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.

Journal: Schizophrenia bulletin

Volume: 43

Issue: 3

Year of Publication: 2017

Affiliated Institutions:  Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK. Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain. Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK. Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Sydney, Australia. Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK. Kyambogo University, Kampala, Uganda. Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.

Abstract summary 

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.

Authors & Co-authors:  Stubbs Brendon B Koyanagi Ai A Schuch Felipe F Firth Joseph J Rosenbaum Simon S Gaughran Fiona F Mugisha James J Vancampfort Davy D

Study Outcome 

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Statistics
Citations :  Vancampfort D, Stubbs B, Mitchell AJ, et al. Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis. World Psychiatry. 2015;14:339–347.
Authors :  8
Identifiers
Doi : 10.1093/schbul/sbw111
SSN : 1745-1701
Study Population
Males,Females
Mesh Terms
Adolescent
Other Terms
activity;exercise;physical activity;physical health;psychosis;psychotic like experiences;schizophrenia
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
United States