Predictors of adherence to exercise interventions in people with schizophrenia.

Journal: European archives of psychiatry and clinical neuroscience

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Affiliated Institutions:  Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nussbaumstrasse , , Munich, Germany. Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany. Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany. Department of Psychiatry and Psychotherapy, University Hospital Charité Berlin, Berlin, Germany. Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany. Clinic of Rehabilitation and Sports Medicine, Hannover Medical School, Hannover, Germany. Department of Psychiatry and Psychotherapy, University Hospital Göttingen, Göttingen, Germany. Department of Sports Medicine, University Hospital Charité Berlin, Berlin, Germany. Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany. Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nussbaumstrasse , , Munich, Germany. Lukas.Roell@med.uni-muenchen.de.

Abstract summary 

Exercise interventions are nowadays considered as effective add-on treatments in people with schizophrenia but are usually associated with high dropout rates. Therefore, the present study investigated potential predictors of adherence from a large multicenter study, encompassing two types of exercise training, conducted over a 6-month period with individuals with schizophrenia. First, we examined the role of multiple participants' characteristics, including levels of functioning, symptom severity, cognitive performance, quality of life, and physical fitness. Second, we used K-means clustering to identify clinical subgroups of participants that potentially exhibited superior adherence. Last, we explored if adherence could be predicted on the individual level using Random Forest, Logistic Regression, and Ridge Regression. We found that individuals with higher levels of functioning at baseline were more likely to adhere to the exercise interventions, while other factors such as symptom severity, cognitive performance, quality of life or physical fitness seemed to be less influential. Accordingly, the high-functioning group with low symptoms exhibited a greater likelihood of adhering to the interventions compared to the severely ill group. Despite incorporating various algorithms, it was not possible to predict adherence at the individual level. These findings add to the understanding of the factors that influence adherence to exercise interventions. They underscore the predictive importance of daily life functioning while indicating a lack of association between symptom severity and adherence. Future research should focus on developing targeted strategies to improve adherence, particularly for people with schizophrenia who suffer from impairments in daily functioning.Clinical trials registration The study of this manuscript which the manuscript is based was registered in the International Clinical Trials Database, ClinicalTrials.gov (NCT number: NCT03466112, https://clinicaltrials.gov/ct2/show/NCT03466112?term=NCT03466112&draw=2&rank=1 ) and in the German Clinical Trials Register (DRKS-ID: DRKS00009804.

Authors & Co-authors:  Schwaiger Maurus Lembeck Papazova Greska Muenz Sykorova Thieme Vogel Mohnke Huppertz Roeh Keller-Varady Malchow Walter Wolfarth Wölwer Henkel Hirjak Schmitt Hasan Meyer-Lindenberg Falkai Roell

Study Outcome 

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Citations :  Walker ER, McGee RE, Druss BG (2015) Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiat 72(4):334–341. https://doi.org/10.1001/jamapsychiatry.2014.2502
Authors :  24
Identifiers
Doi : 10.1007/s00406-024-01789-w
SSN : 1433-8491
Study Population
Male,Female
Mesh Terms
Other Terms
Adherence;Exercise;Machine learning;Randomized-controlled trial;Schizophrenia
Study Design
Study Approach
Country of Study
Publication Country
Germany