Physical activity patterns in adults with severe mental illness
Daumit GL, Goldberg RW, Anthony C, Dickerson F, Brown CH, et al.;
Commented by , 22 Nov 2005
Aim of the study
It has been shown several times that people with schizophrenia die on average at a younger age than the general population (ref. 1) and suicide accounts only for a part of this excess mortality.
The increased interest in comorbid physical illnesses in schizophrenia has also been in part triggered by problems with the atypical antipsychotics some of which have been found to be associated with high rates of weight gain, prolactin increase and cardiac problems.
It is often argued in the literature that one reason for the increased rates of obesity of people with severe mental illness (SMI) is insufficient physical activity due to negative symptoms. Physical inactivity is a leading cause of death and the United States’ Surgeon General recommends regular moderate physical activity.
However, currently little is known about whether and to what extent the prevalence and type of physical activity in people with SMI are different from the general population. The current study tried to elucidate this issue.
Methods
200 outpatients with schizophrenia and affective disorders at two psychiatric institutions in Maryland were surveyed with a self-report using questions from the "National Health and Nutrition Examination Survey (NHANES)".
Each patient was age-gender-race-matched with 15 randomly selected people from the general population assessed in the NHANES III national project. Results: Patients with SMI were more obese than the general population and they reported to be less physically active. In terms of types of physical activity the reported prevalence of jogging, biking, and competitive sports was lower in the SMI sample.
Gardening and yard work were also substantially lower than in the normal population. 29% of SMI patients reported gardening to be their only form of physical activity in contrast to 10% of the controls. Factors associated with regular physical activity in people with mental illness were education and depression rather than schizophrenia as a diagnosis. Factors associated with inactivity were lack of social contact and female gender.
Dr Leucht's comments
Although it is often argued that lack of physical activity may be a factor associated with the high rates of obesity and physical illnesses in schizophrenia, the current study is one of few reports providing sound evidence for this notion.
Given the well-established excess mortality of individuals with major mental disorders, action is needed, but few published physical activity intervention for psychiatric patients exist.
References
1. Harris EC and Barraclough B. Excess mortality of mental disorder. British Journal of Psychiatry 1998; 173; 11-53