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01-02-2017 | Systematic Review

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

Authors: Davy Vancampfort, Simon Rosenbaum, Felipe Schuch, Philip B. Ward, Justin Richards, James Mugisha, Michel Probst, Brendon Stubbs

Published in: Sports Medicine | Issue 2/2017

Abstract

Background

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.

Objectives

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.

Methods

Major electronic databases were searched systematically. A meta-analysis calculating Hedges’ g statistic was undertaken.

Results

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).

Conclusion

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.

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Title: Cardiorespiratory Fitness in Severe Mental Illness: A Systematic Review and Meta-analysis
Authors: Davy Vancampfort
Simon Rosenbaum
Felipe Schuch
Philip B. Ward
Justin Richards
James Mugisha
Michel Probst
Brendon Stubbs
Publication date: 01-02-2017
Publisher: Springer International Publishing
Published in: Sports Medicine / Issue 2/2017
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI: https://doi.org/10.1007/s40279-016-0574-1

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Objectives

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Objectives

Methods

Results

Conclusion

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