42:386-393. [PMID: 33022657 PMCID: PMC8761482 DOI: 10.1123/jsep.2019-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 06/11/2023]
Abstract
Adults with serious mental illness engage in limited physical activity, which contributes to significant health disparities. This study explored the use of both ecological momentary assessments (EMAs) and activity trackers in adults with serious mental illness to examine the bidirectional relationship between activity and affect with multilevel modeling. Affective states were assessed up to seven times per day using EMA across 4 days. The participants (n = 20) were equipped with a waist-worn accelerometer to measure moderate to vigorous physical activity. The participants had a mean EMA compliance rate of 88.3%, and over 90% of completed EMAs were matched with 30-min windows of accelerometer wear. The participants who reported more positive affect than others had a higher probability of engaging in moderate to vigorous physical activity. Engaging in more moderate to vigorous physical activity than one's usual was associated with more negative affect. This study begins to address the effect of momentary mood on physical activity in a population of adults that is typically difficult to reach.
Collapse
Affiliation(s)
- Danielle R. Madden
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Chun Nok Lam
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Brian Redline
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Eldin Dzubur
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Harmony Rhoades
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Stephen S. Intille
- College of Computer and Information Science and Bouvé College of Health Sciences, Northeastern University
| | - Genevieve F. Dunton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Benjamin Henwood
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| |
Collapse
|
10
|
Hubbard G, Thompson CW, Locke R, Jenkins D, Munoz SA, Van Woerden H, Maxwell M, Yang Y, Gorely T. Co-production of "nature walks for wellbeing" public health intervention for people with severe mental illness: use of theory and practical know-how. BMC Public Health 2020; 20:428. [PMID: 32238165 PMCID: PMC7115083 DOI: 10.1186/s12889-020-08518-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 03/12/2020] [Indexed: 12/21/2022] Open
Abstract
Background Interventions need to be developed in a timely and relatively low-cost manner in order to respond to, and quickly address, major public health concerns. We aimed to quickly develop an intervention to support people with severe mental ill-health, that is systematic, well founded both in theory and evidence, without the support of significant funding or resource. In this article we aim to open and elucidate the contents of the ‘black box’ of intervention development. Methods A multidisciplinary team of seven academics and health practitioners, together with service user input, developed an intervention in 2018 by scoping the literature, face-to-face meetings, email and telephone. Researcher fieldnotes were analysed to describe how the intervention was developed in four iterative steps. Results In step 1 and 2, scoping the literature showed that, a) people with severe mental illness have high mortality risk in part due to high levels of sedentary behaviour and low levels of exercise; b) barriers to being active include mood, stress, body weight, money, lack of programmes and facilities and stigma c) ‘nature walks’ has potential as an intervention to address the problem. In Step 3, the team agreed what needed to be included in the intervention so it addressed the “five ways to mental wellbeing” i.e., help people to connect, be active, take notice, keep learning and give. The intervention was mapped to key behavioural change concepts such as, personal relevance, relapse prevention, self-efficacy. In Step 4, the team worked out how best to implement the intervention. The intervention would be delivered over 12 weeks by members of the hospital team and community walk volunteers. Participants would receive a nature walks booklet and text messages. Conclusions We developed a theoretically-informed, evidence-based nature walks programme in a timely and relatively low-cost manner relevant in an era of growing mental illness and funding austerity. Further research is required to test if the intervention is effective and if this approach to intervention development works.
Collapse
Affiliation(s)
- Gill Hubbard
- Department of Nursing and Midwifery, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, Scotland, UK.
| | - Catharine Ward Thompson
- OPENspace research centre, University of Edinburgh, 74 Lauriston Place, Edinburgh, EH3 9DF, UK
| | - Robert Locke
- Partnerships for Well-Being, 33 Wells Street, Inverness, IV35JU, Scotland
| | - Dan Jenkins
- NHS Highland, Larch House, Stoneyfield Business Park, Inverness, IV2 7PA, UK
| | - Sarah-Anne Munoz
- Division of Rural Health and Well-being, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, Scotland, UK, IV2 3JH
| | - Hugo Van Woerden
- NHS Highland, Larch House, Stoneyfield Business Park, Inverness, IV2 7PA, UK
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, FK9 4LA, Scotland
| | - Yaling Yang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Trish Gorely
- Department of Nursing and Midwifery, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, Scotland, UK
| |
Collapse
|
11
|
Thomas EC, Snethen G, McCormick B, Salzer MS. An exploration of linear and curvilinear relationships between community participation and neurocognition among those with serious mental illnesses. Psychiatr Rehabil J 2019; 42:358-365. [PMID: 30945919 PMCID: PMC6776709 DOI: 10.1037/prj0000364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Longitudinal research supports an effect of participation in aspects of community life (e.g., leisure activity, employment) on neurocognition in the general population. This study examined the extent and nature of the relationship between community participation and neurocognition among people with serious mental illnesses. METHOD Participants included 168 adults with schizophrenia spectrum or affective disorder diagnoses who completed the Temple University Community Participation Measure and Brief Assessment of Cognition in Schizophrenia. Hierarchical multiple regression analyses explored linear and curvilinear effects of the amount and breadth of community participation on neurocognition. RESULTS Significant linear relationships existed between amount of community participation and overall neurocognitive functioning, motor speed, verbal fluency, and attention/processing speed, and between breadth of participation and verbal fluency. Significant curvilinear effects were noted between amount of community participation and verbal memory, and between breadth of community participation and overall neurocognitive functioning and motor speed. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Findings suggest that enhanced community participation may contribute to improved neurocognitive functioning, further supporting the importance of this rehabilitation target. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
Affiliation(s)
- Elizabeth C Thomas
- Department of Rehabilitation Sciences, College of Public Health, Temple University
| | - Gretchen Snethen
- Department of Rehabilitation Sciences, College of Public Health, Temple University
| | - Bryan McCormick
- Department of Rehabilitation Sciences, College of Public Health, Temple University
| | - Mark S Salzer
- Department of Rehabilitation Sciences, College of Public Health, Temple University
| |
Collapse
|
12
|
Abdul Rashid NA, Nurjono M, Lee J. Clinical determinants of physical activity and sedentary behaviour in individuals with schizophrenia. Asian J Psychiatr 2019; 46:62-67. [PMID: 31627166 DOI: 10.1016/j.ajp.2019.10.004] [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: 07/01/2019] [Revised: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Modifiable lifestyle factors such as physical activity (PA) have ameliorative effects on commonly reported health conditions in schizophrenia like cardiovascular diseases and diabetes. Similarly, reduction in sedentary behaviour (SB) promotes better physical health. However, engaging individuals with schizophrenia in PA and less SB can be challenging because of symptoms of schizophrenia. The aims of the present study are (i) to examine the profiles of PA and SB in individuals with schizophrenia; and (ii) to identify their respective clinical determinants. METHOD 157 individuals with schizophrenia were recruited. PA and SB were examined via the Global Physical Activity Questionnaire (GPAQ). Psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). Potential clinical predictors of PA and SB were identified via univariate regression analyses and subsequently included in the final multiple regression models for PA and SB respectively. RESULTS 63.7% met the WHO PA guidelines. Work-related activity was the largest domain specific contribution towards PA. Mean duration of SB was approximately 9 h and about 57.3% reported at least 8 h or more of SB daily. Positive symptom was associated with engagement in PA and reduced duration of SB. Negative symptom was associated with greater SB. CONCLUSION With emerging evidence of deleterious health effects of SB independent of PA, it is important to monitor SB in individuals with schizophrenia, particularly those presenting with negative symptoms. While the lack of treatment response for negative symptoms remains a challenge, effort should be made to reduce duration of SB.
Collapse
Affiliation(s)
| | | | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; North Region & Department of Psychosis, Institute of Mental Health, Singapore.
| |
Collapse
|
13
|
Vancampfort D, Lara E, Smith L, Rosenbaum S, Firth J, Stubbs B, Hallgren M, Koyanagi A. Physical activity and loneliness among adults aged 50 years or older in six low- and middle-income countries. Int J Geriatr Psychiatry 2019; 34:1855-1864. [PMID: 31435958 PMCID: PMC6854283 DOI: 10.1002/gps.5202] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 08/10/2019] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Loneliness is widespread and associated with deleterious outcomes in middle-aged and older age people in low- and middle-income countries (LMICs). Physical activity is one potential psychosocial strategy with the potential to reduce loneliness in this population. Thus, the aim of this study was to explore associations between physical activity (PA) and loneliness in middle-aged and older people from six LMICs. MATERIALS AND METHODS Data from the Study on Global Ageing and Adult Health (SAGE) were analyzed. Self-reported data on loneliness and PA (as assessed by the Global Physical Activity Questionnaire) were collected. Participants were dichotomized into those who do and do not meet the international recommendation of 150 minutes of moderate to vigorous PA per week. Associations between loneliness and PA were examined using logistic regressions. RESULTS Among 34 129 individuals aged 50 years or older, the prevalence of loneliness was higher among those not meeting the PA guidelines in all countries, although this difference was not significant in Mexico and South Africa. After full adjustment, not meeting PA guidelines was positively associated with loneliness in the meta-analysis based on country-wise estimates, with a moderate level of between-country heterogeneity being observed (OR = 1.31; 95% CI, 1.07-1.61; I2 = 48.7%). At an individual country level, statistical significance was only reached in Ghana (OR = 1.89; 95% CI = 1.44-2.49). DISCUSSION Our data suggest that physical inactivity and loneliness commonly co-occur in adults aged 50 years or older in LMICs overall but that this association differs by country. Longitudinal studies are required to confirm these findings and investigate potential mechanisms that may inform future interventions.
Collapse
Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
| | - Elvira Lara
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, Prince of Wales Hospital, Sydney, Australia
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Westmead, Australia
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Ai Koyanagi
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- ICREA, Pg. Lluis Companys 23, Barcelona, Spain
| |
Collapse
|
14
|
Vancampfort D, Byansi P, Kinyanda E, Namutebi H, Nalukenge L, Bbosa RS, Ward PB, Mugisha J. Associations between physical inactivity, major depressive disorder, and alcohol use disorder in people living with HIV in a Ugandan fishing community. Int J STD AIDS 2019; 30:1177-1184. [PMID: 31558126 DOI: 10.1177/0956462419863924] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The aim of this cross-sectional study was to explore which variables were associated with physical inactivity in people living with HIV living in a fishing community in Uganda. Secondary aims were to explore the reasons for and barriers to physical activity (PA). Two hundred and fifty-six individuals living with HIV (77 men, 40.5 ± 10.3 years) completed the Physical Activity Vital Sign (PAVS), Patient Health Questionnaire-9 (PHQ-9), and the Alcohol Use Disorders Identification Test. Women had a 1.62 (95% CI = 1.01–2.57), those not having a job a 2.81 (95% CI = 2.00–3.94), and those with depression a 5.67 (95% CI = 2.27–14.17) higher odds for not being physically active for 150 min/week at moderate intensity. Employment and depression status were the only independent significant predictors explaining 27.2% of the PAVS variance. Becoming more healthy and energetic again and reducing stress were the most important PA motives, and musculoskeletal pain, body weakness, and lack of time were the most important PA barriers.
Collapse
Affiliation(s)
- Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,University Psychiatric Centre, KU Leuven, Kortenberg, Belgium
| | - Peter Byansi
- Africa Social Development & Health Initiatives, Kampala, Uganda
| | - Eugene Kinyanda
- Department of Psychiatry, Makerere University, Kampala, Uganda.,Mental Health Project, MRC/LSHTM/UVRI and Senior Wellcome Trust Fellow, Uganda
| | - Hilda Namutebi
- Africa Social Development & Health Initiatives, Kampala, Uganda
| | | | | | - Philip B Ward
- University of New South Wales, Sydney, Australia.,Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - James Mugisha
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda.,Kyambogo University, Kampala, Uganda
| |
Collapse
|
15
|
Henry JD, Moore P, Terrett G, Rendell PG, Scott JG. A comparison of different types of prospective memory reminders in schizophrenia. Schizophr Res 2019; 210:89-93. [PMID: 31227206 DOI: 10.1016/j.schres.2019.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 06/05/2019] [Accepted: 06/05/2019] [Indexed: 10/26/2022]
Abstract
People with schizophrenia often experience difficulties with prospective memory (PM), but few empirical studies have directly compared the effectiveness of different types of reminders in remediating these difficulties. In the present study, two distinct types of reminders were compared to a standard (no reminder) condition in outpatients with schizophrenia (n = 30) and controls (n = 30). Using an adapted version of the well-validated laboratory PM measure, Virtual Week, participants were asked to complete three different conditions (counterbalanced), in which they were (i) provided with access to self-initiated reminders, (ii) provided with experimenter-initiated reminders, and (iii) completed a standard (no-reminder) condition. Both groups benefited from the provision of reminders, but self-initiated reminders were the most beneficial, particularly for time-based tasks. These data align with a broader literature that shows PM can be enhanced by the use of reminders. However, it extends this literature in an important way by showing that these benefits are equivalent for people with schizophrenia, and may be greatest where access to reminders is self-initiated. The implications of these data for the development of rehabilitative interventions are discussed.
Collapse
Affiliation(s)
- Julie D Henry
- School of Psychology, University of Queensland, Brisbane, Australia.
| | - Phillipa Moore
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Gill Terrett
- Australian Catholic University, Melbourne, Australia
| | | | - James G Scott
- The Queensland Centre for Mental Health Research, The University of Queensland Faculty of Medicine, Queensland, Australia; Metro North Mental Health Royal Brisbane and Women's Hospital, Queensland, Australia
| |
Collapse
|
16
|
Factors associated with regular physical activity participation among people with severe mental ill health. Soc Psychiatry Psychiatr Epidemiol 2019; 54:887-895. [PMID: 30535841 DOI: 10.1007/s00127-018-1639-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 12/03/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE People with severe mental ill health (SMI) are less physically active and more sedentary than the general population. There is limited research investigating the correlates of physical activity (PA) in people with SMI impeding the development of successful interventions. This study aimed to assess the factors associated with regular participation of PA among a large sample of people with SMI. METHODS The data for this study were collected from the 'Closing the Gap: Lifestyle Health and Wellbeing' (HWB) cohort that collected data through self-administered questionnaire from participants with SMI. Self-reported participation in regular PA was the main outcome variable. Potential predictors of PA were grouped as demographic, biological, psychological and behavioural variables. Multivariable logistic regressions were conducted considering PA participation as the dependent variable adjusted for possible correlated predictors. RESULTS In total, 3287 people with SMI [mean (SD) age 47.7 (14.58) years, 59% male] were included; 38% reported undertaking regular PA and 61% wanted to undertake more physical activity. Multivariable logistic regressions showed that the following factors were associated with undertaking more regular PA: being male, aged 18-65 years, having a body mass index between 18.5 and 30 kg/m2, having better self-perceived general health condition, not having a health problem that limits activity, giving higher importance to maintain a healthy lifestyle, and eating more fruit and vegetables. CONCLUSIONS Having a better self-perceived general health and placing importance on maintaining a healthy lifestyle were important predictors of regular PA. Lifestyle interventions targeting increased PA among people with SMI should be shaped by their health perception and informed by their needs.
Collapse
|
17
|
Badcock JC, Mackinnon A, Waterreus A, Watts GF, Castle D, McGrath JJ, Morgan VA. Loneliness in psychotic illness and its association with cardiometabolic disorders. Schizophr Res 2019; 204:90-95. [PMID: 30243852 DOI: 10.1016/j.schres.2018.09.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 09/12/2018] [Accepted: 09/17/2018] [Indexed: 10/28/2022]
Abstract
Loneliness is an established risk factor for poor cardiometabolic health. People with psychotic disorders experience high rates of both cardiometabolic disease and loneliness, but how these factors are associated is poorly understood. Thus, using data from the second Australian National Survey of Psychosis we examined whether loneliness is associated with the likelihood of cardiometabolic disorder in psychotic illness. Loneliness was assessed using a single-item measure, with a 4-point scale (not lonely; lonely occasionally; some friends but lonely for company; socially isolated and lonely) whilst cardiometabolic status was assessed in terms of the criteria used to determine metabolic syndrome (elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose). Logistic regression was employed to examine whether loneliness was associated with metabolic syndrome status, and its individual components, with and without adjustment for confounding variables. Increased loneliness was associated with an increased risk of metabolic syndrome in people with psychosis (OR 1.21, 95% CI 1.08-1.36, p < .001) and to the risk of elevated waist circumference (p < .01), elevated triglycerides (p < .05) and reduced high-density lipoprotein cholesterol (p < .05). Notably, these associations largely persisted when controlling for a range of covariates. Feeling lonely is significantly associated with metabolic syndrome, and dyslipidemia specifically, in people with psychotic disorders. These data suggest that the potential benefits of interventions to reduce loneliness in psychosis may extend to cardiovascular as well as psychosocial functioning, and should be explored in future research.
Collapse
Affiliation(s)
- Johanna C Badcock
- Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Faculty of Health and Medical Sciences, The University of Western Australia, Medical Research Foundation Building, Perth, WA 6000, Australia.
| | - Andrew Mackinnon
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia; Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Anna Waterreus
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Faculty of Health and Medical Sciences, The University of Western Australia, Medical Research Foundation Building, Perth, WA 6000, Australia.
| | - Gerald F Watts
- Cardiometabolic Service, Department of Cardiology, Royal Perth Hospital, Perth, WA 6000, Australia; School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Medical Research Foundation Building, Perth, WA 6000, Australia.
| | - David Castle
- St Vincent's Hospital, Melbourne, VIC, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, VIC 3052, Australia.
| | - John J McGrath
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, 8000 Aarhus C, Denmark; Queensland Brain Institute, University of Queensland, Brisbane, QLD 4072, Australia.
| | - Vera A Morgan
- Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Faculty of Health and Medical Sciences, The University of Western Australia, Medical Research Foundation Building, Perth, WA 6000, Australia; Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Faculty of Health and Medical Sciences, The University of Western Australia, Medical Research Foundation Building, Perth, WA 6000, Australia.
| |
Collapse
|
18
|
Thomas EC, Snethen G, Salzer MS. Community participation factors and poor neurocognitive functioning among persons with schizophrenia. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2019; 90:90-97. [PMID: 30676055 DOI: 10.1037/ort0000399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Poor neurocognitive functioning among individuals with schizophrenia is typically conceptualized as resulting from a disease process. The objective of this article is to further expand understanding of poor neurocognition beyond pathogenesis toward a perspective that also incorporates community participation factors. This article focuses on three such factors-sedentary behavior, loneliness, and poverty-that have been demonstrated to be related to neurocognition and are highly prevalent among individuals with schizophrenia. This article provides an overview of the research on each factor and discusses its possible connection to neurocognitive challenges for individuals with schizophrenia. Implications for research, policy, and practice efforts are then proposed to broaden approaches to understanding and addressing neurocognitive challenges in this population. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Collapse
|
19
|
Hallgren M, Nguyen TTD, Lundin A, Vancampfort D, Stubbs B, Schuch F, Bellocco R, Lagerros YT. Prospective associations between physical activity and clinician diagnosed major depressive disorder in adults: A 13-year cohort study. Prev Med 2019; 118:38-43. [PMID: 30316879 DOI: 10.1016/j.ypmed.2018.10.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 09/10/2018] [Accepted: 10/10/2018] [Indexed: 12/24/2022]
Abstract
Regular physical activity (PA) appears to protect against the emergence of depression, but prospective studies linked to clinician diagnoses of major depressive disorder (MDD) remain scarce. It is also unclear whether PA levels recommended for general health are prospectively related to depression onset. We explored these relationships in a cohort of adults followed over 13 years. In total, 43,863 Swedish adults were surveyed in 1997 and responses linked to clinician-diagnosed MDD obtained from specialist medical registers until 2010. Weekly durations of habitual moderate (including walking) and vigorous PA were self-reported. Relationships between total durations of PA, 0-149 ('below'), 150-299 ('achieve'), and ≥300 min ('exceed') with incident MDD were explored using survival analysis with Cox proportional hazards regression. Models were adjusted for relevant covariates. Those with indications of depression at baseline were removed from the primary analyses. Of 25,520 participants with complete data (mean age = 49 years, SD = 16, 65% female), 76% met the recommended weekly duration of PA (≥150 min), and 38% exceeded this duration (≥300 min). During 13-years follow-up 549 MDD cases (1.5%) were identified (incidence rate = 111 cases per 100,000 person-years). Compared to participants who were below, those who exceeded the recommended weekly duration (≥300 min/week) had 29% reduced risk of depression onset (HR 0.71, 95% CI = 0.53-0.96). A non-significant inverse association was observed among those who achieved the minimum duration of 150-min/week (HR 0.86, 95% CI = 0.64-1.14). Habitual PA levels that exceed the duration recommended for general health may reduce the risk of clinician-diagnosed major depression in adults.
Collapse
Affiliation(s)
- Mats Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Solna 171 77, Sweden.
| | - Thi-Thuy-Dung Nguyen
- Department of Public Health Sciences, Karolinska Institutet, Solna 171 77, Sweden
| | - Andreas Lundin
- Department of Public Health Sciences, Karolinska Institutet, Solna 171 77, Sweden
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven, Kortenberg, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom
| | - Felipe Schuch
- Centro Universitário La Salle (Unilasalle), Canoas, Brazil; Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rino Bellocco
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden; Department of Statistics and Quantitative Methods, University of Milano Bicocca, Milan, Italy
| | - Ylva Trolle Lagerros
- Department of Medicine, Clinic of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital Huddinge, Stockholm, Sweden; Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet, 171 77 Solna, Sweden
| |
Collapse
|
20
|
Korman NH, Shah S, Suetani S, Kendall K, Rosenbaum S, Dark F, Nadareishvili K, Siskind D. Evaluating the Feasibility of a Pilot Exercise Intervention Implemented Within a Residential Rehabilitation Unit for People With Severe Mental Illness: GO HEART: (Group Occupational Health Exercise and Rehabilitation Treatment). Front Psychiatry 2018; 9:343. [PMID: 30100885 PMCID: PMC6072846 DOI: 10.3389/fpsyt.2018.00343] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/09/2018] [Indexed: 12/17/2022] Open
Abstract
Purpose: People with severe mental illness are sedentary, have high cardio-metabolic risks and significantly reduced life expectancy. Despite considerable data regarding positive physical and mental health outcomes following exercise interventions, implementation and evaluation of real-world programs is lacking. The primary aim of this study was to assess the feasibility of an exercise intervention implemented by exercise physiology (EP) students within a residential rehabilitation unit for residents with severe mental illness, together with assessment of a range of secondary physical and mental health outcomes pre- and post- the intervention. Design: Single arm, prospective pilot study evaluating outcomes pre- and post- a 10 week intervention. Method: Inactive people with severe mental illness participated in a mixed aerobic and resistance exercise intervention, three times per week for 10 weeks. Data was obtained from a sample of 16 residents with severe mental illness; primary diagnosis schizophrenia (n = 12). Primary outcomes were feasibility as assessed using recruitment, retention and participation rates, as well as reasons for withdrawal and amount of exercise achieved. Secondary outcomes included: functional exercise capacity was measured by the 6-min walk test; metabolic data obtained from anthropometric measurements; blood pressure; fasting cholesterol and blood sugar levels; and physical activity levels and mental health as assessed by self- administered questionnaires measured before and after the intervention. Results: Broad level acceptance of the program: high recruitment (81%), retention (77%), and participation (78%) rates were observed. Promising improvements in functional exercise capacity, volume of exercise, and negative symptoms was demonstrated in those who completed. Conclusions: Exercise interventions delivered by EP students in a residential rehabilitation setting for people with SMI are feasible; group setting, supervision and choice for engagement are important considerations. Evaluation of longitudinal, multi site studies, with the addition of dietary interventions within residential rehabilitation units are warranted. Addressing cost feasibility and cost effectiveness of such programs is recommended. The trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) number, Unique Identifier: ACTRN 12618000478213, http://www.anzctr.org.au Universal trial number (UTN) - U1111-1211-4009.
Collapse
Affiliation(s)
- Nicole H. Korman
- Addiction and Mental Health Services, Metro South Health Services, Brisbane, QLD, Australia
- School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Shelukumar Shah
- Addiction and Mental Health Services, Metro South Health Services, Brisbane, QLD, Australia
| | - Shuichi Suetani
- Addiction and Mental Health Services, Metro South Health Services, Brisbane, QLD, Australia
- School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Karen Kendall
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Frances Dark
- Addiction and Mental Health Services, Metro South Health Services, Brisbane, QLD, Australia
- School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Ketevan Nadareishvili
- Addiction and Mental Health Services, Metro South Health Services, Brisbane, QLD, Australia
| | - Dan Siskind
- Addiction and Mental Health Services, Metro South Health Services, Brisbane, QLD, Australia
- School of Medicine, University of Queensland, Brisbane, QLD, Australia
| |
Collapse
|
21
|
Mucheru D, Hanlon MC, Campbell LE, McEvoy M, MacDonald-Wicks L. Cardiovascular disease lifestyle risk factors in people with psychosis: a cross-sectional study. BMC Public Health 2018; 18:742. [PMID: 29907101 PMCID: PMC6003197 DOI: 10.1186/s12889-018-5649-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/31/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND People with psychosis die on average 25 years earlier than those in the general population, with cardiovascular disease (CVD) contributing to much of the excess mortality. This cross-sectional study aimed to identify the relationship between lifestyle risk factors for CVD - poor nutrition, smoking and low physical activity levels - and dyslipidaemia, hypertension and hyperglycaemia while controlling for potential confounders in 1825 people from the Survey of High Impact Psychosis (SHIP) in Australia. We also aimed to identify clustering patterns of lifestyle risk factors and associated demographic variables. METHODS Three logistic regressions were used to predict the effect of nutrition, smoking and physical activity on dyslipidaemia, hypertension and hyperglycaemia while controlling for clozapine use, sex and age. Clustering patterns of nutrition, smoking and physical activity were examined using the two-step cluster method which is based on hierarchical cluster analysis. Demographic variables associated with different clusters were identified using measures of association. RESULTS Smoking status had a positive association with dyslipidaemia (adjusted odds ratio = 0.50; 95% confidence interval = 0.32-0.78; p = 0.002). Other cardiovascular disease lifestyle risk factors did not have a significant relationship with dyslipidaemia, hypertension and hyperglycaemia. Clustering patterns of lifestyle risk factors showed that younger men, with low education levels, and relying on a government pension, were most likely to display the poorest lifestyle risk behaviours. The largest cluster (42%) of participants was characterised by a mixed demographic profile and were most likely to display poor nutrition and low physical activity levels but less likely to smoke. CONCLUSIONS Only smoking status had a significant positive association with dyslipidaemia which could indicate that there are additional factors affecting the relationship between other cardiovascular lifestyle risk factors and dyslipidaemia, hypertension and hyperglycaemia in people with psychosis. Unknown confounders and traditional lifestyle risk factors may explain the high rates of CVD in this group. Clustering of lifestyle risk factors and their demographic profiles could help the design of intervention programs in people with psychosis.
Collapse
Affiliation(s)
- Doreen Mucheru
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
| | - Mary-Claire Hanlon
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton, 2305 Australia
- Priority Research Centre for Brain and Mental Health, The University of Newcastle, Callaghan, 2308 Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, 2308 Australia
| | - Linda E. Campbell
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton, 2305 Australia
- Faculty of Science, The University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre GrowUpWell, The University of Newcastle, Callaghan, 2308 Australia
| | - Mark McEvoy
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
- Centre for Clinical Epidemiology & Biostatistics, Hunter Medical Research Institute, New Lambton, 2305 Australia
| | - Lesley MacDonald-Wicks
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton, 2305 Australia
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, 2308 Australia
| |
Collapse
|
22
|
Stubbs B, Vancampfort D, Firth J, Hallgren M, Schuch F, Veronese N, Solmi M, Gaughran F, Kahl KG, Rosenbaum S, Ward PB, Carvalho AF, Koyanagi A. Physical activity correlates among people with psychosis: Data from 47 low- and middle-income countries. Schizophr Res 2018. [PMID: 28637633 DOI: 10.1016/j.schres.2017.06.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND People with schizophrenia engage in low levels of physical activity (PA). However, few large-scale studies have investigated the factors that may influence PA participation in individuals with psychosis and data from low- and middle-income countries (LMICs) is especially scarce. Thus, we investigated PA correlates in a large sample of people with a psychosis diagnosis across 47 LMICs. METHODS Cross-sectional data from the World Health Survey, restricting to those with a self-reported lifetime diagnosis of schizophrenia/psychotic disorder, was analyzed. PA was assessed by the International Physical Activity Questionnaire (IPAQ) and participants were dichotomized into those that do and do not (low PA) meet the minimum recommended PA weekly targets (≥150min). A range of socio-demographic, health behavior, and mental and physical health variables were examined using random effects logistic regression. RESULTS Overall 2407 people (mean 42.0years, 41.5% males) with schizophrenia/psychosis were included. The prevalence of low PA was 39.2% (95%CI=37.0%-41.2%). Male sex (odds ratio (OR)=1.33), increasing age, unemployment (vs. employed OR=2.50), urban setting (vs. rural OR=1.75), inadequate fruit consumption (vs. adequate fruit intake OR=3.03), depression (OR=1.33), sleep/energy disturbance, and mobility limitations were significantly associated with low PA. Marital status, education, wealth, smoking, vegetable and alcohol consumption, anxiety, cognition, pain, and chronic medical conditions were not significant correlates. CONCLUSION PA is influenced by a range of factors among people with psychosis. These correlates should be considered in interventions aiming to facilitate PA in psychotic individuals living in LMICs.
Collapse
Affiliation(s)
- Brendon Stubbs
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom.
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven, Kortenberg, Belgium
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom; NICM, School of Science and Health, University of Western Sydney, Australia
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinksa Institute, Stockholm, Sweden
| | - Felipe Schuch
- Unilasalle, Canoas, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Nicola Veronese
- Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy
| | - Marco Solmi
- Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy; National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - Fiona Gaughran
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom
| | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover Medical School, Hannover, Germany
| | - Simon Rosenbaum
- School of Psychiatry, UNSW Australia, The Black Dog Institute, University of New South Wales, Prince of Wales Hospital, Sydney, Australia
| | - Philip B Ward
- School of Psychiatry, UNSW, Sydney, Australia; Schizophrenia Research Institute, Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - Andre F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
| |
Collapse
|
23
|
Physical activity correlates in people with mild cognitive impairment: findings from six low- and middle-income countries. Public Health 2018; 156:15-25. [PMID: 29408186 DOI: 10.1016/j.puhe.2017.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 11/08/2017] [Accepted: 12/01/2017] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Despite promising research showing that physical activity (PA) might improve cognitive functioning in people with mild cognitive impairment (MCI), people with MCI are less physically active compared with the general population. Therefore, the aim of this study was to assess PA correlates among community-dwelling older people with MCI in six low- and middle-income countries. DESIGN Cross-sectional data from the World Health Organization's Study on Global Ageing and Adult Health were analysed. METHODS PA level was assessed by the Global Physical Activity Questionnaire. 4854 participants with MCI (mean age 64.4 years; 55.1% females) were grouped into those who do and do not (low PA) meet the 150 min of moderate-to-vigorous PA per week recommendation. Associations between PA and the correlates were examined using multivariable logistic regressions. RESULTS The prevalence of low PA was 27.4% (95% confidence interval = 25.0-30.0). In the multivariable analysis, older age and unemployment were the only sociodemographic correlates of low PA. The significant positive correlates of low PA in other domains included depression, being underweight, obesity, asthma, chronic lung disease, hearing problems, visual impairment, slow gait, weak grip strength, poor self-rated health, and lower levels of social cohesion. CONCLUSIONS The current data illustrate that a number of sociodemographic and health factors are associated with PA levels among older people with MCI. The promotion of social cohesion may increase the efficacy of public health initiatives while from a health care perspective, somatic co-morbidities, muscle strength and slow gait need to be considered when activating those at risk for dementia.
Collapse
|
24
|
Vancampfort D, Stubbs B, Veronese N, Mugisha J, Swinnen N, Koyanagi A. Correlates of physical activity among depressed older people in six low-income and middle-income countries: A community-based cross-sectional study. Int J Geriatr Psychiatry 2018; 33:e314-e322. [PMID: 28994143 DOI: 10.1002/gps.4796] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 08/17/2017] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Despite the benefits of physical activity (PA) in older people with depression, many do not comply with the International PA guidelines. Thus, we investigated what factors influence PA participation among 915 community-dwelling older adults (aged ≥65 years) with depression in 6 low-income and middle-income countries (LMICs). METHODS Cross-sectional data were analyzed from the World Health Organization's Study on Global Ageing and Adult Health. The sample was restricted to those with DSM-IV depression or receiving depression treatment in the last 12 months. PA was assessed by the Global Physical Activity Questionnaire. Participants were dichotomized into low (ie, not meeting 150 minutes of moderate PA per week) and moderate-to-high physically active groups. Associations between PA and a range of correlates were examined using multivariable logistic regressions. RESULTS The prevalence of low PA was 40.4% (95%CI = 34.8%-46.1%). After adjusting for age, sex, and country, larger household size and unemployment were significant sociodemographic correlates of low PA. Former smoking (vs never), anxiety, mild cognitive impairment (MCI), lower body mass index, bodily pain, asthma, chronic back pain, chronic obstructive pulmonary disease, hearing problems, stroke, slow gait, poor self-rated health, higher levels of disability, and lower levels of social cohesion were identified as significant negative correlates of PA. CONCLUSIONS The current data provide guidance for future interventions across LMICs to assist older people with depression engage in regular PA. The promotion of social cohesion may increase the efficacy of future public health initiatives, while from a clinical perspective, somatic co-morbidities, MCI, pain, and slow gait need to be considered.
Collapse
Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.,KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - James Mugisha
- Kyambogo University, Kampala, Uganda.,Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Nathalie Swinnen
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.,KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| |
Collapse
|
25
|
Koyanagi A, Stubbs B, Vancampfort D. Correlates of low physical activity across 46 low- and middle-income countries: A cross-sectional analysis of community-based data. Prev Med 2018; 106:107-113. [PMID: 29066372 DOI: 10.1016/j.ypmed.2017.10.023] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/09/2017] [Accepted: 10/18/2017] [Indexed: 11/24/2022]
Abstract
Physical inactivity accounts for 5.5% of all avoidable global deaths. However, a paucity of multinational studies, particularly in low- and middle-income countries (LMICs), has investigated correlates of physical activity (PA). Thus, we assessed the correlates of PA using cross-sectional, community-based data of the World Health Survey including 46 LMICs. PA was assessed by the International Physical Activity Questionnaire (IPAQ) and participants were dichotomized into those who do (≥150min moderate-vigorous PA per week) and do not (<150min=low PA) comply with the World Health Organization (WHO) PA recommendations. Multivariable logistic regression was used to assess the PA correlates. The prevalence of low PA in 206,356 persons (mean age 38.4years; 49.6% males) was 29.2% (95%CI=28.3%-30.0%). In the overall sample, female sex, not married/cohabiting, high education and wealth, unemployment, and urban setting were significant sociodemographic correlates of low PA. In terms of other correlates, inadequate fruit and vegetable intake, subsyndromal depression, worse sleep/energy and cognition, visual impairment, hearing problems and asthma were associated with not meeting the WHO recommendations. There were some variations in the correlates depending on age and sex. Interventions should be developed that operate at multiple levels of influence and take into account age- and gender-related PA patterns in order to assist people in LMICs to comply with the WHO PA recommendations. Researchers, funding bodies, practitioners and policymakers in education, mental and physical health, and urban planning have a critical role to play.
Collapse
Affiliation(s)
- Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom.
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; University Psychiatric Centre KU Leuven, Kortenberg, Belgium.
| |
Collapse
|
26
|
Suetani S, Mamun A, Williams GM, Najman JM, McGrath JJ, Scott JG. The association between adolescent psychopathology and subsequent physical activity in young adulthood: a 21-year birth cohort study. Psychol Med 2018; 48:269-278. [PMID: 28625171 DOI: 10.1017/s0033291717001660] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND The beneficial effects of physical activity (PA) for both physical and mental wellbeing are well established. Given that adolescence presents a critical developmental period during which life-long patterns of PA become established, the exploration of the longitudinal impact of adolescent psychopathology on adult PA status is of interest. METHODS We analysed prospective data from 3663 young adults who participated in the Mater-University of Queensland Study of Pregnancy. Psychopathology was measured using the Youth Self-Report (YSR) at age 14. Participants' engagement in three types of PA (vigorous exercise, moderate exercise and walking) at age 21 were dichotomised into either 'none' or 'any'. For our main analysis, we examined the association between the YSR score and subsequent PA engagement using logistic regression. We also conducted sensitivity analyses of longitudinal associations between the YSR internalising and externalising symptoms score at age 14 and PA engagement at age 21. RESULTS We found no longitudinal association between the total YSR score at age 14 and PA engagement at age 21. In addition, there was no longitudinal association between the YSR internalising or externalising symptoms and PA engagement. CONCLUSION Our findings suggest that there is no longitudinal association between adolescent psychopathology and PA in young adulthood.
Collapse
Affiliation(s)
- S Suetani
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health,Wacol,Australia
| | - A Mamun
- Institute for Social Science Research,The University of Queensland, Indooroopilly,Australia
| | - G M Williams
- School of Population Health, The University of Queensland,Herston,Australia
| | - J M Najman
- School of Population Health, The University of Queensland,Herston,Australia
| | - J J McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health,Wacol,Australia
| | - J G Scott
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health,Wacol,Australia
| |
Collapse
|
27
|
Romain AJ, Abdel-Baki A. Using the transtheoretical model to predict physical activity level of overweight adults with serious mental illness. Psychiatry Res 2017; 258:476-480. [PMID: 28890227 DOI: 10.1016/j.psychres.2017.08.093] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 08/30/2017] [Accepted: 08/30/2017] [Indexed: 12/13/2022]
Abstract
Although physical activity (PA) is recommended for individuals with serious mental illness (ISMI), most of them are inactive or insufficiently active. The transtheoretical model (TTM) has been proposed to explain the motivational factors associated with PA however, there is little evidence of its applicability to ISMI. So, the objective was to analyse whether TTM components are related to PA in overweight ISMI. In this cross-sectional study, participants completed the Global Physical Activity Questionnaire to assess their PA level and TTM components: stages of change (SOC), decisional balance (pros and cons), self-efficacy and processes of change (POC; experiential and behavioural). 43 overweight ISMI (27 males, mean age 29.0 ± 6.64, mean BMI 31.91 ± 5.10kg/m2, 30% with schizophrenia, and 44% inactive), referred to a PA programme were recruited. PA was positively correlated with POC and perceived pros, with TTM constructs accounting for 14.5% of PA variance. Mean level of behavioural POC and perceived pros were higher in physically active than in inactive participants. So, this study confirms that TTM components are associated with PA in overweight ISMI. Therefore, the TTM should be considered when planning PA interventions for ISMI.
Collapse
Affiliation(s)
- Ahmed Jérôme Romain
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, Québec, Canada.
| | - Amal Abdel-Baki
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, Québec, Canada; Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Clinique des Jeunes Adultes Psychotiques, University Hospital of Montreal (CHUM) -Notre-Dame Hospital, Montréal, Québec, Canada
| |
Collapse
|
28
|
Suetani S, Mamun A, Williams GM, Najman JM, McGrath JJ, Scott JG. Longitudinal association between physical activity engagement during adolescence and mental health outcomes in young adults: A 21-year birth cohort study. J Psychiatr Res 2017; 94:116-123. [PMID: 28704729 DOI: 10.1016/j.jpsychires.2017.06.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 06/30/2017] [Accepted: 06/30/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Previous studies provide mixed evidence that physical activity engagement (PAE) in adolescence is associated with later mental health outcomes. This study aimed to examine the association between PAE at age 14 and mental health outcomes at age 21 using a large birth cohort study. MATERIAL AND METHODS Prospective data from the Mater-University of Queensland Study of Pregnancy, consisting of 3493 young adults, were analyzed. PAE at age 14 was estimated using self-report, and participants were categorized into; (1) frequent, (2) infrequent, or (3) no PAE group. Mental health outcomes at age 21 consisted of; (1) common mental disorders, (2) psychosis-related outcomes, and, (3) emotional and behavioral problems. The association between PAE in adolescence and later mental health outcomes in young adulthood was examined using logistic regression, adjusted for age, sex, body mass index, and adolescent psychopathology. RESULTS No PAE at age 14 was associated with the increased likelihood of lifetime diagnosis of any affective disorder, elevated delusional ideation, and endorsement of visual perceptual disturbance at age 21. Conversely, infrequent PAE at age 14 was associated with the decreased likelihood of subsequent lifetime diagnosis of any substance use disorder. CONCLUSION Our findings suggest that lack of PAE in adolescence influences some, but not all, later mental health outcomes. Interventions to increase PAE in adolescence may represent an opportunity to prevent future mental health problems.
Collapse
Affiliation(s)
- Shuichi Suetani
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia; Queensland Brain Institute, The University of Queensland, St Lucia, Australia; Metro South Addiction and Mental Health Services, Brisbane, Australia.
| | - Abdullah Mamun
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Australia
| | - Gail M Williams
- School of Population Health, The University of Queensland, Herston, Australia
| | - Jake M Najman
- School of Population Health, The University of Queensland, Herston, Australia; School of Social Science, The University of Queensland, St Lucia, Australia
| | - John J McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia; Queensland Brain Institute, The University of Queensland, St Lucia, Australia; National Centre for Register-based Research, The Aarhus University, Aarhus C, Denmark
| | - James G Scott
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia; University of Queensland Centre for Clinical Research, The University of Queensland, Herston, Australia; Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, Australia
| |
Collapse
|
29
|
Vancampfort D, Stubbs B, Koyanagi A. Physical activity correlates in people with anxiety: Data from 46 low- and middle-income countries. Gen Hosp Psychiatry 2017; 49:26-31. [PMID: 29122146 DOI: 10.1016/j.genhosppsych.2017.04.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/19/2017] [Accepted: 04/21/2017] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There is a lack of nationally-representative data on the correlates of physical activity (PA) among people with anxiety symptoms. Thus, we investigated PA correlates among community-dwelling adults with anxiety symptoms in 46 low- and middle-income countries (LMICs) using predominantly nationally-representative data. METHOD Cross-sectional data from the World Health Survey were analysed. PA was assessed by the International Physical Activity Questionnaire (IPAQ) and participants were dichotomised into those that do (≥150min moderate-vigorous PA) and do not (<150min) meet recommended PA weekly targets. Multivariable logistic regression was used to assess the correlates. RESULTS The analysis included 24,850 people with anxiety symptoms (43.3±16.6years; 39.7% males). The prevalence of low PA was 33.1% (95%CI=31.6%-34.6%). Older age [e.g., OR=4.57 for age≥65 vs. 18-24years], not married/cohabiting (vs. married/cohabiting OR=1.36), being in the richest quintile (vs. poorest OR=1.41), unemployed (vs. employed OR=2.18), inadequate vegetable consumption (vs. adequate OR=1.66), and poor sleep/energy, worse cognition, pain/discomfort and mobility difficulties were all significant correlates of low PA. CONCLUSIONS PA is associated with a range of factors among people with anxiety symptoms. Future interventions might target the identified correlates in order to facilitate people with anxiety to be more physically active.
Collapse
Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; University Psychiatric Centre KU Leuven, Kortenberg, Belgium.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| |
Collapse
|
30
|
Vancampfort D, Stubbs B, Firth J, Hallgren M, Schuch F, Lahti J, Rosenbaum S, Ward PB, Mugisha J, Carvalho AF, Koyanagi A. Physical activity correlates among 24,230 people with depression across 46 low- and middle-income countries. J Affect Disord 2017. [PMID: 28633049 DOI: 10.1016/j.jad.2017.06.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND There is a paucity of nationally representative data available on the correlates of physical activity (PA) among people with depression, especially in low- and middle-income countries (LMICs). Thus, we investigated PA correlates among community-dwelling adults with depression in this setting. METHODS World Health Survey data included 24,230 adults (43.1 ± 16.1 years; 36.1% male) with ICD-10 diagnoses of depression including brief depressive episode and subsyndromal depression aged ≥ 18 years from 46 LMICs. PA was assessed by the International Physical Activity Questionnaire. Participants were dichotomised into low and moderate-to-high physically active groups. Associations between PA and a range of sociodemographic, health behaviour and mental and physical health variables were examined using multivariable logistic regressions. RESULTS 34.8% of participants with depression were physically inactive. In the multivariate analyses, inactivity was associated with male sex, older age, not being married/cohabiting, high socio-economic status, unemployment, living in an urban setting, less vegetable consumption, and poor sleep/ low energy. In addition, mobility difficulties and some somatic co-morbidity were associated with not complying with the 150min per week moderate-to-vigorous PA recommendations. CONCLUSIONS The current data provide guidance for future population level interventions across LMICs to help people with depression engage in regular PA.
Collapse
Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; University Psychiatric Centre KU Leuven, Kortenberg, Belgium.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom; NICM, School of Science and Health, University of Western Sydney, Australia
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinksa Institute, Stockholm, Sweden
| | - Felipe Schuch
- Unilasalle, Canoas, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Jouni Lahti
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Simon Rosenbaum
- Black Dog Institute, Randwick, Australia; School of Psychiatry, UNSW, Sydney, Australia
| | - Philip B Ward
- School of Psychiatry, UNSW, Sydney, Australia; Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - James Mugisha
- Kyambogo University, Kampala, Uganda; Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - André F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| |
Collapse
|
31
|
Lederman O, Suetani S, Stanton R, Chapman J, Korman N, Rosenbaum S, Ward PB, Siskind D. Embedding exercise interventions as routine mental health care: implementation strategies in residential, inpatient and community settings. Australas Psychiatry 2017; 25:451-455. [PMID: 28585448 DOI: 10.1177/1039856217711054] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Evaluation of physical activity (PA) programs among populations with severe mental illness (SMI) has predominately focused on efficacy and therapeutic benefits. There is now strong evidence to support the benefits of PA in people with SMI. What remains is a gap in the implementation of pragmatic and sustainable PA interventions in mental-health settings. The current paper provides examples of interventions that have been successfully implemented in Australian settings, identifies key components of successful PA interventions and outlines practical strategies that can assist with widespread implementation of PA interventions in mental-health settings. CONCLUSIONS There is an emergence of PA interventions being imbedded within a variety of mental-health settings. These interventions vary in terms of mode and intensity of service delivery. Yet, all aim to increase PA and reduce sedentary behaviour. Adopting the identified strategies may help facilitate successful implementation and increase access to PA interventions for mental-health service users.
Collapse
Affiliation(s)
- Oscar Lederman
- School of Medical Sciences, University of New South Wales, Sydney, NSW, and; Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Shuichi Suetani
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, and; Queensland Brain Institute, University of Queensland, St Lucia, QLD, and; School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Robert Stanton
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Justin Chapman
- Queensland Police-Citizens Youth Welfare Association, Brisbane, QLD, and; QIMR Berghofer Medical Research Institute, QLD, Australia
| | - Nicole Korman
- School of Medicine, University of Queensland, Brisbane, QLD; Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, NSW, and; The Black Dog Institute, University of New South Wales, Hospital Road, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, NSW, and; Schizophrenia Research Unit, South Western Sydney Local Health District and Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Dan Siskind
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, and; School of Medicine, University of Queensland, Brisbane, QLD, and; Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia
| |
Collapse
|
32
|
Suetani S, Saha S, Eyles DW, Scott JG, McGrath JJ. Prevalence and correlates of suboptimal vitamin D status in people living with psychotic disorders: Data from the Australian Survey of High Impact Psychosis. Aust N Z J Psychiatry 2017; 51:921-929. [PMID: 28829181 DOI: 10.1177/0004867416681853] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Having sufficient sera concentrations of 25-hydroxyvitamin D is important for a range of health outcomes including cardiometabolic diseases. Clinical studies in people with psychotic disorders suggest that a sizable proportion has suboptimal vitamin D status (i.e. vitamin D deficiency or insufficiency). Individuals with psychosis also have many of the risk factors associated with suboptimal vitamin D status such as smoking, obesity, and reduced physical activity. The aim of this study was to examine the prevalence and socio-demographic and clinical correlates of vitamin D status using a large, population-based sample of adults with psychotic disorders. METHODS Data were collected as part of the Survey of High Impact Psychosis, a population-based survey of Australians aged 18-64 years with a psychotic disorder. 25-Hydroxyvitamin D concentration was measured in 463 participants. 25-Hydroxyvitamin D concentration was dichotomised into optimal (above 50 nmol/L) and suboptimal (below 50 nmol/L). The influence of a range of socio-demographic and clinical variables on vitamin D status was examined using logistic regression. RESULTS Nearly half (43.6%) of the participants had suboptimal vitamin D status. Those with (a) increased physical activity or (b) positive symptoms had significantly reduced odds of having suboptimal vitamin D status. However, there were no significant associations between suboptimal vitamin D status and other psychiatric symptom measures or cardiometabolic risk factors. CONCLUSION Many people with psychotic disorders have suboptimal vitamin D status. As part of the routine assessment of physical health status, clinicians should remain mindful of vitamin D status in this vulnerable population and encourage the use of appropriate vitamin D supplements.
Collapse
Affiliation(s)
- Shuichi Suetani
- 1 Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,2 Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
| | - Sukanta Saha
- 1 Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,2 Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
| | - Darryl W Eyles
- 1 Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,2 Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
| | - James G Scott
- 1 Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,3 University of Queensland Centre for Clinical Research, University of Queensland, Herston, QLD, Australia.,4 Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - John J McGrath
- 1 Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,2 Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
| |
Collapse
|
33
|
Suetani S, Saha S, Milad A, Eakin E, Scott JG, McGrath JJ. Common mental disorders and recent physical activity status: findings from a National Community Survey. Soc Psychiatry Psychiatr Epidemiol 2017; 52:795-802. [PMID: 27832319 DOI: 10.1007/s00127-016-1307-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 10/30/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To explore the association between histories of common mental disorders, delusional-like experiences, and recent physical activity using a large nationally representative population-based sample from Australia. We predicted that a past history of a common mental disorder or delusional-like experiences would be associated with insufficient physical activity. METHODS The study was based on the Australian National Survey of Mental Health and Wellbeing 2007 (n = 8841). The Composite International Diagnostic Interview was used to identify a lifetime and past year history of common mental disorders and delusional-like experiences. Physical activity over the preceding week was estimated using the questions based on the Active Australia survey with respondents classified as (a) insufficiently physically active versus (b) sufficiently physically active based on national recommendations. We examined the relationship between the variables of interest using logistic regression, adjusting for potential confounding factors. RESULTS Almost half of the participants (46.0%) were classified as sufficiently physically active. Compared to those with no past mental disorder, those with lifetime or past year history of common mental disorders did not differ on recent physical activity status. Furthermore, we found no significant association between the number of lifetime mental disorders or the presence of delusional-like experience and recent physical activity status. CONCLUSIONS Our findings suggest that a diagnosis of common mental disorder, with or without recent symptoms and comorbid diagnoses, or even having self-ascribed perception of poor mental well-being, is not associated with insufficient physical activity.
Collapse
Affiliation(s)
- Shuichi Suetani
- School of Medicine, University of Queensland, Brisbane, Australia. .,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, 4076, Australia. .,Queensland Brain Institute, University of Queensland, St Lucia, Australia.
| | - Sukanta Saha
- School of Medicine, University of Queensland, Brisbane, Australia.,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, 4076, Australia.,Queensland Brain Institute, University of Queensland, St Lucia, Australia
| | - Adam Milad
- School of Public Health, University of Queensland, Herston, Australia
| | - Elizabeth Eakin
- School of Public Health, University of Queensland, Herston, Australia
| | - James G Scott
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, 4076, Australia.,University of Queensland Centre for Clinical Research, University of Queensland, Herston, Australia.,Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, Australia
| | - John J McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, 4076, Australia.,Queensland Brain Institute, University of Queensland, St Lucia, Australia
| |
Collapse
|
34
|
Stubbs B, Koyanagi A, Schuch F, Firth J, Rosenbaum S, Gaughran F, Mugisha J, Vancampfort D. Physical Activity Levels and Psychosis: A Mediation Analysis of Factors Influencing Physical Activity Target Achievement Among 204 186 People Across 46 Low- and Middle-Income Countries. Schizophr Bull 2017; 43:536-545. [PMID: 27562855 PMCID: PMC5464271 DOI: 10.1093/schbul/sbw111] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Physical activity (PA) can help reduce cardiovascular disease and premature mortality in people with psychosis. However, there is a paucity of representative data on PA in people with psychosis, especially from low- and middle-income countries (LMICs). Moreover, data on subclinical psychosis and PA is absent. This study explored whether complying with PA recommendations of 150 minutes of moderate-vigorous PA per week is related to: (1) psychotic symptoms without a psychosis diagnosis (subclinical psychosis); and (2) clinical psychosis (psychosis diagnosis). A total of 204 186 participants aged 18-64 years from 46 LMICs recruited via the World Health Survey were subdivided into those with (1) no psychosis diagnosis and no psychotic symptoms in the past 12 months (controls); (2) subclinical psychosis; and (3) psychosis diagnosis. People with a psychosis diagnosis had significantly higher odds for low PA in the overall sample (OR = 1.36; 95% CI = 1.04-1.78; P = .024) and among males (OR = 2.29; 95% CI = 1.57-3.34; P < .0001) but not females (OR = 0.93; 95% CI = 0.67-1.30; P = .6712). No difference was found among those with subclinical psychosis vs controls. Mediation analyses demonstrated that mobility difficulties explained the largest amount of low PA among males (18.5%) followed by self-care difficulties (16.3%), depression (16.1%), cognition (11.8%), pain and discomfort (11.4%), interpersonal activities (8.6%), sleep and energy (7.2%), and vision (3.0%). The results from the largest dataset on PA and psychosis and first in LMICs, found that psychosis diagnosis (especially among males) but not subclinical psychosis, is associated with physical inactivity. Population level interventions seeking to increase PA among people with psychosis may help improve health outcomes.
Collapse
Affiliation(s)
- Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK;,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain;,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Felipe Schuch
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil;,Programa de Pós Graduação em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Joseph Firth
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Simon Rosenbaum
- Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Fiona Gaughran
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - James Mugisha
- Kyambogo University, Kampala, Uganda;,Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium;,KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
| |
Collapse
|
35
|
Morgan VA, Waterreus A, Carr V, Castle D, Cohen M, Harvey C, Galletly C, Mackinnon A, McGorry P, McGrath JJ, Neil AL, Saw S, Badcock JC, Foley DL, Waghorn G, Coker S, Jablensky A. Responding to challenges for people with psychotic illness: Updated evidence from the Survey of High Impact Psychosis. Aust N Z J Psychiatry 2017; 51:124-140. [PMID: 27913580 DOI: 10.1177/0004867416679738] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The objective is to summarise recent findings from the 2010 Australian Survey of High Impact Psychosis (SHIP) and examine their implications for future policy and planning to improve mental health, physical health and other circumstances of people with a psychotic disorder. METHODS Survey of High Impact Psychosis collected nationally representative data on 1825 people with psychotic illness. Over 60 papers have been published covering key challenges reported by participants: financial problems, loneliness and social isolation, unemployment, poor physical health, uncontrolled symptoms of mental illness, and lack of stable, suitable housing. Findings are summarised under the rubric of participant-ranked top challenges. RESULTS The main income source for the majority (85%) of participants was a government benefit. Only one-third was employed, and the most appropriate employment services for this group were under-utilised. High rates of loneliness and social isolation impacted mental and physical health. The rate of cardiometabolic disease was well above the general population rate, and associated risk factors were present from a very young age. Childhood abuse (30.6%), adult violent victimisation (16.4%) and alcohol and substance abuse/dependence (lifetime rates of 50.5% and 54.5%, respectively) complicated the clinical profile. Treatment with medication was suboptimal, with physical health conditions undertreated, a high rate of psychotropic polypharmacy and underutilisation of clozapine in chronic persistent psychotic illness. Only 38.6% received evidence-based psychosocial therapies. In the previous year, 27.4% had changed housing and 12.8% had been homeless, on average for 155 days. CONCLUSION Money, social engagement and employment are the most important challenges for people with psychotic illness, as well as good physical and mental health. An integrated approach to recovery is needed to optimise service delivery and augment evidence-based clinical practice with measures to improve physical health and social circumstances. Meeting these challenges has the potential to reduce costs to government and society, as well as promote recovery.
Collapse
Affiliation(s)
- Vera A Morgan
- 1 Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia.,2 Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia
| | - Anna Waterreus
- 1 Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia
| | - Vaughan Carr
- 3 Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,4 Schizophrenia Research Institute and Neuroscience Research Australia, Sydney, NSW, Australia.,5 Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - David Castle
- 6 St Vincent's Hospital, Melbourne, VIC, Australia.,7 Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Martin Cohen
- 8 Hunter New England Mental Health, Newcastle, NSW, Australia.,9 The University of Newcastle, Newcastle, NSW, Australia
| | - Carol Harvey
- 7 Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Cherrie Galletly
- 10 Discipline of Psychiatry, School of Medicine, The University of Adelaide, Adelaide, SA, Australia.,11 Ramsay Health Care, Mental Health Services, Adelaide, SA, Australia.,12 Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Andrew Mackinnon
- 13 Black Dog Institute and University of New South Wales, Sydney, NSW Australia.,14 Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Patrick McGorry
- 15 Orygen Youth Health Research Centre, Melbourne, VIC, Australia
| | - John J McGrath
- 16 Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia.,17 Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Amanda L Neil
- 18 Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Suzy Saw
- 19 Health Data Analysis Pty Ltd, Canberra, ACT, Australia
| | - Johanna C Badcock
- 2 Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia.,20 Cooperative Research Centre-Mental Health, Carlton, VIC, Australia
| | - Debra L Foley
- 21 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Geoff Waghorn
- 17 Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Sarah Coker
- 22 SANE Australia, Melbourne, VIC, Australia
| | - Assen Jablensky
- 2 Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia.,20 Cooperative Research Centre-Mental Health, Carlton, VIC, Australia
| |
Collapse
|
36
|
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: 239] [Impact Index Per Article: 29.9] [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.
Collapse
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
| |
Collapse
|