Cardiorespiratory Fitness in Severe Mental Illness: A Systematic Review and Meta-analysis.

Journal: Sports medicine (Auckland, N.Z.)

Volume: 47

Issue: 2

Year of Publication: 2018

Affiliated Institutions:  Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium. davy.vancampfort@uc-kortenberg.be. School of Psychiatry, University of New South Wales, Sydney, NSW, Australia. Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil. School of Public Health and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia. Butabika National Referral and Mental Health Hospital, Kampala, Uganda. Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.

Abstract summary 

Cardiorespiratory fitness (CRF) among people with severe mental illness (SMI) (i.e., schizophrenia, bipolar disorder, and major depressive disorder) is a critical clinical risk factor given its relationship to cardiovascular disease and premature mortality.This study aimed to: (1) investigate the mean CRF in people with SMI versus healthy controls; (2) explore moderators of CRF; and (3) investigate whether CRF improved with exercise interventions and establish if fitness improves more than body mass index following exercise interventions.Major electronic databases were searched systematically. A meta-analysis calculating Hedges' g statistic was undertaken.Across 23 eligible studies, pooled mean CRF was 28.7 mL/kg/min [95 % confidence interval (CI) 27.3 to 30.0 mL/kg/min, p < 0.001, n = 980]. People with SMI had significantly lower CRF compared with controls (n = 310) (Hedges' g = -1.01, 95 % CI -1.18 to -0.85, p < 0.001). There were no differences between diagnostic subgroups. In a multivariate regression, first-episode (β = 6.6, 95 % CI 0.6-12.6) and inpatient (β = 5.3, 95 % CI 1.6-9.0) status were significant predictors of higher CRF. Exercise improved CRF (Hedges' g = 0.33, 95 % CI = 0.21-0.45, p = 0.001), but did not reduce body mass index. Higher CRF improvements were observed following interventions at high intensity, with higher frequency (at least three times per week) and supervised by qualified personnel (i.e., physiotherapists and exercise physiologists).The multidisciplinary treatment of people with SMI should include a focus on improving fitness to reduce all-cause mortality. Qualified healthcare professionals supporting people with SMI in maintaining an active lifestyle should be included as part of multidisciplinary teams in mental health treatment.

Authors & Co-authors:  Vancampfort Davy D Rosenbaum Simon S Schuch Felipe F Ward Philip B PB Richards Justin J Mugisha James J Probst Michel M Stubbs Brendon B

Study Outcome 

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Statistics
Citations :  Br J Sports Med. 2007 Jan;41(1):29-33
Authors :  8
Identifiers
Doi : 10.1007/s40279-016-0574-1
SSN : 1179-2035
Study Population
Male,Female
Mesh Terms
Body Mass Index
Other Terms
Study Design
Cross Sectional Study
Study Approach
Systemic Review
Country of Study
Publication Country
New Zealand