Top

Social Psychiatry and Psychiatric Epidemiology

Published in:

Open Access 01-07-2019 | Original Paper

Factors associated with regular physical activity participation among people with severe mental ill health

Authors: Masuma Pervin Mishu, Emily J. Peckham, Paul N. Heron, Garry A. Tew, Brendon Stubbs, Simon Gilbody

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 7/2019

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.

Murray CJ, Vos T, Lozano R et al (2012) Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2197–2223. https://doi.org/10.1016/S0140-6736(12)61689-4 CrossRefPubMed

Vos T, Flaxman AD, Naghavi M et al (2012) Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2163–2196. https://doi.org/10.1016/S0140-6736(12)61729-2 CrossRefPubMedPubMedCentral

McCrone P, Dhanasiri S, Patel A et al (2008) Paying the price: the cost of mental health care in England to 2026

Razzano LA, Cook JA, Yost C et al (2015) Factors associated with co-occurring medical conditions among adults with serious mental disorders. Schizophr Res 161:458–464. https://doi.org/10.1016/j.schres.2014.11.021 CrossRefPubMed

Ribe AR, Laursen TM, Sandbaek A et al (2014) Long-term mortality of persons with severe mental illness and diabetes: a population-based cohort study in Denmark. Psychol Med 44:3097–3107. https://doi.org/10.1017/S0033291714000634 CrossRefPubMed

Holt RI (2012) Cardiovascular disease and diabetes in people with severe mental illness: causes, consequences and pragmatic management: review. South Afr J Diabetes Vasc Dis 9:107–111

Brown S, Kim M, Mitchell C, Inskip H (2010) Twenty-five year mortality of a community cohort with schizophrenia. Br J Psychiatry 196:116–121. https://doi.org/10.1192/bjp.bp.109.067512 CrossRefPubMedPubMedCentral

De Hert M, Dekker JM, Wood D et al (2009) Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC. Eur Psychiatry 24:412–424. https://doi.org/10.1016/j.eurpsy.2009.01.005 CrossRefPubMed

Osborn DJ, Levy G, Nazareth I, et al (2007) Relative risk of cardiovascular and cancer mortality in people with severe mental illness from the united kingdom’s general practice research database. Arch Gen Psychiatry 64:242–249. https://doi.org/10.1001/archpsyc.64.2.242 CrossRefPubMed

10.

Correll CU, Solmi M, Veronese N et al (2017) Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry 16:163–180. https://doi.org/10.1002/wps.20420 CrossRefPubMedPubMedCentral

11.

Naci H, Ioannidis JP (2013) Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study. Bmj 347:f5577. https://doi.org/10.1136/bmj.f5577 CrossRefPubMedPubMedCentral

12.

Nocon M, Hiemann T, Müller-Riemenschneider F et al (2008) Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil 15:239–246. https://doi.org/10.1097/HJR.0b013e3282f55e09 CrossRefPubMed

13.

Rosenbaum S, Tiedemann A, Sherrington C et al (2014) Physical activity interventions for people with mental illness: a systematic review and meta-analysis. J Clin Psychiatry 75:964–974. https://doi.org/10.4088/JCP.13r08765 CrossRef

14.

Firth J, Stubbs B, Rosenbaum S et al (2017) Aerobic exercise improves cognitive functioning in people with Schizophrenia: a systematic review and meta-analysis. Schizophr Bull 43:546–556. https://doi.org/10.1093/schbul/sbw115 CrossRefPubMed

15.

Vancampfort D, Rosenbaum S, Schuch F et al (2017) Cardiorespiratory fitness in severe mental illness: a systematic review and meta-analysis. Sport Med 47:343–352. https://doi.org/10.1007/s40279-016-0574-1 CrossRef

16.

Melo MC, Daher Ede F, Albuquerque SG, de Bruin VM (2016) Exercise in bipolar patients: a systematic review. J Affect Disord 198:32–38CrossRefPubMed

17.

Vancampfort D, Stubbs B (2017) Physical activity and metabolic disease among people with affective disorders: Prevention, management and implementation. J Affect Disord 224:87–94. https://doi.org/10.1016/j.jad.2016.07.042 CrossRefPubMed

18.

Schuch FB, Vancampfort D, Richards J et al (2016) Exercise as a treatment for depression: a meta-analysis adjusting for publication bias. J Psychiatr Res 77:42–51. https://doi.org/10.1016/j.jpsychires.2016.02.023 CrossRef

19.

Stubbs B, Vancampfort D, Hallgren M et al (2018) EPA guidance on physical activity as a treatment for severe mental illness: a meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental. Eur Psychiatry 54:124–144. https://doi.org/10.1016/j.eurpsy.2018.07.004 CrossRefPubMed

20.

Stanton R, Happell B (2013) Exercise for mental illness: a systematic review of inpatient studies. Int J Ment Health Nurs 23:232–242CrossRefPubMed

21.

Vancampfort D, Firth J, Schuch FB et al (2017) Sedentary behavior and physical activity levels in people with schizophrenia, bipolar disorder and major depressive disorder: a global systematic review and meta-analysis. World Psychiatry 16:308–315. https://doi.org/10.1002/wps.20458 CrossRefPubMedPubMedCentral

22.

Nyboe L, Lund H (2013) Low levels of physical activity in patients with severe mental illness. Nord J Psychiatry 67:43–46. https://doi.org/10.3109/08039488.2012.675588 CrossRefPubMed

23.

Ussher M, Stanbury L, Cheeseman V, Faulkner G (2007) Physical activity preferences and perceived barriers to activity among persons with severe mental illness in the United Kingdom. Psychiatr Serv 58:405–408. https://doi.org/10.1176/ps.2007.58.3.405 CrossRefPubMed

24.

Vancampfort D, Firth J, Schuch F et al (2016) Physical activity and sedentary behavior in people with bipolar disorder: a systematic review and meta-analysis. J Affect Disord 201:145–152CrossRefPubMed

25.

Stubbs B, Williams J, Gaughran F, Craig T (2016) How sedentary are people with psychosis? A systematic review and meta-analysis. Schizophr Res 171:103–109. https://doi.org/10.1016/j.schres.2016.01.034 CrossRefPubMed

26.

Vancampfort D, Knapen J, Probst M et al (2012) A systematic review of correlates of physical activity in patients with schizophrenia. Acta Psychiatr Scand 125:352–362CrossRefPubMed

27.

Vancampfort D, Stubbs B, Sienaert P et al (2015) What are the factors that influence physical activity participation in individuals with depression? A review of physical activity correlates from 59 studies. Psychiatr Danub 27:210–224PubMed

28.

Vancampfort D, Correll CU, Probst M et al (2012) A review of physical activity correlates in patients with bipolar disorder. J Affect Disord 145:285–291CrossRefPubMed

29.

Vancampfort D, Sienaert P, Wyckaert S et al (2016) Sitting time, physical fitness impairments and metabolic abnormalities in people with bipolar disorder: an exploratory study. Psychiatry Res 242:7–12CrossRefPubMed

30.

HWB (2018) The Lifestyle Health and Wellbeing (HWB) survey. https://www.york.ac.uk/healthsciences/research/mental-health/projects/lifestylehealthandwellbeingsurvey/. Accessed 6 Jun 2018

31.

NHS (2010) Changes to QOF 2010/11—NHS Employers. In: GMS Contract. http://www.nhsemployers.org/your-workforce/primary-care-contacts/general-medical-services/quality-and-outcomes-framework/archive-2006-2012/changes-to-qof-2010-11. Accessed 31 Aug 2018

32.

Yusuf HR, Croft JB, Giles WH et alt (1996) Leisure-time physical activity among older adults: United states, 1990. Arch Intern Med 156:1321–1326. https://doi.org/10.1001/archinte.1996.00440110093012 CrossRefPubMed

33.

Bursac Z, Gauss CH, Williams DK, Hosmer DW (2008) Purposeful selection of variables in logistic regression. Source Code Biol Med 3:17. https://doi.org/10.1186/1751-0473-3-17 CrossRefPubMedPubMedCentral

34.

Suetani S, Waterreus A, Morgan V et al (2016) Correlates of physical activity in people living with psychotic illness. Acta Psychiatr Scand 134:129–137CrossRefPubMed

35.

Firth J, Rosenbaum S, Stubbs B et al (2016) Motivating factors and barriers towards exercise in severe mental illness: a systematic review and meta-analysis. Psychol Med 46:2869–2881. https://doi.org/10.1017/s0033291716001732 CrossRefPubMedPubMedCentral

36.

Bassilios B, Judd F, Pattison P et al (2014) Predictors of exercise in individuals with schizophrenia: a test of the transtheoretical model of behavior change. Clin Schizophr Relat Psychoses 8:173–182CrossRef

37.

Vancampfort D, Wyckaert S, Sienaert P et al (2015) The functional exercise capacity in patients with bipolar disorder versus healthy controls: a pilot study. Psychiatry Res 229:194–199. https://doi.org/10.1016/j.psychres.2015.07.040 CrossRefPubMed

38.

Vancampfort D, Probst M, Sweers K et al (2011) Relationships between obesity, functional exercise capacity, physical activity participation and physical self-perception in people with schizophrenia. Acta Psychiatr Scand 123:423–430CrossRefPubMed

39.

Ribeiro SML, Malmstrom TK, Morley JE, Miller DK (2017) Fruit and vegetable intake, physical activity, and depressive symptoms in the African American Health (AAH) study. J Affect Disord 220:31–37CrossRefPubMed

40.

Stubbs B, Vancampfort D, Firth J et al (2018) Physical activity correlates among people with psychosis: data from 47 low- and middle-income countries. Schizophr Res 193:412–417. https://doi.org/10.1016/j.schres.2017.06.025 CrossRefPubMed

41.

Dipasquale S, Pariante CM, Dazzan P et al (2013) The dietary pattern of patients with schizophrenia: a systematic review. J Psychiatr Res 47:197–207. https://doi.org/10.1016/j.jpsychires.2012.10.005 CrossRefPubMed

42.

Firth J, Stubbs B, Teasdale SB et al (2018) Diet as a hot topic in psychiatry: a population-scale study of nutritional intake and inflammatory potential in severe mental illness. World Psychiatry 17:365–367. https://doi.org/10.1002/wps.20571 CrossRefPubMedPubMedCentral

43.

Vancampfort D, De Hert M, Vansteenkiste M et al (2013) The importance of self-determined motivation towards physical activity in patients with schizophrenia. Psychiatry Res 210:812–818CrossRefPubMed

44.

Vancampfort D, Stubbs B, Venigalla SK, Probst M (2015) Adopting and maintaining physical activity behaviours in people with severe mental illness: The importance of autonomous motivation. Prev Med (Baltim) 81:216–220CrossRef

45.

Ashdown-Franks G, Williams J, Vancampfort D et al (2018) Is it possible for people with severe mental illness to sit less and move more? A systematic review of interventions to increase physical activity or reduce sedentary behaviour. Schizophr Res. https://doi.org/10.1016/j.schres.2018.06.058 CrossRefPubMed

46.

Firth J, Carney R, Elliott R et al (2018) Exercise as an intervention for first-episode psychosis: a feasibility study. Early Interv Psychiatry 12:307–315. https://doi.org/10.1111/eip.12329 CrossRefPubMed

47.

Firth J, Stubbs B, Vancampfort D et al (2017) The validity and value of self-reported physical activity and accelerometry in people with Schizophrenia: a Population-Scale Study of the UK Biobank. Schizophr Bull. https://doi.org/10.1093/schbul/sbx149 CrossRefPubMedPubMedCentral

48.

Soundy A, Freeman P, Stubbs B et al (2014) The transcending benefits of physical activity for individuals with schizophrenia: a systematic review and meta-ethnography. Psychiatry Res 220:11–19. https://doi.org/10.1016/j.psychres.2014.07.083 CrossRefPubMed

49.

Vancampfort D, De Hert M, De Herdt A et al (2013) Associations between physical activity and the built environment in patients with schizophrenia: a multi-centre study. Gen Hosp Psychiatry 35:653–658CrossRefPubMed

Title: Factors associated with regular physical activity participation among people with severe mental ill health
Authors: Masuma Pervin Mishu
Emily J. Peckham
Paul N. Heron
Garry A. Tew
Brendon Stubbs
Simon Gilbody
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Published in: Social Psychiatry and Psychiatric Epidemiology / Issue 7/2019
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-018-1639-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Factors associated with regular physical activity participation among people with severe mental ill health

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 7/2019

Incident depression and mortality among people with different types of dementia: results from a longitudinal cohort study

Five-year rehospitalization experience of a state-wide cohort of persons with schizophrenia

Socioeconomic position and suicidal behaviour in rural Sri Lanka: a prospective cohort study of 168,000+ people

The association of time since spousal loss and depression in widowhood: a systematic review and meta-analysis

Compulsory admission at first presentation to services for psychosis: does ethnicity still matter? Findings from two population-based studies of first episode psychosis

Assessing needs for psychiatric treatment in prisoners: 3. Comparison of care received by black and minority ethnic prisoners and by white prisoners