ORCID Profile
0000-0002-8984-4941
Current Organisation
University of New South Wales
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Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.GENHOSPPSYCH.2015.01.004
Abstract: People with schizophrenia experience increased rates of osteoporosis and may be at heightened risk of fractures. We conducted a systematic review and meta-analysis to investigate fractures among people with schizophrenia compared to people without mental illness. We systematically searched major electronic databases from inception until October 2014. Articles were included that reported the number of fractures in people with schizophrenia and a control group. Two independent authors conducted searches, completed methodological assessment and extracted data. Data were narratively synthesized, and a random-effects incidence rate ratio (IRR) meta-analysis was performed. Eight studies were included encompassing 48,384 people with schizophrenia (49.9-75.2 years, 41%-100% female) and 3,945,783 controls. The pooled adjusted rate of fractures per 1000 person-years was 5.54 [95% confidence interval (CI)=4.92-5.57] in people with schizophrenia and 3.48 (95% CI=3.39-3.64) in control participants. The comparative meta-analysis showed that people with schizophrenia experience an increased rate of fractures compared to control participants (IRR 1.72, 95% CI=1.24-2.39, I2=49% n=168,914). There were insufficient data to conduct moderation analysis, but the narrative review consistently highlighted that antipsychotic medication was an important risk factor for fractures. People with schizophrenia are at significantly increased risk of fractures. Future research is required to understand the mechanisms and should seek to validate fracture prediction algorithms used in the general population. Importantly, there is a need to develop preventative strategies to improve bone health and reduce fracture risk involving the wider multidisciplinary team and incorporating falls-prevention strategies.
Publisher: Springer Science and Business Media LLC
Date: 20-11-2018
Publisher: Human Kinetics
Date: 11-2021
Abstract: The Australasian Society for Physical Activity aims to advance the science and practice of physical activity in Australia, New Zealand, the Pacific Islands, East Asia, South Asia, Southeast Asia, and Oceania. Fun, enjoyment, and cross-disciplinary discourse are important to ensure the network of physical activity professionals and our collective voice continues to grow. In May 2021, Australasian Society for Physical Activity’s Early Career Network curated an engaging online Physical Activity Debate attended by 206 professionals. This commentary provides a synopsis of the debate and the central arguments presented by the affirmative and negatives teams. The authors describe the debate format and interactive design of the online Physical Activity Debate to provide insights for future online events that aim to boost interaction among physical activity professionals from various disciplines.
Publisher: Elsevier BV
Date: 10-2021
Publisher: Wiley
Date: 29-06-2022
DOI: 10.1111/AJCO.13594
Abstract: Exercise physiologists and physiotherapists can provide exercise interventions for cancer survivors however, many do not access this support. Our primary aim explored referral habits to exercise professionals and attitudes of oncology professionals. Secondary aims explored fitness levels of oncology professionals and the relationship between fitness and exercise referral habits. Oncology professionals (n = 67) attending a national cancer conference in Australia participated in this cross-sectional study (23% doctors, 11% nurses, 25% allied health, and 41% other). A subgroup (n = 49) completed a fitness assessment measuring aerobic fitness (3-minute step test), muscle strength (handgrip dynamometry), and body composition (waist-to-hip ratio). Oncology professionals in a position to refer patients to exercise professionals were assessed on their history of patient referrals. Sixty-seven of 750 eligible conference delegates participated (9% recruitment rate), of which 73% completed fitness assessments. Participants displayed above average physical activity and fitness levels with 60% meeting exercise guidelines. The majority (92%) agreed that exercise is important among cancer survivors to attenuate treatment-associated symptoms. Most understand the role of exercise physiologists (61%) and physiotherapists (64%) in cancer care. Seventy-three percent reported that referral to exercise professionals is optimal to increase exercise participation. Most (82%) oncology professionals who are able to refer patients to exercise professionals have self-reported doing so, while 91% recommended exercise themselves. Sixty-two percent were aware of evidence-based exercise guidelines. Fitness levels (p = 0.25), strength (p = 0.88), and physical activity (p = 0.33) did not impact referrals made to exercise professionals. There was high awareness exercise-oncology benefits and evidence-based guidelines existed among s led participants. Oncology professionals understand the role of exercise professionals, reflected by high self-reported referral rates. Implementing referral pathways to exercise professionals in cancer care may facilitate improved patient outcomes.
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.SCHRES.2018.02.035
Abstract: To comprehensively assess cardio-metabolic risk factors and their management in a large s le of outpatients treated with clozapine. Observational cross-sectional study of all clozapine users attending specialized clozapine monitoring outpatient clinics in three public hospitals in Sydney, Australia were approached to participate over the one-year period 01/10/2015-30/09/2016. Cardio-metabolic risk factors including metabolic syndrome, risk for future development of diabetes, smoking, physical activity, nutrition, and prescribed medications were assessed at face-to-face interview and through medical record review. Among patients who had cardio-metabolic risk factors, the proportion receiving appropriate management was assessed. Of 451 registered clozapine clinic attenders, 92.2% completed questionnaires and anthropometric measurements. 58.3% met criteria for metabolic syndrome. 79.6% were overweight or obese. 55.9% had blood pressure meeting metabolic syndrome criteria. 46.6% had elevated fasting blood glucose and 55.2% had elevated blood triglycerides. 43.6% were current smokers. Only 10% achieved recommended weekly physical activity levels. Unhealthy food categories were highly consumed. 32.1% were on additional antipsychotics. In the majority of in iduals, cardio-metabolic risk factors were untreated or under-treated. Clozapine use was associated with very high rates of cardiovascular and metabolic risk factors, which were frequently under-treated. Management of both physical and mental health should be prioritized. Polypharmacy should be rationalized. Future research should investigate the effectiveness of smoking cessation and lifestyle interventions in this high-risk population.
Publisher: Wiley
Date: 15-07-2022
DOI: 10.1002/HPJA.633
Abstract: People with severe mental illness have adverse health outcomes compared to the general population. Lifestyle interventions are effective in improving health outcomes in this population. Current cultural processes in mental health services do not generally incorporate physical health care practices. Innovative education is required to improve knowledge and confidence of staff in the delivery of preventative health measures. The Keeping our Staff in Mind (KoSiM) program delivered a brief lifestyle intervention to mental health staff. A qualitative analysis following the Standards for Reporting Qualitative Research was undertaken. Semi‐structured interviews designed to elicit information about the acceptability of the program and the impact of the intervention on participants' personal and professional lives. The interviews were analysed using thematic analysis, with coding independently developed and reviewed by three authors. Of the 103 eligible participants, 75 were interviewed. Responses revealed four main themes: (i) positive changes in clinician's approach to physical health care, (ii) improvements in attitudes to self‐care and family wellbeing, (iii) positive changes in workplace culture associated with physical health care delivery and (iv) high levels of acceptability of the program. The KoSiM model may be useful in other settings as a means of changing the culture of mental health services to better integrate physical health care as a core part of mental health service provision. A novel approach using staff focussed lifestyle interventions model may cut through the resistance that is encountered when implementing proven methods of clinical intervention where cultural barriers exist.
Publisher: Wiley
Date: 04-03-2015
DOI: 10.1111/ACPS.12407
Abstract: Cardiorespiratory fitness (CRF) is a major modifiable risk factor for cardiovascular disease (CVD). We conducted a clinical overview to highlight the reduced CRF expressed as maximal oxygen uptake (VO2max) (or predicted) or peak oxygen uptake (VO2 peak) in people with schizophrenia compared to the general population. We also aimed to identify correlates of and clinical strategies to improve CRF. We systematically searched major electronic databases from inception until November 2014. A meta-analysis calculating the standardised mean difference (SMD) was employed. CRF was significantly reduced in people with schizophrenia (n = 154) with a SMD of -0.96 (95% CI -1.29 to -0.64) (N = 5) compared to controls (n = 182). Negative symptoms, increased body mass index and female gender were negatively associated with CRF. Promoting physical activity may improve CRF in people with schizophrenia by up to 4-4.5 ml/kg/min following a 6-8 weeks programme (N = 4, n = 98). People with schizophrenia have a large and significantly reduced CRF. Given the overwhelming evidence for physical activity as the cornerstone of preventing and managing CVD in the general population, incorporating such interventions in the treatment of people with schizophrenia is justified and urgently required. We present clear practical strategies of how this can be achieved within clinical settings.
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.PSYCHRES.2014.08.049
Abstract: Cardiovascular fitness is reduced in people with schizophrenia and is related to an increased morbidity and mortality. There is mounting interest in the accurate measurement of cardiovascular fitness in schizophrenia, yet existing measures used in the general population have not been tested on validity and reliability in this high-risk group. Therefore, we examined the reproducibility and feasibility of the Astrand-Rhyming sub-maximal exercise test in patients with schizophrenia or schizoaffective disorder. Secondary aims were to assess minimal detectable changes, practice effects and the presence of clinical symptoms that are associated with cardio-respiratory fitness (expressed as estimated oxygen uptake). From 47 patients with schizophrenia or schizoaffective disorder two trials of the Astrand-Rhyming test, administered within three days, were analysed. The intraclass correlation coefficient for the estimated oxygen uptake between the two tests was 0.92 (95% confidence interval: 0.85-0.95). The minimal detectable change was 6.5mlO2/min/kg. No practice effect could be detected. A backward regression analysis demonstrated that illness duration, negative symptoms and level of physical activity explained 63.0% of the variance in estimated oxygen uptake. The current study demonstrates that the Astrand-Rhyming test can be recommended for evaluating the aerobic fitness in patients with schizophrenia or schizoaffective disorder.
Publisher: African Journals Online (AJOL)
Date: 07-10-2020
DOI: 10.4314/AHS.V20I3.49
Abstract: Background: In order to facilitate people with psychosis to increase their physical activity (PA) levels, a reliable measure- ment of these levels is of relevance. Objectives: The primary aim of current study was to explore the test-retest of the Simple Physical Activity Questionnaire (SIMPAQ) in Ugandan outpatients with psychosis. A second aim was to explore correlates of the SIMPAQ, including de- mographic variables and antipsychotic medication dose. Methods: Thirty-four women (33.9±8.0 years) and 21 men completed the SIMPAQ twice in a day. The test-retest reliability was assessed using Spearman Rho correlations coefficients. Differences in subgroups were analysed with Mann Whitney U tests. Results: The SIMPAQ showed a good test-retest reliability with correlates ranging from 0.78 (P .001) for structured exer- cise to 0.96 (P .001) for walking. Women, non-smokers and those without HIV/AIDS showed higher incidental PA than men, smokers and those with HIV/AIDS. Conclusion: The SIMPAQ is a reliable tool to assess PA and sedentary levels in Ugandan outpatients with psychosis. Men, smokers and those with HIV/AIDS appear to be at risk for lower incidental PA. Keywords: Physical activity sedentary lifestyle psychosis.
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/PY15130
Abstract: Cardiometabolic morbidity is a significant contributor to the poorer health outcomes experienced by people with intellectual disability (ID). Tailoring cardiometabolic monitoring tools developed for the general population to better fit the altered risk profiles and extra needs of people with ID may help to improve health outcomes. This paper describes a new cardiometabolic monitoring framework designed to address the extra needs of people with ID. The framework was adapted from a generalist guideline after a process of extensive consultation with the original authors and over 30 ID and cardiometabolic experts. In addition to standard cardiometabolic monitoring practice, the framework encourages clinicians to: anticipate and address barriers to care such as communication difficulties and fear of blood tests account for socioeconomic and genetic factors altering baseline cardiometabolic risk and carefully rationalize psychotropic prescription. Together with this framework, a toolkit of free cardiometabolic resources tailored for people with ID and formal and informal carers is included. The monitoring framework promotes a multidisciplinary and holistic approach to cardiometabolic care for people with ID.
Publisher: ACM
Date: 08-03-2021
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.PSYCHRES.2017.11.067
Abstract: This study investigated cardio-metabolic risk factors among patients with severe mental illness who do or do not meet the recommendations of 150min per week of physical activity. A secondary aim was to assess whether those that do meet the recommendations report lower levels of mental health symptoms. 107 (60♀) Ugandan in- and outpatients (mean age=34.4 ± 9.7 years) with severe mental illness (depression=7, bipolar disorder=55, schizophrenia=45) completed the Physical Activity Vital Sign (PAVS) method and Brief Symptoms Inventory -18. Participants were also screened for abdominal obesity (waist circumference>90cm), overweight (body mass index≥25) and hypertension (systolic pressure≥140mmHg and/or diastolic pressure≥90mmHg).48.6% (n = 52) of patients met the physical activity recommendations as assessed by the PAVS method. 41.1% (n = 44) were overweight, 40.2% (n = 43) had abdominal obesity and 23.4% (n = 25) had hypertension. Those who did not meet the physical activity recommendations were significantly older, had a higher BSI-18 somatisation score, and had a higher risk of overweight [relative risk (RR) = 2.88, 95% confidence interval (CI) = 1.59-4.99], abdominal obesity (RR = 1.82, 95%CI = 1.13-2.93), and hypertension (RR = 2.16, 95%CI = 0.99-4.73). The PAVS is a feasible method of assessing physical activity among patients with severe mental illness in a low resource setting. The PAVS may have clinical utility for physical and mental health risk stratification.
Publisher: Elsevier BV
Date: 02-2021
Publisher: Oxford University Press (OUP)
Date: 16-06-2017
DOI: 10.1093/AJE/KWX159
Abstract: In this study, we assessed the association of chronic medical conditions and multimorbidity with perceived stress among community-dwelling adults in 44 low- and middle-income countries. Data from the World Health Survey (2002-2004), including 229,293 adults, were analyzed. A perceived stress score (range, 0 (lowest stress)-100 (highest stress)) was computed on the basis of 2 questions from the Perceived Stress Scale. Eleven chronic conditions were assessed. Multivariable linear regression analyses were conducted to explore the associations. All chronic conditions were associated with significantly higher mean perceived stress scores, with the exception of edentulism. The associations were particularly strong for depression (β = 14.71, 95% confidence interval (CI): 13.68, 15.74), visual impairment (β = 10.66, 95% CI: 8.09, 13.23), and schizophrenia (β = 9.98, 95% CI: 7.71, 12.24). Compared with no chronic conditions, the β coefficients for perceived stress with the presence of 1, 2, 3, and ≥4 chronic conditions were 5.58 (95% CI: 4.94, 6.23), 9.58 (95% CI: 8.67, 10.49), 14.15 (95% CI: 12.63, 15.67), and 20.17 (95% CI: 18.29, 22.05), respectively. The associations with perceived stress were significantly stronger among the poorest in iduals for arthritis, asthma, diabetes, edentulism, and ≥4 chronic conditions. Our data suggest that a range of chronic conditions and multimorbidity are associated with greatly increased perceived stress among people in low- and middle-income countries, and that the poorest persons may be a particularly vulnerable group.
Publisher: Elsevier BV
Date: 10-2015
DOI: 10.1016/J.PSYCHRES.2015.07.081
Abstract: Increased control group responses (CGR) make it more difficult to establish the effectiveness of interventions to improve symptoms in schizophrenia. We conducted a meta-analysis of CGR within randomised control trials (RCTs) comparing exercise and a control condition in people with schizophrenia. We found no evidence of a CGR for total, positive or negative symptoms. Control group responses do not negatively impact exercise RCTs that have clearly demonstrated substantial beneficial effects of exercise in this population.
Publisher: Wiley
Date: 17-10-2019
DOI: 10.1111/AJR.12551
Publisher: Wiley
Date: 04-09-2016
DOI: 10.1111/EIP.12373
Abstract: Physical activity has the potential to improve the health of patients with first-episode psychosis (FEP), yet many patients with FEP remain inactive. Exploring the theoretical basis of the motivational processes linked to the adoption and maintenance of physical activity behaviours in FEP patients can assist with the design and delivery of physical activity interventions. Within the self-determination theory and the transtheoretical model (stages of change) frameworks, we investigated motives for physical activity adoption and maintenance in FEP. Overall 56 FEP patients (20♀) (24 ± 4 years) completed the Behavioural Regulation in Exercise Questionnaire 2 to assess exercise motives, and the Patient-Centred Assessment and Counselling for Exercise to determine stage of change. Gender and setting differences in motives for physical activity were compared with unpaired t-tests. The relationship between motives for physical activity and stage of change was investigated using anova with post-hoc Scheffe tests. No significant differences were found according to gender and setting. Multivariate analyses found significantly higher levels of amotivation and lower levels of autonomous motivation in the earlier stages of change. Our results suggest that in FEP patients, autonomous regulations may play an important role in the adoption and maintenance of physical activity behaviours. The study provides a platform for future research to investigate the importance of autonomous motivation within physical activity interventions for this population.
Publisher: Informa UK Limited
Date: 22-04-2016
Publisher: SAGE Publications
Date: 11-05-2020
Abstract: The aim of this paper was to cross-sectionally examine the association between physical health indicators and PTSD symptomatology. A cross-sectional study was conducted among inpatients of a service related trauma-focused ward. Physical and mental health indicators including sleep quality, fitness, physical activity, body mass index and PTSD symptomatology were assessed. Among 60 inpatients, significant associations were found between sedentary time ( r = 0.42 p .001) and sleep quality ( r = 0.40 p .001) with PTSD symptomatology. The vast majority of inpatients ( n = 56 93%) were found to be either overweight or obese according to body mass index. Inpatients of a PTSD treatment facility had extremely high rates of obesity, physical inactivity, poor cardiorespiratory fitness and poor sleep quality. Sedentary behaviour is a modifiable risk factor associated with symptoms and physical health.
Publisher: Oxford University Press (OUP)
Date: 24-10-2017
Publisher: Elsevier BV
Date: 03-2022
Publisher: Wiley
Date: 25-09-2015
DOI: 10.1002/WPS.20252
Publisher: Elsevier BV
Date: 06-2016
DOI: 10.1016/J.JPSYCHIRES.2016.02.023
Abstract: The effects of exercise on depression have been a source of contentious debate. Meta-analyses have demonstrated a range of effect sizes. Both inclusion criteria and heterogeneity may influence the effect sizes reported. The extent and influence of publication bias is also unknown. Randomized controlled trials (RCTs) were identified from a recent Cochrane review and searches of major electronic databases from 01/2013 to 08/2015. We included RCTs of exercise interventions in people with depression (including those with a diagnosis of major depressive disorder (MDD) or ratings on depressive symptoms), comparing exercise versus control conditions. A random effects meta-analysis calculating the standardized mean difference (SMD, 95% confidence interval CI), meta-regressions, trim and fill and fail-safe n analyses were conducted. Twenty-five RCTs were included comparing exercise versus control comparison groups, including 9 examining participants with MDD. Overall, exercise had a large and significant effect on depression (SMD adjusted for publication bias = 1.11 (95% CI 0.79-1.43)) with a fail-safe number of 1057. Most adjusted analyses suggested publication bias led to an underestimated SMD. Larger effects were found for interventions in MDD, utilising aerobic exercise, at moderate and vigorous intensities, in a supervised and unsupervised format. In MDD, larger effects were found for moderate intensity, aerobic exercise, and interventions supervised by exercise professionals. Exercise has a large and significant antidepressant effect in people with depression (including MDD). Previous meta-analyses may have underestimated the benefits of exercise due to publication bias. Our data strongly support the claim that exercise is an evidence-based treatment for depression.
Publisher: Wiley
Date: 18-09-2020
DOI: 10.1002/HPJA.406
Abstract: Posttraumatic stress disorder (PTSD) and psychological injuries are debilitating health problems facing police officers. There is increasing interest in the role of exercise as an intervention. We aimed to determine the preliminary effectiveness of the RECONNECT exercise program for NSW Police Officers experiencing PTSD or psychological injury. An open trial was conducted between 2016 and 2017 across three NSW sites. RECONNECT consisted of twice weekly, supervised exercise sessions for three months. Outcomes were assessed at baseline, week 6 and week 12 (intervention completion) and included PTSD symptoms, depression, anxiety and stress, insomnia severity and alcohol use. Data were analysed using linear mixed models. Results: In total, n = 60 Officers were consecutively referred to the program (35% female, mean age 42.0 ± 8.9 years). The majority had a clinical diagnosis of PTSD (n = 48, 80%). A clinically significant reduction in PTSD (Cohen's d = 0.96), depression (d = 0.71), anxiety (d = 0.55) and stress (d = 0.69) symptoms was found from baseline to week 12. Drop‐out and lost to follow‐up was high. Higher baseline PTSD severity was associated with an increased likelihood to complete postintervention assessment. RECONNECT appears to be effective in reducing symptoms of PTSD. Exercise may be an effective component of PTSD treatment.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2016
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/PY14054
Abstract: Mental illness affects the lives of a significant number of Australians. In addition to pharmacological and psychological interventions, exercise has demonstrated benefits for people with mental illness including symptom reduction, improved cardiovascular risk profile and improved physical capacity. Unfortunately, evidence shows that clinician-delivered exercise advice is not routinely offered. This is despite patient acceptability for exercise. This article summarises the recent evidence supporting the prescription of exercise for people with mental illness and offers a model incorporating basic exercise prescription, and referral pathways for specialised advice. Current exercise prescription patterns for people with mental illness may not meet patient expectations therefore, clinicians should consider exercise referral schemes to increase the accessibility of interventions for people with a mental illness.
Publisher: Wiley
Date: 05-10-2016
DOI: 10.1111/ACPS.12654
Abstract: Physical activity (PA) is good for health, yet several small-scale studies have suggested that depression is associated with low PA. A paucity of nationally representative studies investigating this relationship exists, particularly in low- and middle-income countries (LMICs). This study explored the global association of PA with depression and its mediating factors. Participants from 36 LMICs from the World Health Survey were included. Multivariable logistic regression analyses were undertaken exploring the relationship between PA and depression. Across 178 867 people (mean ± SD age = 36.2 ± 13.5 years 49.9% male), the prevalence of depression and the prevalence of low PA were 6.6% and 16.8% respectively. The prevalence of low PA was significantly higher among those with depression vs. no depression (26.0% vs. 15.8%, P < 0.0001). In the adjusted model, depression was associated with higher odds for low PA (OR = 1.42 95% CI = 1.24-1.63). Mediation analyses demonstrated that low PA among people with depression was explained by mobility limitations (40.3%), pain and discomfort (35.8%), disruptions in sleep and energy (25.2%), cognition (19.4%) and vision (10.9%). In iduals with depression engage in lower levels of PA in LMICs. Future longitudinal research is warranted to better understand the relationships observed.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2016
Publisher: Cold Spring Harbor Laboratory
Date: 09-12-2020
DOI: 10.1101/2020.12.08.20245829
Abstract: In addition to risking their physical well-being, frontline physicians are enduring significant emotional burden both at work and home during the COVID-19 pandemic. This study aims to investigate the levels of anxiety and depressive symptoms and to identify associated factors among Bangladeshi physicians during the COVID-19 outbreak. A cross-sectional study using an online survey was conducted between April 21 and May 10, 2020. Outcomes assessed included demographic questions, COVID-19 related questions, and the Hospital Anxiety and Depression Scale (HADS). The survey was completed by 412 Bangladeshi physicians. The findings revealed that, in terms of standardized HADS cut-off points, the prevalence of anxiety and depressive symptoms among physicians was 67.72% and 48.5% respectively. Risk factors for higher rates of anxiety or depressive symptoms were: being female, physicians who had experienced COVID-19 like symptoms during the pandemic, those who had not received incentives, those who used self-funded PPE, not received adequate training, lacking perceived self-efficacy to manage COVID -19 positive patients, greater perceived stress of being infected, fear of getting assaulted/humiliated, being more connected with social media, having lower income levels to support the family, feeling more agitated, less than 2 hours of leisure activity per day and short sleep duration. All these factors were found to be positively associated with anxiety and depression in unadjusted and adjusted statistical models. This study identifies a real concern about the prevalence of anxiety and depressive symptoms among Bangladeshi physicians and identifies several associated factors during the COVID-19 pandemic. Given the vulnerability of the physicians in this extraordinary period whilst they are putting their own lives at risk to help people infected by COVID-19, health authorities should address the psychological needs of medical staff and formulate effective strategies to support vital frontline health workers. This study reports a novel and concerning findings on the prevalence of anxiety and depression symptoms with identification of several important associated factors among Bangladeshi physicians during the COVID-19 pandemic. The cross-sectional nature of the study design could not establish causal relationship between the dependent and independent variables. This study was carried out by conducting a web-based survey, which might generate s ling bias by excluding the physicians who do not have access to internet or inactive in social medias, and thus limit the generalizability of the findings.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.PSYCHRES.2019.112675
Abstract: Longitudinal prospective cohorts have suggested that physical activity (PA) may be a protective factor against psychosis and schizophrenia. However, no meta-analysis has been conducted. The study aims to examine the prospective relationship between PA and incident psychosis/schizophrenia. Major databases were searched from inception to July 2019 for prospective studies that calculated the odds ratio (OR) or the adjusted odds ratio (AOR) of incident psychosis/schizophrenia in people with higher PA against people with lower PA. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was conducted, for OR and AOR, separately. Across 4 cohorts (N = 30,025 median males = 50%, median follow-up = 32 years), people with high self-reported PA (versus low PA) were at reduced odds of developing psychosis/schizophrenia (OR = 0.73, 95%CI 0.532 to 0.995, p = 0.047). Analysis including 2 cohorts presenting AOR were not statistically significant (AOR = 0.59, 95%CI 0.253 to 1.383, p = 0.226). Overall study quality was high (mean NOS = 7.0). The literature on the topic is scarce, whilst crude analysis suggests that PA may be a protective factor against the emergence of psychosis/schizophrenia, but when adjusting for covariates, the association is no longer significant. Further studies with objective physical activity and adjustment for confounders are needed.
Publisher: Elsevier BV
Date: 07-2020
Publisher: Hindawi Limited
Date: 17-06-2019
DOI: 10.1002/DA.22915
Abstract: Prospective cohorts have suggested that physical activity (PA) can decrease the risk of incident anxiety. However, no meta-analysis has been conducted. To examine the prospective relationship between PA and incident anxiety and explore potential moderators. Searches were conducted on major databases from inception to October 10, 2018 for prospective studies (at least 1 year of follow-up) that calculated the odds ratio (OR) of incident anxiety in people with high PA against people with low PA. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was conducted and heterogeneity was explored using subgroup and meta-regression analysis. Across 14 cohorts of 13 unique prospective studies (N = 75,831, median males = 50.1%) followed for 357,424 person-years, people with high self-reported PA (versus low PA) were at reduced odds of developing anxiety (adjusted odds ratio [AOR] = 0.74 95% confidence level [95% CI] = 0.62, 0.88 crude OR = 0.80 95% CI = 0.69, 0.92). High self-reported PA was protective against the emergence of agoraphobia (AOR = 0.42 95% CI = 0.18, 0.98) and posttraumatic stress disorder (AOR = 0.57 95% CI = 0.39, 0.85). The protective effects for anxiety were evident in Asia (AOR = 0.31 95% CI = 0.10, 0.96) and Europe (AOR = 0.82 95% CI = 0.69, 0.97) for children/adolescents (AOR = 0.52 95% CI = 0.29, 0.90) and adults (AOR = 0.81 95% CI = 0.69, 0.95). Results remained robust when adjusting for confounding factors. Overall study quality was moderate to high (mean NOS = 6.7 out of 9). Evidence supports the notion that self-reported PA can confer protection against the emergence of anxiety regardless of demographic factors. In particular, higher PA levels protects from agoraphobia and posttraumatic disorder.
Publisher: Informa UK Limited
Date: 08-07-2019
DOI: 10.1080/01612840.2019.1613701
Abstract: The association between psychotic illness and poor physical health is now clearly articulated in the literature. By contrast the impact of depression and/or anxiety on physical health is considerably less understood, despite depression being the leading cause of disability worldwide and is associated with significantly higher prevalence of physical comorbidities than found in the general population. An Australia national cross-sectional population-based survey was conducted to ascertain the prevalence of chronic physical health conditions in persons with, and without depression and/or anxiety, allowing for demographic characteristics and lifestyle factors. The telephone-based survey was conducted using trained interviewers. Survey questions included those eliciting information about demographics, health status, and health behaviours. Independent t-tests and chi square tests showed demographic, health behaviours, and physical illness differed between those with and without depression and/or anxiety. Heart disease, high blood pressure, stroke, cancer, arthritis, chronic neck and/or back pain, and asthma were significantly higher in participants diagnosed with depression and/or anxiety. Binary logistic regression showed the strongest predictor of chronic illness was having a diagnosis of depression and/or anxiety. Depression and anxiety present major health problems impacting a considerable proportion of the population. A greater understanding of the associated physical health issues should provide impetus to broaden the physical health and mental illness research agenda to include these diagnoses.
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.SCHRES.2016.05.017
Abstract: Physical activity (PA) improves health outcomes in people with schizophrenia. It is unclear how much PA people with schizophrenia undertake and what influences PA participation. We conducted a meta-analysis to investigate PA levels and predictors in people with schizophrenia. Major databases were searched from inception till 02/2016 for articles measuring PA (self-report questionnaire (SRQ) or objective measure (e.g. accelerometer)) in people with schizophrenia, including first episode psychosis (FEP). A random effects meta-analysis and meta-regression analysis were conducted. 35 studies representing 3453 in iduals with schizophrenia (40.0years 64.0% male) were included. Engagement in light PA was 80.44min (95% CI 68.32-92.52, n=2658), 47.1min moderate-vigorous PA (95% CI 31.5-62.8, n=559) and 1.05min (95% CI 0.48-1.62, n=2533) vigorous PA per day. People with schizophrenia engaged in significantly less moderate (hedges g=-0.45, 95% CI -0.79 to -0.1, p=0.01) and vigorous PA (g=-0.4, 95% CI -0.60 to -0.18) versus controls. Higher light to moderate, but lower vigorous PA levels were observed in outpatients and in studies utilizing objective measures versus SRQ. 56.6% (95% CI 45.8-66.8, studies=12) met the recommended 150min of moderate physical activity per week. Depressive symptoms and older age were associated with less vigorous PA in meta-regression analyses. Our data confirm that people with schizophrenia engage in significantly less moderate and vigorous PA versus controls. Interventions aiming to increase PA, regardless of intensity are indicated for people with schizophrenia, while specifically increasing moderate-vigorous PA should be a priority given the established health benefits.
Publisher: Springer Science and Business Media LLC
Date: 20-11-2020
DOI: 10.1007/S40279-019-01228-0
Abstract: Exercise is an efficacious therapy for many chronic diseases. Integrating efficacious evidence-based interventions (EBIs), such as exercise, into daily healthcare practice is a slow and complex pursuit. Implementation science seeks to understand and address this phenomenon by conducting studies about the methods used to promote the routine uptake of EBIs. The purpose of this article is to explore implementation science and a common conceptual framework in the discipline, the Consolidated Framework for Implementation Research (CFIR), as it applies to exercise EBI. We conclude by offering recommendations for future research that leverage implementation science priorities to highlight the potential of this research field for advancing the implementation of exercise EBI.
Publisher: Wiley
Date: 11-11-2019
DOI: 10.1111/AJR.12563
Abstract: To assess temporal trends in service provision by Accredited Exercise Physiologists based on remoteness classification using Australian Bureau of Statistics remoteness classifications of Major Cities, Inner Regional, Outer Regional, Remote and Very Remote. Cross-sectional analysis of publicly available Medicare Benefits Schedule datasets, for Medicare item number 10953 from 2012-2013 to 2016-2017. Number of claims, benefits paid, fees charges and number of providers for Medicare item number 10953. Accredited Exercise Physiologist service delivery demonstrates growth across all areas of remoteness classification. Rebates and fees mirror service delivery trends. The rate of service growth was significantly greater in Major Cities compared with all other remoteness classifications. Provider numbers show a steady increase from 2012-2013 to 2016-2017 but number remains higher in Major Cities compared with all other remoteness locations. Given the high proportion of chronic and complex illness in rural and remote areas, and the limited access to allied health care services, we propose more needs to be done to position Accredited Exercise Physiologists in these regions of increasing need. These findings have implications for future development of the Accredited Exercise Physiologist profession.
Publisher: Informa UK Limited
Date: 27-01-2020
DOI: 10.1080/17437199.2019.1706616
Abstract: Goal-setting is a widely used and accepted strategy for promoting physical activity. Locke and Latham's goal-setting theory is the primary theoretical framework for setting goals in psychology and plays a prominent role in physical activity promotion. Recently, however, there have been calls to reconsider current goal-setting practice in this field. Therefore, we aimed to critically review and update the application of goal-setting theory in physical activity promotion, by examining core developments in this theory since 1990. Current practice relies on setting specific 'performance' goals as a means of increasing physical activity (e.g., 10,000 steps national physical activity guidelines). This approach was initially consistent with key tenets of goal-setting theory. However, since 1990 this theory has evolved to differentiate between performance and learning goals. Both goal types are context-dependent and it is now recognised that, in some cases, performance goals can even be detrimental to the achievement of desired outcomes. Consequently, current practice may be theoretically appropriate for physically active in iduals but a different approach (e.g., learning goals) may be preferable for inactive in iduals who are new to physical activity (i.e., most of the population). We conclude by discussing implications for policy, research, and practice in goal-setting for physical activity promotion.
Publisher: Wiley
Date: 23-03-2015
DOI: 10.1111/EIP.12238
Abstract: To review intervention variables and outcomes of studies designed to increase physical activity or exercise participation among people experiencing first-episode psychosis. A systematic review of electronic databases was conducted from inception to November 2014. Eleven eligible studies describing 12 interventions were included (n = 351 14-35 years) incorporating health coaching (n = 5), exercise prescriptions based on physiological parameters (e.g. heart rate) (n = 3), supervised, in idually tailored programmes (n = 2), an Internet-delivered intervention and a yoga intervention. The majority of the interventions were delivered over 12 weeks (n = 6) and in community settings (n = 11). Five studies assessed aerobic capacity (VO2 max or VO2 peak) and three studies assessed self-reported physical activity levels. Considerable heterogeneity in the design, implementation and assessment of interventions was found. There is an urgent need to better understand how physical activity can be increased in line with the internationally endorsed HeaL (Healthy Active Lives) Declaration 5-year physical activity target.
Publisher: Informa UK Limited
Date: 15-10-2020
Publisher: Cold Spring Harbor Laboratory
Date: 06-12-2022
DOI: 10.1101/2022.12.05.22283129
Abstract: Meta-analytic evidence confirms a range of interventions, including mindfulness, physical activity and sleep hygiene, can reduce psychological distress in university students. However, it is unclear which intervention is most effective. Artificial intelligence (AI) driven adaptive trials may be an efficient method to determine what works best and for whom. The primary purpose of the study is to rank the effectiveness of mindfulness, physical activity, sleep hygiene and an active control on reducing distress, using a multi-arm contextual bandit-based AI-adaptive trial method. Furthermore, the study will explore which interventions have the largest effect for students with different levels of baseline distress severity. The Vibe Up study is a pragmatically-oriented, decentralised AI-adaptive group sequential randomised controlled trial (RCT) comparing the effectiveness of one of three brief, two week digital self-guided interventions (mindfulness, physical activity, or sleep hygiene) or active control (ecological momentary assessment) in reducing self-reported psychological distress in Australian university students. The adaptive trial methodology involves up to 12 sequential mini-trials that allow for the optimisation of allocation ratios. The primary outcome is change in psychological distress (DASS-21 total score) from pre-intervention to post-intervention. Secondary outcomes include change in depression, anxiety, and stress (measured by DASS-21 subscales) from pre-intervention to post-intervention. Planned contrasts will compare the four groups (i.e., the three intervention and control) using self-reported psychological distress at pre-specified time points for interim analyses. The study aims to determine the best performing intervention, as well as ranking of other interventions. Ethical approval was sought and obtained from the UNSW Sydney Human Research Ethics Committee (HREC A, HC200466). A trial protocol adhering to the requirements of the Guideline for Good Clinical Practice [1] was prepared for and approved by the Sponsor, UNSW Sydney (Protocol number: HC200466_CTP). The trial is registered with the Australian New Zealand Clinical Trials Registry (AC-TRN12621001223820). The study addresses an important clinical question using novel, advanced methods The trial uses short-duration interventions designed to improve coping responses to transient stressors, which addresses the most common needs of university students A value of information analysis is included to compare the value of the new trial methods with traditionalapproaches Digital phenotyping is used to explore smartphone sensor information with clinical outcomes More than 12 mini-trials might be required to determine the ranking for the interventions The interventions may prove to be of the same level of effectiveness for each level of severity Interventions other than those examined in this study, such as CBT, may be more effective and remain untested The methodology assumes that the three digital interventions are configured to deliver similar doses and/or have approximate fidelity with standard methods
Publisher: Springer Science and Business Media LLC
Date: 30-05-2021
DOI: 10.1186/S12885-021-08196-7
Abstract: Exercise is efficacious for people living after a cancer diagnosis. However, implementation of exercise interventions in real-world settings is challenging. Implementation outcomes are defined as ‘the effects of deliberate and purposive actions to implement new treatments, practices, and services’. Measuring implementation outcomes is a practical way of evaluating implementation success. This systematic review explores the implementation outcomes of exercise interventions evaluated under real-world conditions for cancer care. Using PRISMA guidelines, an electronic database search of Medline, PsycInfo, CINAHL, Web of Science, SportsDiscus, Scopus and Cochrane Central Registry of Controlled Trials was conducted for studies published between January 2000 and February 2020. The Moving through Cancer registry was hand searched. The Implementation Outcomes Framework guided data extraction. Inclusion criteria were adult populations with a cancer diagnosis. Efficacy studies were excluded. Thirty-seven articles that described 31 unique programs met the inclusion criteria. Implementation outcomes commonly evaluated were feasibility (unique programs n = 17, 54.8%) and adoption (unique programs n = 14, 45.2%). Interventions were typically delivered in the community (unique programs n = 17, 58.6%), in groups (unique programs n = 14, 48.3%) and supervised by a qualified health professional (unique programs n = 14, 48.3%). Implementation outcomes infrequently evaluated were penetration (unique programs n = 1, 3.2%) and sustainability (unique programs n = 1, 3.2%). Exercise studies need to measure and evaluate implementation outcomes under real-world conditions. Robust measurement and reporting of implementation outcomes can help to identify what strategies are essential for successful implementation of exercise interventions. Understanding how exercise interventions can be successful implemented is important so that people living after a cancer diagnosis can derive the benefits of exercise.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2013
Publisher: Informa UK Limited
Date: 19-06-2020
Publisher: Cambridge University Press (CUP)
Date: 17-07-2018
Publisher: Wiley
Date: 15-12-2020
DOI: 10.1111/INM.12683
Abstract: The life expectancy gap experienced by people living with severe mental illness is primarily a result of cardiometabolic disease that is often exacerbated by side effects of antipsychotic medication. Commencement of atypical antipsychotic medication is commonly associated with weight gain. The Keeping the Body in Mind programme has demonstrated that early intervention with lifestyle activities can attenuate this weight gain and potentially improve long-term health outcomes. The aim of this study was to explore the experiences of young people who participated in the Keeping the Body in Mind programme, a targeted lifestyle intervention programme. A qualitative approach was used employing a semi-structured interview format. The interview schedule included questions related to four topics: aspects of the programmes that were useful, attributes of staff members that influenced the programme, changes in attitudes towards their own physical health, and suggestions for programme improvements. Interviews were recorded with duration ranging from 40 to 65 min. Thematic analysis was used to detect and assemble codes. These were then synthesized and classified into themes. Eleven participants were interviewed (seven males), aged between 18 and 25 years. Thematic analysis revealed four main themes: the role of physical health in mental health recovery the importance of staff interactions the value of peer interaction and graduation to a sustainable healthy lifestyle. Study participants reported that they valued the programme for both their physical health and mental health recovery.
Publisher: Elsevier BV
Date: 10-2016
Publisher: Informa UK Limited
Date: 31-01-2022
DOI: 10.1080/17437199.2021.2023608
Abstract: The SMART acronym (e.g., Specific, Measurable, Achievable, Realistic, Timebound) is a highly prominent strategy for setting physical activity goals. While it is intuitive, and its practical value has been recognised, the scientific underpinnings of the SMART acronym are less clear. Therefore, we aimed to narratively review and critically examine the scientific underpinnings of the SMART acronym and its application in physical activity promotion. Specifically, our review suggests that the SMART acronym: is not based on scientific theory is not consistent with empirical evidence does not consider what type of goal is set is not applied consistently is lacking detailed guidance has redundancy in its criteria is not being used as originally intended and has a risk of potentially harmful effects. These issues are likely leading to sub-optimal outcomes, confusion, and inconsistency. Recommendations are provided to guide the field towards better practice and, ultimately, more effective goal setting interventions to help in iduals become physically active.
Publisher: Wiley
Date: 21-09-2017
DOI: 10.1002/WPS.20458
Publisher: Wiley
Date: 26-02-2016
DOI: 10.1111/EIP.12230
Abstract: Initiating antipsychotic medication frequently induces rapid, clinically significant weight gain. We aimed to evaluate the effectiveness of a lifestyle and life skills intervention, delivered within 4 weeks of antipsychotic medication initiation, in attenuating weight gain in youth aged 14-25 years with first-episode psychosis (FEP). We undertook a prospective, controlled study in two early psychosis community services. Intervention participants (n = 16) received a 12-week in idualized intervention delivered by specialist clinical staff (nurse, dietician and exercise physiologist) and youth peer wellness coaches, in addition to standard care. A comparison group was recruited from a similar service and received standard care (n = 12). The intervention group experienced significantly less weight gain at 12 weeks compared to standard care (1.8 kg, 95% CI -0.4 to 2.8 vs. 7.8 kg, 4.8-10.7, P < 0.001). Thirteen per cent (2/16) of the intervention group experienced clinically significant weight gain (greater than 7% of baseline weight), while 75% (9/12) of the standard care group experienced this level of weight gain. Similar positive effects of the intervention were observed for waist circumference. A lifestyle and life skills intervention delivered as part of standard care attenuated antipsychotic-induced weight gain in young people with FEP. The intervention was acceptable to the young people referred to the service. Such interventions may prevent the seeding of future disease risk and in the long-term help reduce the life expectancy gap for people living with serious mental illness.
Publisher: Hindawi Limited
Date: 2016
DOI: 10.1155/2016/4612953
Abstract: Currently, there are no effective pharmaceutical treatments to reduce cognitive decline or prevent dementia. At the same time, the global population is aging, and rates of dementia and mild cognitive impairment (MCI) are on the rise. As such, there is an increasing interest in complementary and alternative interventions to treat or reduce the risk of cognitive decline. Depression is one potentially modifiable risk factor for cognitive decline and dementia. Notably, exercise and yoga are two interventions known to both reduce symptoms of depression and improve cognitive function. The current review discusses the efficacy of exercise and yoga to ameliorate depression and thereby reduce the risk of cognitive decline and potentially prevent dementia. Potential mechanisms of change, treatment implications, and future directions are discussed.
Publisher: Royal College of Psychiatrists
Date: 02-2017
DOI: 10.1192/BJP.BP.115.177139
Abstract: Nutrition interventions would appear fundamental for weight management and cardiometabolic risk reduction in people experiencing severe mental illness (SMI). Comprehensive evaluation of nutrition interventions is lacking. To subject randomised controlled trials of nutrition interventions in people with SMI to systematic review and meta-analysis, and to measure anthropometric and biochemical parameters and nutritional intake. An electronic database search identified trials with nutrition intervention components. Trials were pooled for meta-analysis. Meta-regression analyses were performed on anthropometric moderators. Interventions led to significant weight loss (19 studies), reduced body mass index (17 studies), decreased waist circumference (10 studies) and lower blood glucose levels (5 studies). Dietitian-led interventions (6 studies) and studies delivered at antipsychotic initiation (4 studies) had larger effect sizes. Evidence supports nutrition interventions as standard care in preventing and treating weight gain among people experiencing SMI.
Publisher: Elsevier BV
Date: 11-2018
Publisher: Research Square Platform LLC
Date: 15-08-2019
Abstract: Background: Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness. Methods: The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Investigators from 43 centres in 23 countries collected reliability and validity data on the SIMPAQ from patients with DSM or ICD mental illness diagnoses. Test-retest repeatability was assessed one-week apart. Results: Criterion SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1,010 participants. The SIMPAQ had good test-retest reliability (Spearman rho approximately 0.70). Criterion validity for moderate-vigorous physical activity was comparable to studies conducted in general population s les. Criterion validity of the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had greater criterion validity. This alternative method is recommended for use in future studies employing the SIMPAQ. Conclusions: The SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals.
Publisher: Wiley
Date: 21-09-2017
DOI: 10.1002/WPS.20472
Publisher: Elsevier BV
Date: 02-2201
Publisher: American Psychiatric Association Publishing
Date: 07-2018
DOI: 10.1176/APPI.AJP.2018.17111194
Abstract: The authors examined the prospective relationship between physical activity and incident depression and explored potential moderators. Prospective cohort studies evaluating incident depression were searched from database inception through Oct. 18, 2017, on PubMed, PsycINFO, Embase, and SPORTDiscus. Demographic and clinical data, data on physical activity and depression assessments, and odds ratios, relative risks, and hazard ratios with 95% confidence intervals were extracted. Random-effects meta-analyses were conducted, and the potential sources of heterogeneity were explored. Methodological quality was assessed using the Newcastle-Ottawa Scale. A total of 49 unique prospective studies (N=266,939 median proportion of males across studies, 47%) were followed up for 1,837,794 person-years. Compared with people with low levels of physical activity, those with high levels had lower odds of developing depression (adjusted odds ratio=0.83, 95% CI=0.79, 0.88 I Available evidence supports the notion that physical activity can confer protection against the emergence of depression regardless of age and geographical region.
Publisher: Springer Science and Business Media LLC
Date: 14-06-2016
DOI: 10.1007/S40279-016-0574-1
Abstract: 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.
Publisher: Frontiers Media SA
Date: 11-12-2017
Publisher: Elsevier BV
Date: 2019
DOI: 10.2139/SSRN.3391379
Publisher: Elsevier BV
Date: 08-2016
DOI: 10.1016/J.PSYCHRES.2016.05.042
Abstract: Antipsychotics are used increasingly in adolescents for a range of psychiatric disorders. The aim of the current study was to investigate whether physical activity levels and physical fitness of adolescent inpatients treated with antipsychotic medication, differs from either (i) antipsychotic naïve adolescents with mental health problems and, (ii) healthy controls. All participants completed the Physical Activity Questionnaire for Adolescents, the Positive-and-Negative-Affect-Schedule and performed the Eurofit test battery. Adolescents with mental health problems (irrespective of antipsychotic medication) were significantly (P<0.05) less physically active and had an impaired whole body balance, running speed and cardiovascular endurance compared to healthy controls (n=15, 8♂, 15.9±1.3 years). Adolescents treated with antipsychotic medication (n=15, 8♂, 15.5±1.3 years) were less physically active and had an impaired whole body balance compared with antipsychotic naïve adolescents (n=15, 8♂, 15.7±1.4 years). Given the overwhelming deleterious impact of physical inactivity and low physical fitness on physical and mental health outcomes, interventions specifically targeting physical activity and physical fitness among adolescents experiencing mental illness, both treated with, and not treated with antipsychotic medication are warranted as a priority. Antipsychotic medication should be considered as a risk factor for physical inactivity and poor physical fitness.
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.METABOL.2015.04.009
Abstract: People with posttraumatic stress disorder (PTSD) have a higher mortality than the general population, mainly due to cardiovascular diseases (CVD). Metabolic syndrome (MetS) and its components are highly predictive of CVD. The aim of this meta-analysis was to describe pooled frequencies of MetS and its components in people with PTSD and to compare MetS prevalence in PTSD versus the general population. Medline, PsycARTICLES, Embase and CINAHL were searched until 02/2015 for cross-sectional and baseline data of longitudinal studies in adults with PTSD. Two independent reviewers conducted the searches and extracted data. Random effects meta-analysis with a relative risk, subgroups and meta-regression analyses were employed. Overall, 9 studies met the inclusion criteria including 9,673 in iduals in midlife with PTSD and 6852 general population controls. The pooled MetS prevalence was 38.7% (95% CI = 32.1%-45.6% Q = 52.1, p < 0.001 N = 9 n = 9,673 age range = 44-61 years). Abdominal obesity was observed in 49.3% (95% CI = 29.7%-69.0%), hyperglycemia in 36.1% (95% CI = 18.8%-55.6%), hypertriglyceridemia in 45.9% (95% CI = 12.2%-81.9%), low high density-lipoprotein-cholesterol in 46.4% (95% CI = 26.4%-67.0%) and hypertension in 76.9% (95% CI = 67.9%-84.8%). The MetS prevalence was consistently high across geographical regions, settings or populations (war veterans or not). Compared with matched general population controls, people with PTSD had an almost double increased risk for MetS (RR = 1.82 95% CI = 1.72-1.92 p < 0.001). Most analyses were not statistically heterogeneous. MetS is highly prevalent in people with PTSD. Routine screening and multidisciplinary management of medical and behavioral conditions is needed. Future research should focus on how cardio-metabolic outcomes are moderated by clinical and treatment characteristics and genetic factors.
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.PSYCHRES.2016.01.064
Abstract: The International Physical Activity Questionnaire (IPAQ) is a self-report questionnaire commonly used in mental health care settings to assess physical activity. However, despite its frequent use, its validity has not been investigated in people with bipolar disorder. The aim of this pilot study was to examine the concurrent validity of the energy expenditure recorded with the IPAQ compared with an objective measure, the Sensewear Armband (SWA). Twenty outpatients with bipolar disorder wore a SWA for 8 full consecutive days and subsequently completed the IPAQ. There was a significant correlation between the active (moderate and vigorous physical activity) energy expenditure as assessed with the IPAQ and SWA (minimum 10min bouts). The IPAQ overestimated active energy expenditure and underestimated total energy expenditure from physical activity by almost 40% compared with the SWA. Results demonstrate that the IPAQ should be used with caution as a measure for estimating energy expenditure from physical activity in outpatients with bipolar disorder.
Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.PSYCHRES.2021.114335
Abstract: This study explored the efficacy of lay health worker (LHW)-led physical activity (PA) counselling for primary care patients with mental health problems (PCMH) and their support partners. Forty-nine (41♀, median age=47, interquartile range=22) PCMH and 49 support partners [9♀, 31(9)years] participated in once weekly counselling based on the mental contrasting and implementation of intentions framework for 8 weeks. All participants completed the Simple Physical Activity Questionnaire (SIMPAQ) and World Health Organization Disability Assessment Schedule 2 (WHODAS 2), while PCMH completed the Multidimensional Scale for Perceived Social Support (MSPSS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Alcohol Use Disorders Identification Test (AUDIT) pre- and immediately post-intervention. In PCMH significant (P<0.001) increases in walking, exercising and incidental PA (SIMPAQ) levels, reductions in depressive (PHQ-9) and anxiety (GAD-7) symptoms and improvements in mobility and participation (WHODAS 2) were observed. Perceived support from significant others (MSPSS) significantly increased. In support partners, a significant reduction in time spent sedentary, increase in incidental PA (SIMPAQ) and improvement in the perception of getting alone with others (WHODAS 2) was seen. Our study demonstrates that LHW-led PA counselling is beneficial for PCMH and their support partners. Randomized controlled trials are warranted to confirm these positive findings.
Publisher: Elsevier BV
Date: 08-2019
Publisher: Research Square Platform LLC
Date: 18-12-2019
Abstract: Background: Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness. Methods: The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Investigators from 43 centres in 23 countries collected reliability and validity data on the SIMPAQ from patients with DSM or ICD mental illness diagnoses. Test-retest repeatability was assessed one-week apart. Results: Criterion SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1,010 participants. The SIMPAQ had good test-retest reliability (Spearman rho approximately 0.70). Criterion validity for moderate-vigorous physical activity was comparable to studies conducted in general population s les. Criterion validity of the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had greater criterion validity. This alternative method is recommended for use in future studies employing the SIMPAQ. Conclusions: The SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals.
Publisher: Oxford University Press (OUP)
Date: 19-04-2018
Publisher: Mark Allen Group
Date: 11-2013
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.JAD.2017.04.046
Abstract: Various psychological interventions are effective for reducing symptoms of anxiety when used alone, or as an adjunct to anti-anxiety medications. Recent studies have further indicated that smartphone-supported psychological interventions may also reduce anxiety, although the role of mobile devices in the treatment and management of anxiety disorders has yet to be established. We conducted a systematic review and meta-analysis of all randomized clinical trials (RCTs) reporting the effects of psychological interventions delivered via smartphone on symptoms of anxiety (sub-clinical or diagnosed anxiety disorders). A systematic search of major electronic databases conducted in November 2016 identified 9 eligible RCTs, with 1837 participants. Random-effects meta-analyses were used to calculate the standardized mean difference (as Hedges' g) between smartphone interventions and control conditions. Significantly greater reductions in total anxiety scores were observed from smartphone interventions than control conditions (g=0.325, 95% C.I.=0.17-0.48, p<0.01), with no evidence of publication bias. Effect sizes from smartphone interventions were significantly greater when compared to waitlist/inactive controls (g=0.45, 95% C.I.=0.30-0.61, p<0.01) than active control conditions (g=0.19, 95% C.I.=0.07-0.31, p=0.003). The extent to which smartphone interventions can match (or exceed) the efficacy of recognised treatments for anxiety has yet to established. This meta-analysis shows that psychological interventions delivered via smartphone devices can reduce anxiety. Future research should aim to develop pragmatic methods for implementing smartphone-based support for people with anxiety, while also comparing the efficacy of these interventions to standard face-to-face psychological care.
Publisher: Public Library of Science (PLoS)
Date: 08-2019
Publisher: Springer Science and Business Media LLC
Date: 22-10-2019
DOI: 10.1186/S12913-019-4608-X
Abstract: Despite an increase in studies showing the efficacy of lifestyle interventions in improving the poor health outcomes for people with severe mental illness (SMI), routine implementation remains ad hoc. Recently, a multidisciplinary lifestyle enhancing treatment for inpatients with SMI (MULTI) was implemented as part of routine care at a long-term inpatient facility in the Netherlands, resulting in significant health improvements after 18 months. The current study aimed to identify barriers and facilitators of its implementation. Determinants associated with the implementation of MULTI, related to the innovation, the users (patients, the healthcare professionals (HCPs)), and the organisational context, were assessed at the three wards that delivered MULTI. The evidence-based Measurement Instrument for Determinants of Innovations was used to assess determinants (29 items), each measured through a 5-point Likert scale and additional open-ended questions. We considered determinants to which ≥20% of the HCPs or patients responded negatively (“totally disagree/disagree”, score 3) as barriers and to which ≥80% of HCPs or patients responded positively (“agree/totally agree”, score 3) as facilitators. We included responses to open-ended questions if the topic was mentioned by ≥2 HCPs or patients. In total 50 HCPs (online questionnaire) and 46 patients (semi-structured interview) were invited to participate in the study. Participating HCPs ( n = 42) mentioned organisational factors as the strongest barriers (e.g. organisational changes and financial resources). Patients ( n = 33) mentioned the complexity of participating in MULTI as the main barrier, which could partly be due to organisational factors (e.g. lack of time for nurses to improve tailoring). The implementation was facilitated by positive attitudes of HCPs and patients towards MULTI, including their own role in it. Open responses of HCPs and patients showed strong commitment, collaboration and ownership towards MULTI. This is the first study analysing the implementation of a pragmatic lifestyle intervention targeting SMI inpatients in routine clinical care. Positive attitudes of both HCPs and patients towards such an approach facilitated the implementation of MULTI. We suggest that strategies addressing organisational implementation barriers are needed to further improve and maintain MULTI, to succeed in achieving positive health-related outcomes in inpatients with SMI.
Publisher: Wiley
Date: 30-10-2016
Publisher: Wiley
Date: 06-08-2014
DOI: 10.1111/ACPS.12325
Abstract: To conduct a meta-analysis investigating the prevalence of pain in people with bipolar disorder (BD). A systematic review and random effects meta-analysis searching major electronic databases from inception till 01/2014 in accordance with the PRISMA statement. We included articles reporting quantitative data on the prevalence of pain in people with BD with or without a healthy control group. Two independent authors conducted searches, extracted data, and completed methodological quality assessment. Twenty two cross-sectional studies were included, representing 12,375,644 in iduals (BD n=171,352, n controls=12,204,292). The prevalence of pain in people with BD was 28.9% (95% CI=16.4-43.4%, BD n=171,352). The relative risk (RR) of pain in BD compared to controls was 2.14 (95% CI=1.67-2.75%, n=12,342,577). The prevalence of migraine was 14.2% (95% CI=10.6-18.3%, BD n=127,905), and the RR was 3.30 (95% CI=2.27-4.80%, n=6,732,220).About 23.7% (95% CI=13.1-36.3%, n=106,214) of people with BD experienced chronic pain. Age, percentage of males, methodological quality, and method of BD classification did not explain the observed heterogeneity. People with BD experience significantly increased levels of pain (particularly chronic pain and migraine). The assessment and treatment of pain should form an integral part of the management of BD.
Publisher: Elsevier BV
Date: 05-2015
Publisher: Informa UK Limited
Date: 15-02-2018
DOI: 10.1080/09638237.2018.1437614
Abstract: Exercise interventions are efficacious in reducing cardiometabolic risk and improving symptoms in people with severe mental illness, yet evidence guiding the implementation and scalability of such efforts is lacking. Given increasing efforts to address the disparity in physical health outcomes facing people with a mental illness, novel approaches to increasing adoption of effective interventions are required. Exercise interventions targeting mental health staff may improve staff health while also creating more positive attitudes towards the role of lifestyle interventions for people experiencing mental illness. We aimed to determine the feasibility, acceptability and effectiveness of exercise interventions delivered to staff working in mental health services. A systematic review was conducted from database inception, until November 2017. Studies recruiting staff participants to receive an exercise intervention were eligible for inclusion. Five studies met the inclusion criteria. Physical health interventions for mental health staff were feasible and acceptable with low dropout rates. Reductions in anthropometric measures and work-related stress were reported. Limited evidence suggests that exercise interventions targeting mental health staff are feasible and acceptable. Further research is required to determine the efficacy of such interventions and the impact such strategies may have on staff culture and patient outcomes.
Publisher: Elsevier BV
Date: 2016
Publisher: Wiley
Date: 14-03-2016
DOI: 10.1111/ACPS.12562
Publisher: Informa UK Limited
Date: 17-03-2023
Publisher: Elsevier BV
Date: 03-2019
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.YPMED.2019.105819
Abstract: Physical inactivity is a serious public health concern in adolescents from low- and middle-income countries (LMICs). Despite this, only a few multinational studies has investigated correlates of physical activity (PA) in young adolescents in this part of the world. In this study, we identified physical activity correlates using data from the Global school-based Student Health Survey. In total, 142,118 adolescents from 48 LMICs (age 13.8 ± 1.0 years 49% girls) were included in the analyses. PA was assessed by the PACE+ Adolescent Physical Activity Measure and participants were dichotomised into those who do (60 min of moderate-vigorous PA every day of the week) and do not comply with the World Health Organization recommendations. We used multivariable logistic regression in order to assess the correlates. The prevalence of low PA was 15.3% (95%CI = 14.5%-16.1%). Boys (OR = 1.64 95%CI = 1.47-1.83) and those who participated in physical education for ≥5 days/week (OR = 1.12 95%CI = 1.10-1.15) were more likely to meet PA guidelines, while adolescents with food insecurity (OR = 0.85 95%CI = 0.80-0.90), low fruit and vegetable intake (OR = 0.68 95%CI = 0.63-0.74), low parental support/monitoring (OR = 0.68 95%CI = 0.62-0.74), no friends (OR = 0.80 95%CI = 0.72-0.88), and who experienced bullying (OR = 0.93 95%CI = 0.86-0.99) were less likely to have adequate levels of PA. There were a few variations in the correlates depending on country-income level. Our data indicate that in adolescents aged 12 to 15 years living in LMICs physical activity participation is a complex and multi-dimensional behavior determined by sociocultural, socio-economic, and policy-related factors. Longitudinal research is needed to confirm/refute the present findings.
Publisher: SAGE Publications
Date: 02-07-2016
Abstract: Physical activity (PA) and exercise is increasingly being recognised as an efficacious component of treatment for various mental disorders. The association between PA and cardiometabolic disease is well established, as is the strong link between mental illness, sedentary behaviour and poor cardiometabolic health. Ex les of successful integration of clinical PA programs within mental health treatment facilities are increasing. The aim of this review was to summarise the evidence regarding PA and mental illness, and to present ex les of clinical exercise programs within Australian mental health facilities. A narrative synthesis of systematic reviews and clinical trials was conducted. Evidence supporting the inclusion of PA programs as an adjunct to treatment for various conditions was presented including depression, schizophrenia, anxiety disorders, post-traumatic stress disorder and substance abuse. In light of the available evidence, the inclusion of clinical PA programs within mental health treatment, facilitated by dedicated clinicians (exercise physiologists / physiotherapists) was justified. PA is a feasible, effective and acceptable adjunct to usual care for a variety of mental disorders. There is a clear need for greater investment in initiatives aiming to increase PA among people experiencing mental illness, given the benefits to both mental and physical health outcomes.
Publisher: Springer Science and Business Media LLC
Date: 21-02-2023
DOI: 10.1038/S41598-023-29503-1
Abstract: Women with PCOS have substantially greater symptoms of depression and anxiety, and a lower health-related quality of life (HRQoL) compared to women without PCOS. The aim of this study was to determine if high-intensity interval training (HIIT) could provide greater improvements in mental health outcomes than standard moderate-intensity continuous training (MICT). Twenty-nine overweight women with PCOS aged 18–45 years were randomly assigned to 12 weeks of either MICT (60–75% HR peak , N = 15) or HIIT ( 90% HR peak , N = 14). Outcome measures included symptoms of depression, anxiety and stress (DASS-21), general HRQoL (SF-36) and PCOS specific HRQoL (PCOSQ) collected at baseline and post-intervention. Reductions in depression (Δ − 1.7, P = 0.005), anxiety (Δ − 3.4, P 0.001) and stress (Δ − 2.4, P = 0.003) scores were observed in the HIIT group, while MICT only resulted in a reduction in stress scores (Δ − 2.9, P = 0.001). Reductions in anxiety scores were significantly higher in the HIIT group compared to the MICT group (β = − 2.24, P = 0.020). Both HIIT and MICT significantly improved multiple domain scores from the SF-36 and PCOSQ. This study highlights the potential of HIIT for improving mental health and HRQoL in overweight women with PCOS. HIIT may be a viable strategy to reduce symptoms of depression and anxiety in women with PCOS, however, large-scale studies are required to confirm these findings. Trial registration number : ACTRN12615000242527.
Publisher: MDPI AG
Date: 28-09-2022
Abstract: Introduction: Despite the health benefits of regular physical activity, women experiencing socioeconomic disadvantage are at high risk of inactivity. Reasons are multifactorial but likely include broad structural and contextual factors, e.g., lack of access to physical activity programs, as well as in idual and interpersonal factors, e.g., lack of motivation and childcaring responsibilities. Few studies among women of low socioeconomic position (SEP) have explored these factors in-depth, yet an understanding of these factors can help inform the development and improve the uptake of exercise referral schemes. The Theoretical Domains Framework (TDF) and COM-B model (capability, opportunity, motivation and behaviour) were employed to understand behaviours for intervention development. Therefore, using these behaviour change models, this study aimed to explore the barriers and facilitators influencing the use of an exercise referral scheme among women living in a socioeconomically disadvantaged area. Methods: Semi-structured interviews were conducted with women who had registered with a free exercise referral scheme (Live Life Get Active) and living in a low socioeconomic neighbourhood in Sydney, Australia. Reflexive thematic analysis and framework analysis were used to allow naturally identified themes to be determined and then allocated to theoretically driven domains. Results: Nine women were interviewed (aged 30–69 years). Eighteen themes were identified and mapped directly on to the six COM-B constructs. The most reported barriers to using the physical activity referral scheme related to the opportunity construct of the COM-B model, specifically childcare responsibilities, work commitments and environmental barriers. Key facilitators were enjoyment (motivation), no cost (opportunity), instructor led (opportunity) and social support (opportunity). Conclusion: Future exercise referral schemes targeting women living in low-SEP neighbourhoods should ensure programs are designed and delivered to overcome barriers aligned with the constructs of the COM-B model, particularly opportunity-related constructors.
Publisher: Wiley
Date: 28-01-2020
DOI: 10.1002/HPJA.320
Abstract: People living with mental illness die on average 15 years earlier than the general population, primarily due to preventable and premature cardiovascular disease. Lifestyle interventions can be effective in reducing cardiovascular risk, yet mental health services do not routinely provide targeted lifestyle interventions. Exposing mental health staff to lifestyle interventions prior to targeting patients may be critical to changing culture and improving patient outcomes. This study aimed to improve the physical health of mental health staff through a targeted lifestyle intervention. A pragmatic single-arm intervention study was conducted in a public mental health service, including inpatient and community settings, in Sydney, Australia. Participants in this study were n = 212 clinical and non-clinical staff. A five-session in idualised lifestyle intervention (delivered over 5 weeks) incorporating physical activity and nutritional counselling was delivered by multidisciplinary teams. Participants were assessed at baseline, following the intervention, and at follow-up (mean = 16.7 weeks). The primary outcome was the barriers, attitudes, knowledge and confidence regarding screening, promoting and intervening to improve physical health outcomes of patients (M-BACK questionnaire). Secondary outcomes included anthropometric measures, cardiorespiratory fitness, sedentary time and nutritional intake. Repeated measures ANCOVAs were performed. A total of 212 staff (79% female) participated in this study. M-BACK total score significantly increased from baseline to follow-up (P < .001). Waist circumference, sedentary time and total energy intake all significantly decreased (all P's < .001) and cardiorespiratory fitness significantly increased (P < .001). A brief lifestyle intervention for staff of a public mental health service may increase the capability of the participants to improve their own physical health. SO WHAT?: Improving staff health may be an important strategy in improving the uptake and/or the effectiveness of lifestyle interventions targeting mental health service users.
Publisher: Springer Science and Business Media LLC
Date: 19-12-2015
DOI: 10.1007/S10597-014-9787-7
Abstract: In idual dietetic consultations were trialled in a community-based first-episode psychosis program. Participants received eight in idualised dietetic consultations, plus weekly shopping tours and cooking groups. The outcome measure was waist circumference (WC). In total, 30 patients commenced the program. An intention-to-treat analysis revealed, a statistically significant reduction in WC (mean=2.1±5.4 cm, t=2.1, df=29, p=0.04). Similar results were found for the 14 participants who attended all eight sessions (mean WC reduction=2.9±4.7 cm, t=2.3, df=13, p=0.04). Dietetic consultations were feasible and effective in reducing WC, and could enhance programs to reduce cardiometabolic risk in youth with psychosis using lifestyle interventions.
Publisher: Wiley
Date: 03-01-2014
DOI: 10.1111/INM.12057
Abstract: The aim of the present study was to: (i) document the prevalence of risk factors for non-communicable diseases among mental health consumers (inpatients) with various diagnoses and (ii) audit the frequency of waist circumference (WC) documentation before and after an intervention that involved a single nurse-education session, and change in assessment-form design. The study was undertaken in a private psychiatric hospital in Sydney, Australia. Twenty-five nurses participated in the educational intervention. File audits were performed prior to intervention delivery (n = 60), and 3 months' (n = 60), and 9 months' (n = 60) post-intervention. Files were randomly selected, and demographic (age, diagnosis) and risk factor (WC, body mass index (BMI), smoking status, blood pressure) data were extracted. WC was higher in this cohort compared to published general population means, and only 19% of patients had a BMI within the healthy range. In total, 37% of patients smoked, while 31% were hypertensive. At baseline, none of the audited files reported WC, which increased to 35 of the 60 (58%) files audited at the 3-month follow up. At the 9-month follow up, 25 of the 60 (42%) files audited reported a WC. In the 120 post-intervention files audited, only two patients refused measurement. These results illustrate the poor physical health of inpatients, and suggest that nurse-assessed metabolic monitoring can be enhanced with minimal training.
Publisher: Elsevier BV
Date: 10-2021
Publisher: Elsevier BV
Date: 03-2021
Publisher: Informa UK Limited
Date: 15-09-2016
DOI: 10.1080/09638288.2016.1226412
Abstract: People with posttraumatic stress disorder (PTSD) have an increased risk of cardiovascular diseases (CVD). Physical fitness is a key modifiable risk factor for CVD and associated mortality. We reviewed the evidence-base regarding physical fitness in people with PTSD. Two independent reviewers searched PubMed, CINAHL, PsycARTICLES, PEDro, and SPORTDiscus from inception until May 2016 using the key words "fitness" OR "exercise" AND "posttraumatic stress disorder" OR "PTSD". In total, 5 studies involving 192 (44 female) in iduals with PTSD met the inclusion criteria. Lower baseline physical fitness are associated with greater reductions in avoidance and hyperarousal symptoms, as well as with total, physical, and social symptoms of anxiety sensitivity. Rigorous data comparing physical fitness with age- and gender matched general population controls are currently lacking. The research field regarding physical fitness in people with PTSD is still in its infancy. Given the established relationships between physical fitness, morbidity and mortality in the general population and the current gaps in the PTSD literature, targets for future research include exploring: (a) whether people with PTSD are at risk of low physical fitness and therefore in need of intensified assessment, treatment and follow-up, (b) the relationships among physical fitness, overall health status, chronic disease risk reduction, disability, and mortality in in iduals PTSD, (c) psychometric properties of submaximal physical fitness tests in PTSD, (d) physical fitness changes following physical activity in PTSD, and (e) optimal methods of integrating physical activity programs within current treatment models for PTSD. Implications for Rehabilitation People with PTSD should aim to achieve 150 minutes of moderate or 75 minutes vigorous physical activity per week while also engaging in resistance training exercises at least twice a week. Health care professionals should assist people with PTSD to overcome barriers to physical activity such as physical pain, loss of energy, lack of interest and motivation, generalized fatigue and feelings of hyperarousal.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.JPSYCHIRES.2018.11.004
Abstract: People living with mental illness often experience poor sleep quality compared to the general population. Poor sleep quality exacerbates symptoms of mental illness and contributes to increased physical comorbidities. Exercise has been shown to be an effective non-pharmacological treatment for managing poor sleep in the general population. Little is known regarding the efficacy of targeted exercise interventions for improving sleep quality amongst in iduals with a mental illness. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) examining the impact of exercise on sleep quality in people with mental illness. Major electronic databases were searched from inception until June 2018 for exercise-based RCTs that included either subjective and/or objective measures of sleep quality in people with severe mental illness (SMI). Eight RCT's were included in the meta-analysis, involving use of a range of exercise modalities in people with SMI diagnoses. Overall, exercise had a large statistically significant effect on sleep quality (hedges g = 0.73, 95% CI (0.18, 1.28), p-value = 0.01 N = 8, n = 1,329, I
Publisher: Wiley
Date: 25-12-2019
DOI: 10.1002/BRB3.1491
Publisher: Wiley
Date: 19-09-2021
DOI: 10.1002/HPJA.538
Abstract: The COVID‐19 pandemic and associated social distancing regulations have disproportionally impacted the health of older adults. Lifestyle interventions targeting physical activity, diet and fostering social connection may help to alleviate the potential negative health consequences. This study aimed to determine the feasibility and preliminary effectiveness of delivering an online group lifestyle intervention for older adults during the COVID‐19 pandemic. Adults aged 60+, living in Australia were recruited to a single‐arm feasibility study of a 6‐week program delivered via a private Facebook group between June‐August 2020. Facilitators provided motivation and education on weekly topics including goal setting and reducing sedentary behaviour in the form of Facebook posts and group video calls. Primary outcomes included feasibility and acceptability and secondary outcomes included psychological distress, quality of life (AQoL‐6D), functioning, loneliness and physical activity (PA) with assessments conducted at baseline, post‐intervention and 4‐week follow‐up. N = 11 participants were recruited and n = 10 (91%) completed the post‐assessment questionnaires. High acceptability was observed and exploratory analysis from pre‐post intervention found evidence of an effect on secondary outcomes. A mental health informed lifestyle program delivered online via Facebook appears feasible and well‐accepted among older adults and may help to prevent some of the consequences of inactivity and social isolation associated with the pandemic. Online lifestyle interventions appear safe and may provide a scalable, cost‐effective strategy for protecting the physical and mental health of older adults during the COVID‐19 pandemic.
Publisher: MDPI AG
Date: 28-02-2023
Abstract: (1) Background: Adolescent refugees in Lebanon and Lebanese youth are both at high risk of suffering from reduced psychological well-being. Sport is an evidence-based strategy for improving mental and physical health, and climbing is a type of sport that may positively impact both. The aim of this study is to test the effect of a manualized, psychosocial group climbing intervention on the well-being, distress, self-efficacy, and social cohesion of adolescents in Lebanon. In addition, the mechanisms behind psychological changes will be investigated. (2) Methods: In this mixed-methods waitlist-controlled study, we are allocating a minimum of 160 participants to an intervention (IG) or a control group (CG). The primary outcome is overall mental well-being (WEMWBS) after the 8-week intervention. Secondary outcomes include distress symptoms (K-6 Distress Scale), self-efficacy (General Self-Efficacy Scale GSE), and social cohesion. Potential mechanisms of change and implementation factors are being investigated through qualitative interviews with a subgroup of 40 IG participants. (3) Conclusions: The results may contribute to knowledge of sports interventions and their effects on psychological well-being and will provide insights regarding low-intensity interventions for supporting adolescent refugees and host populations in conflict-affected settings. The study was prospectively registered at the ISRCTN platform (current-controlled trials). ISRCTN13005983.
Publisher: Elsevier BV
Date: 04-2017
DOI: 10.1016/J.PSYCHRES.2017.01.049
Abstract: In iduals living with schizophrenia are 2-3 times more likely to experience type 2 diabetes mellitus. Diabetes medication adherence is essential to reduce morbidity and mortality in this population. We conducted a meta-analysis of diabetes medication adherence among people with schizophrenia, and compared this to those without schizophrenia. A systematic search strategy was used to identify all articles reporting adherence to diabetes medications among patients with schizophrenia. In total, 10 unique studies reporting data from 33,910 people with schizophrenia were included. Random effects meta-analysis showed people with schizophrenia adhered to medication on 77.3% of days prescribed (n=32080, 95%CI=73.6-81%, I
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.PSYCHRES.2016.04.054
Abstract: Exercise has established efficacy as an antidepressant in people with depression. However, few meta-analyses have assessed the effects of exercise across different domains of Quality of Life (QoL) in people with depression. Furthermore, there has been no previous meta-analysis of control group response in relation to QoL in exercise trials for depression. Randomized Clinical Trials(RCTs) were initially identified from a Cochrane review, and those including QoL assessments were included in the analysis. Search of major electronic databases were conducted to identify RCTs that compared the exercise effects on QoL versus control condition in people with depression. A random effects meta-analysis was employed to evaluate the Standardized Mean Difference (SMD). Six RCTs were included. Exercise significantly improved physical and psychological domains and overall QoL. Effects on social relationship and environment domains were not significant. No significant control group response was found for any domain or overall QoL. Exercise can be considered as a therapeutic strategy to improve physical and psychological domains and overall QoL of people with depression, with no effect evident across the social and environmental domains. The lack of improvement among control groups reinforces the role of exercise as a treatment for depression with benefits to QoL.
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.PSYCHRES.2017.06.066
Abstract: The aim of this study was to investigate whether cardiorespiratory fitness among outpatients with bipolar disorder is associated with health related quality of life (HRQL) and explore differences versus healthy controls. Outpatients with bipolar disorder and healthy controls matched for age, sex and body mass index completed the 36-item Short Form Health Survey, the Positive-and-Negative-Affect-Schedule (PANAS), a maximal cardiorespiratory fitness test, and wore a Sensewear Armband to measure physical activity and sedentary behavior for eight days. Unpaired t-tests, Pearson correlations and backward regression analyses were performed. Outpatients with bipolar disorder (n = 20 14♀ 47.9 ± 7.9 years) had a significantly lower physical and mental HRQL than healthy controls (n = 20 14♀ 47.8 ± 7.6 years), a lower maximum oxygen uptake (VO
Publisher: BMJ
Date: 04-01-2023
Publisher: Cambridge University Press (CUP)
Date: 09-08-2016
DOI: 10.1017/S0033291716001732
Abstract: Exercise can improve clinical outcomes in people with severe mental illness (SMI). However, this population typically engages in low levels of physical activity with poor adherence to exercise interventions. Understanding the motivating factors and barriers towards exercise for people with SMI would help to maximize exercise participation. A search of major electronic databases was conducted from inception until May 2016. Quantitative studies providing proportional data on the motivating factors and/or barriers towards exercise among patients with SMI were eligible. Random-effects meta-analyses were undertaken to calculate proportional data and 95% confidence intervals (CI) for motivating factors and barriers toward exercise. From 1468 studies, 12 independent studies of 6431 psychiatric patients were eligible for inclusion. Meta-analyses showed that 91% of people with SMI endorsed ‘improving health’ as a reason for exercise ( N = 6, n = 790, 95% CI 80–94). Among specific aspects of health and well-being, the most common motivations were ‘losing weight’ (83% of patients), ‘improving mood’ (81%) and ‘reducing stress’ (78%). However, low mood and stress were also identified as the most prevalent barriers towards exercise (61% of patients), followed by ‘lack of support’ (50%). Many of the desirable outcomes of exercise for people with SMI, such as mood improvement, stress reduction and increased energy, are inversely related to the barriers of depression, stress and fatigue which frequently restrict their participation in exercise. Providing patients with professional support to identify and achieve their exercise goals may enable them to overcome psychological barriers, and maintain motivation towards regular physical activity.
Publisher: Informa UK Limited
Date: 23-06-2018
DOI: 10.1080/09638237.2017.1340627
Abstract: Accredited Exercise Physiologists (AEPs) are trained to deliver exercise and physical activity interventions for people with chronic and complex health conditions including those with mental illness. However, their views on exercise for mental illness, their exercise prescription practices, and need for further training are unknown. To examine the way in which Australian AEPs prescribe exercise for people with mental illness. Eighty-one AEPs (33.3 ± 10.4 years) completed an online version of the Exercise in Mental Illness Questionnaire. Findings are reported using descriptive statistics. AEPs report a high level of knowledge and confidence in prescribing exercise for people with mental illness. AEPs rate exercise to be at least of equal value to many established treatments for mental illness, and frequently prescribe exercise based on current best-practice principles. A need for additional training was identified. The response rate was low (2.4%) making generalisations from the findings difficult. Exercise prescription practices utilised by AEPs are consistent with current best-practice guidelines and there is frequent consultation with consumers to in idualise exercise based on their preferences and available resources. Further training is deemed important.
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.NEUROIMAGE.2017.11.007
Abstract: Hippoc al volume increase in response to aerobic exercise has been consistently observed in animal models. However, the evidence from human studies is equivocal. We undertook a systematic review to identify all controlled trials examining the effect of aerobic exercise on the hippoc al volumes in humans, and applied meta-analytic techniques to determine if aerobic exercise resulted in volumetric increases. We also sought to establish how volume changes differed in relation to unilateral measures of left/right hippoc al volume, and across the lifespan. A systematic search identified 4398 articles, of which 14 were eligible for inclusion in the primary analysis. A random-effects meta-analysis showed no significant effect of aerobic exercise on total hippoc al volume across the 737 participants. However, aerobic exercise had significant positive effects on left hippoc al volume in comparison to control conditions. Post-hoc analyses indicated effects were driven through exercise preventing the volumetric decreases which occur over time. These results provide meta-analytic evidence for exercise-induced volumetric retention in the left hippoc us. Aerobic exercise interventions may be useful for preventing age-related hippoc al deterioration and maintaining neuronal health.
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.SCHRES.2016.01.001
Abstract: This study investigated whether in patients with schizophrenia the Physical Activity Vital Sign (PAVS) assessment can identify those at higher risk of cardio-metabolic abnormalities. One hundred patients with schizophrenia completed the PAVS-questions exploring whether they adhered to the general physical activity recommendations, underwent a full-fasting metabolic screening, and performed a six-minute walk test (6 MWT). Those who do not adhere to the health recommendations according to the PAVS (n=61) were significantly older (37.1±11.3 versus 32.5±8.5 years, P=0.033) and more likely to be women (30/36 versus 31/64, P<0.001). Patients who do not meet the physical activity recommendations have a higher BMI (27.0±6.4 versus 23.3±3.1, P=0.017) performed worse on the 6MWT (531.1±84.2 m versus 657.0±98.2 m, P<0.001) and are at a significantly higher risk for cardio-metabolic diseases. Relative risks ranged from 1.07 (0.84-1.36) for having dyslipidemia to 4.65 (1.77-12.17) for having hypertension. PAVS-baseline assessment should be included in the routine assessment of people with schizophrenia.
Publisher: Elsevier BV
Date: 07-2018
Publisher: Elsevier BV
Date: 2018
Publisher: Cambridge University Press (CUP)
Date: 06-03-2017
DOI: 10.1017/NEU.2017.1
Publisher: Oxford University Press (OUP)
Date: 06-06-2020
DOI: 10.1093/TBM/IBZ067
Abstract: The scandal of premature mortality in people with serious mental illness is well established. Despite an increase in studies evaluating the efficacy of lifestyle interventions, translating this evidence into routine clinical care and policies is challenging, in part due to limited effectiveness or implementation research. We highlight the challenge of implementation that is increasingly recognized in clinical practice, advocate for adopting implementation science to study the implementation and systematic update of effective interventions in practice and policy, and provide directions for future research.
Publisher: JMIR Publications Inc.
Date: 14-10-2021
Abstract: ackground: Noncommunicable diseases (NCDs) are the leading cause of death globally. Promoting physical activity and healthy eating is essential to help manage the NCD burden and reduce mortality. Social media may be a potential platform for delivering and scaling health promotion initiatives. bjective: In this systematic review, we aimed to examine i) the feasibility and acceptability of social media interventions targeting physical activity and/or diet for people with NCDs, ii) the effectiveness of these interventions on exercise and diet behaviours, iii) specific design components used to promote user engagement and iv) the effectiveness on other health outcomes. ethods: We searched MEDLINE, Google Scholar, CINAHL, EMBASE, and SPORTDiscus from inception until June 2021. Social media interventions targeting physical activity and/or diet were included. Participants were any age, with a diagnosis of one of the following categories of NCDs cardiovascular disease, cancer, chronic respiratory disease, diabetes or mental illness. Interventions using social media alone or as part of an intervention with other modes of delivery were included. Eligible study designs were randomised controlled trials (RCTs), non-randomised controlled trials, feasibility or pilot studies, or quasi-experimental studies. esults: A total of 2,358 publications were identified. After removal of duplicates, 2,233 publication titles and abstracts were screened, and 10 publications were eligible, describing 8 in idual studies. The study designs included n=5 RCTs and n=3 pilot or feasibility studies, all published between 2016 and 2020. S le sizes ranged from n=11 to n=312. Half of the studies were conducted in the United States of America. Clinical populations included severe mental illness (n=2), cardiovascular disease (n=2), chronic obstructive pulmonary disease (n=2), cancer (n=1) and Type 2 diabetes (n=1). Facebook (n=3) and WeChat (n=3) were the most used social media platforms. The majority utilised social media to deliver health education and facilitate social support and all studies reported % retention. Four of the five included RCTS reported significant improvements in exercise behaviours (e.g., step count, exercise capacity) while diet was only assessed in two studies and results were non-significant. Of the 6 included RCTs (including 1 pilot RCT), study quality ranged from fair to good according to the PEDRo quality checklist. onclusions: Social media interventions appear to be feasible and acceptable among specific ND populations and preliminary evidence suggests interventions delivered solely via social media or in addition to other modalities may be effective for improving exercise behaviours. The evidence for diet behaviours remains unclear. While overall there is an emerging evidence base, more rigorous evaluation including replication studies are needed to determine the efficacy of social media interventions. RD42021251838
Publisher: Elsevier BV
Date: 10-2021
Publisher: Wiley
Date: 21-03-2018
DOI: 10.1111/EIP.12544
Publisher: Elsevier BV
Date: 2150
DOI: 10.1016/J.COMPPSYCH.2014.10.007
Abstract: This cross-sectional study examined the association between psychiatric symptoms and motivation for physical activity within the self-determination theory (SDT) framework in people with schizophrenia. Over a 4-month period, 55 (17♀) inpatients with a DSM-V diagnosis of schizophrenia were assessed with the Psychosis Evaluation tool for Common use by Caregivers (PECC) and the Behavioural Regulation in Exercise Questionnaire (BREQ-2), that provided separate scores for amotivation, external, introjected and autonomous regulation. Spearman correlation coefficients were examined between these motivation scores and symptom ratings. The BREQ-2 score for autonomous regulations (2.6±1.1) was significantly correlated with the PECC negative symptoms score (10.3±4.1) (r=-0.34, p=0.011). No other significant correlations between BREQ-2 and PECC scores were found. The BREQ-2 score for external regulations (0.7±0.9) was associated with older age (35.2±11.3years) (r=-0.30, p=0.024). These findings provide evidence that negative symptoms are associated with lower autonomous motivation towards physical activity in inpatients with schizophrenia. Future longitudinal research should confirm the current findings. Such research will guide physical activity approaches aimed at facilitating enhanced physical and mental health outcomes in in iduals with schizophrenia.
Publisher: Elsevier BV
Date: 12-2016
Publisher: SAGE Publications
Date: 23-01-2018
Publisher: Human Kinetics
Date: 2021
Abstract: Purpose: To examine the reliability and convergent validity of self-reported questionnaires (SRQs) to measure physical activity (PA). Methods : Systematic review with meta-analysis. The validity and reliability of SRQs to assess PA in people with mental disorders (January 20, 2020). Random-effects meta-analyses were performed pooling (1) test–retest correlations or (2) the convergent validity between the SRQs and objective measures (eg, accelerometry). Associations were provided in r values with the 95% confidence interval. Methodological quality was assessed. Results : A total of 9 unique studies (N = 1344 40.5% females) were included. The authors found a moderate correlation test–retest reliability for PA SRQs in the assessment of vigorous PA ( r = .69 [.38 to .85] P = .001), moderate to vigorous PA ( r = .63 [.25 to .84] P = .003), moderate PA ( r = .63 [.39 to .79] P = .001), and good correlation total PA ( r = .75 [.37 to .92] P = .001). The SRQs have moderate correlations with objective measures for moderate to vigorous PA ( r = .25 [.18 to .32] P = .0001) and total PA ( r = .47 [.28 to .62] P = .005), a poor correlation for moderate PA ( r = .18 [.03 to .36] P = .047), and no correlation with vigorous PA ( r = .06 [−.10 to .22] P = .440). Conclusion : Current evidence indicates that SRQs are reliable over time to assess moderate, vigorous, and total PA levels and valid when assessing moderate PA.
Publisher: Elsevier BV
Date: 05-2015
Publisher: SAGE Publications
Date: 07-12-2017
Abstract: Single bouts of aerobic exercise and meditation have been shown to improve anxiety states. Yet to be evaluated in the literature, we sought to examine the effects of a single, short bout of aerobic exercise or meditation, as well as exercise and meditation combined on state anxiety among young adults. Randomized controlled trial. University. Participants (N = 110, mean age = 21.4 years) were randomly assigned to walk, meditate, walk then meditate, meditate then walk, or to sit (inactive control). All walking and meditation bouts were 10 minutes in duration. Participants’ state anxiety was monitored before and after the intervention using the State Trait Anxiety Inventory questionnaire. Significant group × time interaction effects were observed ( P = .01). Post hoc paired t tests revealed that state anxiety significantly decreased from baseline to postintervention in the meditation ( P = .002), meditation then walk ( P = .002), and walk then meditation ( P = .03) groups but not the walk ( P = .75) or control ( P = .45) groups. Meditation (vs a brisk walk) may be a preferred method of attenuating anxiety symptomology. In iduals desiring the health benefits associated with aerobic exercise may achieve additional anxiolytic benefits if they employ a brief meditation session before or after exercising.
Publisher: Elsevier BV
Date: 04-2012
Publisher: Informa UK Limited
Date: 04-07-2015
DOI: 10.3109/09638237.2015.1036974
Abstract: Although antipsychotic medications help manage clinical symptom severity, most people with schizophrenia continue to function poorly in the community. To determine whether the Global Assessment of Functioning (GAF) score is associated with aerobic capacity in people with schizophrenia. Thirty-four male (34.1 ± 12.0 years) and 16 female (33.1 ± 8.7 years) persons with schizophrenia performed the Astrand-Rhyming cycle ergometer test in order to estimate the maximal oxygen uptake (VO2max) and were assessed with the GAF, the Psychosis Evaluation tool for Common use by Caregivers and the International Physical Activity Questionnaire. The mean GAF-score was 41.9 ± 9.4, while the mean estimated VO2max was 34.5 ± 8.7mlO2/min/kg. There was a moderate association between the GAF-score and VO2max (r = 0.45, p < 0.001). Positive, negative and cognitive symptoms were negatively (p < 0.05) associated with the GAF-score, physical activity participation positively (p < 0.05). A backward regression analysis demonstrated that VO2max explained 19.1% of the GAF-score variance. In people with schizophrenia, the aerobic capacity is associated with a person's global functioning. Clinicians should consider incorporating assessment of aerobic capacity into their test battery in order to measure the health consequences of schizophrenia and its treatment.
Publisher: Elsevier BV
Date: 07-2017
Publisher: Elsevier BV
Date: 10-2021
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.JAD.2017.06.012
Abstract: There is a paucity of nationally representative data available on the correlates of physical activity (PA) among people with depression, especially in low- and middle-income countries (LMICs). Thus, we investigated PA correlates among community-dwelling adults with depression in this setting. World Health Survey data included 24,230 adults (43.1 ± 16.1 years 36.1% male) with ICD-10 diagnoses of depression including brief depressive episode and subsyndromal depression aged ≥ 18 years from 46 LMICs. PA was assessed by the International Physical Activity Questionnaire. Participants were dichotomised into low and moderate-to-high physically active groups. Associations between PA and a range of sociodemographic, health behaviour and mental and physical health variables were examined using multivariable logistic regressions. 34.8% of participants with depression were physically inactive. In the multivariate analyses, inactivity was associated with male sex, older age, not being married/cohabiting, high socio-economic status, unemployment, living in an urban setting, less vegetable consumption, and poor sleep/ low energy. In addition, mobility difficulties and some somatic co-morbidity were associated with not complying with the 150min per week moderate-to-vigorous PA recommendations. The current data provide guidance for future population level interventions across LMICs to help people with depression engage in regular PA.
Publisher: JMIR Publications Inc.
Date: 22-04-2021
DOI: 10.2196/23432
Abstract: First responders (eg, police, firefighters, and paramedics) are at high risk of experiencing poor mental health. Physical activity interventions can help reduce symptoms and improve mental health in this group. More research is needed to evaluate accessible, low-cost methods of delivering programs. Social media may be a potential platform for delivering group-based physical activity interventions. This study aims to examine the feasibility and acceptability of delivering a mental health–informed physical activity program for first responders and their self-nominated support partners. This study also aims to assess the feasibility of applying a novel multiple time series design and to explore the impact of the intervention on mental health symptoms, sleep quality, quality of life, and physical activity levels. We co-designed a 10-week web-based physical activity program delivered via a private Facebook group. We provided education and motivation around different topics weekly (eg, goal setting, overcoming barriers to exercise, and reducing sedentary behavior) and provided participants with a Fitbit. A multiple time series design was applied to assess psychological distress levels, with participants acting as their own control before the intervention. In total, 24 participants (12 first responders and 12 nominated support partners) were recruited, and 21 (88%) completed the postassessment questionnaires. High acceptability was observed in the qualitative interviews. Exploratory analyses revealed significant reductions in psychological distress during the intervention. Preintervention and postintervention analysis showed significant improvements in quality of life (P=.001 Cohen d=0.60) total depression, anxiety, and stress scores (P=.047 Cohen d=0.35) and minutes of walking (P=.04 Cohen d=0.55). Changes in perceived social support from family (P=.07 Cohen d=0.37), friends (P=.10 Cohen d=0.38), and sleep quality (P=.28 Cohen d=0.19) were not significant. The results provide preliminary support for the use of social media and a multiple time series design to deliver mental health–informed physical activity interventions for first responders and their support partners. Therefore, an adequately powered trial is required. Australian New Zealand Clinical Trials Registry (ACTRN): 12618001267246 anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001267246.
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.YPMED.2016.10.011
Abstract: Physical activity (PA) is protective from future depression, however, the potential impact of cardiorespiratory fitness (CRF) on the development of depression is less clear. We aimed to investigate if lower levels of CRF are associated with a higher risk for depression onset. Major electronic databases were searched, from inception to January 2016 for prospective cohort studies evaluating the association between CRF and incident depression. Pooled hazard ratio (HR) with 95% confidence intervals (CIs) were calculated. Methodological quality was evaluated using the Newcastle-Ottawa scale (NOS). Three prospective studies were identified and data from two studies were pooled. Our data provide preliminary evidence found that people with low CRF and medium CRF were at increased risk of developing depression (n=1,128,290, HR=1.76, 95% CI 1.61-1.91, p<0.001, I
Publisher: Cambridge University Press (CUP)
Date: 05-05-2016
DOI: 10.1017/NEU.2016.21
Abstract: Although considerable evidence supports the efficacy of exercise as an antidepressant treatment, critical reviews informing routine practice and future research directions are scarce. We critically reviewed exercise studies for clinically depressed adults, focussing on the PICOS criteria referred to participants, interventions, comparisons, outcomes, and study designs. Most studies have not screened their s les for symptom heterogeneity. Also, they have employed heterogeneous exercise interventions and control groups that may lead to an underestimation of the benefits of exercise. In addition, pragmatic trials allowing scalable replication and implementation in routine practice are scarce. Future studies, can consider the research domain criteria as a diagnostic framework, and conduct moderator analyses to identify depressed subgroups with symptomatology and biopsychosocial characteristics associated with differential responses to exercise interventions. The search for biomarkers of the antidepressant responses to exercise should be prioritised. Further, non-physically active comparison groups should be used to minimise treatment cross-overs and thus the underestimation of the effects of exercise interventions. Finally, the use of outcome measures that maintain their validity at low and moderate levels of symptom severity and the development of trials with a pragmatic design are essential. The current evidence base is fraught with methodological considerations that need to be taken into account in order to increase further our understanding on the impact of exercise as medicine in depression. Future research should include moderator analyses, incorporate biomarker assays, use appropriate control and comparison groups, assess outcomes with psychometrically sensitive measures, and prioritise pragmatic trials towards transition to routine practice.
Publisher: Cambridge University Press (CUP)
Date: 10-10-2018
DOI: 10.1017/S0033291717002653
Abstract: We aimed to establish the treatment effect of physical activity for depression in young people through meta-analysis. Four databases were searched to September 2016 for randomised controlled trials of physical activity interventions for adolescents and young adults, 12–25 years, experiencing a diagnosis or threshold symptoms of depression. Random-effects meta-analysis was used to estimate the standardised mean difference (SMD) between physical activity and control conditions. Subgroup analysis and meta-regression investigated potential treatment effect modifiers. Acceptability was estimated using dropout. Trials were assessed against risk of bias domains and overall quality of evidence was assessed using GRADE criteria. Seventeen trials were eligible and 16 provided data from 771 participants showing a large effect of physical activity on depression symptoms compared to controls (SMD = −0.82, 95% CI = −1.02 to −0.61, p 0.05, I 2 = 38%). The effect remained robust in trials with clinical s les ( k = 5, SMD = −0.72, 95% CI = −1.15 to −0.30), and in trials using attention/activity placebo controls ( k = 7, SMD = −0.82, 95% CI = −1.05 to −0.59). Dropout was 11% across physical activity arms and equivalent in controls ( k = 12, RD = −0.01, 95% CI = −0.04 to 0.03, p = 0.70). However, the quality of RCT-level evidence contributing to the primary analysis was downgraded two levels to LOW (trial-level risk of bias, suspected publication bias), suggesting uncertainty in the size of effect and caution in its interpretation. While physical activity appears to be a promising and acceptable intervention for adolescents and young adults experiencing depression, robust clinical effectiveness trials that minimise risk of bias are required to increase confidence in the current finding. The specific intervention characteristics required to improve depression remain unclear, however best candidates given current evidence may include, but are not limited to, supervised, aerobic-based activity of moderate-to-vigorous intensity, engaged in multiple times per week over eight or more weeks. Further research is needed. (Registration: PROSPERO-CRD 42015024388).
Publisher: Human Kinetics
Date: 08-2016
Abstract: People with posttraumatic stress disorder (PTSD) are more likely than the general population to be physically inactive. The present review systematically evaluated correlates of physical activity across the socioecological model for people with PTSD. Two independent reviewers searched Embase, PubMed, PsycARTICLES, and CINAHL from inception until June 2015, combining the medical subject heading “posttraumatic stress disorder” or “PTSD,” with “physical activity” or “exercise.” Data were extracted by the same independent researchers and summarized according to the socioecological model. Eight papers involving 1368 (994 men) participants (age range = 18–70 years) were eligible and enabled evaluation of 21 correlates. The only correlate (n ≥ 4) consistently associated with lower physical activity participation in people with PTSD was symptoms of hyperarousal. No consistent facilitators were identified. Hyperarousal symptoms are associated with lower physical activity participation among people with PTSD and should be considered in the design and delivery of in idualized exercise programs targeting this population. The role of social, environmental, and policy factors on physical activity participation among people with PTSD is unknown and should be addressed by future research.
Publisher: AMPCo
Date: 05-2016
DOI: 10.5694/MJA15.01165
Publisher: Wiley
Date: 28-07-2015
DOI: 10.1111/INM.12145
Abstract: The purpose of this cross-sectional study was to investigate whether aerobic fitness contributes to the health-related quality of life (HRQoL) in people with schizophrenia, while adjusting for other previously-established contributory factors. Thirty-four male (34.1 ± 12.0 years) and 13 female (34.3 ± 9.2 years) participants performed a submaximal Astrand-Rhyming cycle ergometer test and completed the 36-item Short-Form Health Survey, the International Physical Activity Questionnaire, and the Psychosis Evaluation tool for Common Use by Caregivers. After controlling for age and sex, illness duration (12.4 ± 11.2 years, r(2) = 0.38, P < 0.001), fewer positive (9.3 ± 4.3, r(2) = 0.30, P = 0.006) and cognitive (8.4 ± 3.8, r(2) = 0.28, P = 0.011) symptoms, and higher aerobic fitness (34.5 ± 8.7 ml O2 min(-1) kg(-1), r(2) = 0.36, P = 0.001) were found to be independent significant predictors of physical HRQoL (mean score 66.6 ± 18.5). However, when all variables were included in the same regression model, only illness duration (P = 0.004) and positive symptoms (P = 0.045) remained significant predictors, while there was a trend (P < 0.10) for age and aerobic fitness. The final model explained 54% of the variability in physical HRQoL. No significant correlates for mental HRQoL (54.9 ± 18.5) were found. People with schizophrenia might improve their physical HRQoL by improving their aerobic fitness. Mental health nurses should assist in facilitating improvements in aerobic fitness through facilitating physical activity participation in patients with schizophrenia.
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.SCHRES.2015.09.029
Abstract: To determine if exercise can improve cardiorespiratory fitness in people with schizophrenia. Major electronic databases were searched systematically until May 2015. A meta-analysis calculating Hedges' g statistic was undertaken. Engaging in exercise improves cardiorespiratory fitness in people with schizophrenia (g = 0.40, 95% CI = 0.16–0.64, p = 0.001, N = 7, n = 77). Data from four controlled studies demonstrated that exercise (n = 53) significantly improves cardiorespiratory fitness compared to control groups (n = 48) (g = 0.43, 95% CI = 0.05–0.82, p = 0.028). Considering the current findings, the multidisciplinary treatment of schizophrenia should include a focus on both, improving "fitness" and reducing "fatness", in order to reduce all-cause mortality.
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.YPMED.2017.07.005
Abstract: This study aimed to investigate the bi-directional relationship between different domains of physical activity (PA), sedentary behaviour (SB) and depressive symptoms among women living in socioeconomically disadvantaged neighbourhoods in Victoria, Australia. Women (n=1033), aged 18-46years at Wave 1 (2007/08), completed self-report measures of PA (leisure-time, transport, occupational, domestic), SB (TV viewing, computer use, overall sitting time) and depressive symptoms (CES-D 10) at each study time-point (Wave 2: 2010/11, Wave 3: 2012/13). Separate linear mixed models were fitted to examine if change in depressive symptoms differed dependent on each of the baseline PA or SB measures. Similarly, baseline depressive symptoms were used as a predictor of change in PA and SB. In secondary analyses, associations between baseline PA or SB and odds of becoming 'at risk' of depression among those not 'at risk' at baseline were examined using logistic regression. There was no evidence that change in depressive symptoms differed depending on PA or SB at baseline. In general, there was also no evidence that change in PA or SB differed depending on baseline depressive symptoms. One exception was change in leisure-time PA, which declined more among those with heightened depressive symptoms at baseline (Interaction: β=-0.003, 95% CI=-0.007, -0.0003). Transport-related PA (adjusted OR=1.06, 95% CI=1.013, 1.101) and domestic PA (adjusted OR=1.02, 95% CI=1.003, 1.040) were associated with greater odds of becoming at risk of depression at wave 3. There was limited evidence of a bi-directional relationship between PA, SB and depressive symptoms in women living in socioeconomically disadvantaged neighbourhoods.
Publisher: Cambridge University Press (CUP)
Date: 15-01-2016
DOI: 10.1017/S2045796015001043
Abstract: Despite overwhelming evidence demonstrating a persisting gap in life expectancy between those with psychotic illness and the general population, there has been no widespread implementation of interventions to improve the physical wellbeing of people with psychotic illness. This article explores opportunities to ‘Bridge the Gap’ in life expectancy. We describe an Australian evidence-based intervention that has substantially improved the physical health of young people recently commenced on antipsychotic medication. Further epidemiological research, accompanied by cultural change within mental health services, is an essential precursor to the implementation of effective and sustainable lifestyle interventions. There are other relatively neglected areas of physical wellbeing for people with psychotic illness, such as screening and diagnosis of malignancies, which need more research and clinical attention. While there has been progress with intervention development and evaluation, translation of evidence-based short-term intervention studies into feasible and sustainable system-wide changes within routine mental health service settings remains a challenge. Developing an implementation framework to support such change is an urgent priority so as to bridge the persisting premature mortality in people living with psychotic illness.
Publisher: EDITORA SCIENTIFIC
Date: 06-2022
Publisher: SAGE Publications
Date: 30-11-2016
Publisher: Informa UK Limited
Date: 05-01-2016
DOI: 10.3109/09638288.2015.1116622
Abstract: Research has only recently started to consider the applicability of physical activity (PA) for people with schizophrenia. Although there is increasing evidence for the benefits of physical activity, this population remains generally physically inactive and sedentary. The aim of the current study is to highlight 10 pertinent physical activity research questions in people with schizophrenia. The International Organisation of Physical Therapy in Mental Health (IOPTMH) executed a consultation of its National Organisations (n = 13) to identify the most salient questions relevant to guide clinical practise on physical activity in people with schizophrenia. We identified the following 10 questions: (1) What are the benefits of physical activity for people with schizophrenia? (2) What are the mechanisms of the physical activity effects in people with schizophrenia? (3) What are the most prominent safety issues for physical activity prescription in people with schizophrenia? (4) What is the most optimal physical activity prescription for people with schizophrenia? (5) What are the key barriers for engaging people with schizophrenia in physical activity? (6) What are the most effective motivational interventions for physical activity adoption and maintenance in people with schizophrenia? (7) How do we translate physical activity research into clinical and community practise? (8) How can we ensure integration of physical therapists within the multidisciplinary mental health treatment team? (9) How can we prevent sedentary behaviour in people with schizophrenia? (10) What is the most appropriate physical activity assessment method in clinical practise? Addressing these questions is critical for developing evidence-based approaches for promoting and sustaining an active lifestyle in people with schizophrenia. Ultimately, achieving this will improve the quality of life of this population. Implications for Rehabilitation Investigation of behaviour change interventions for people with schizophrenia is critical. A low cost, easy to use, clinical, valid physical activity questionnaire is urgently needed.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.YPMED.2016.10.001
Abstract: Cardiorespiratory fitness (CRF) is a modifiable risk factor for cardiovascular disease and premature mortality. CRF levels and moderators among people living with HIV (PLWH) are unknown. The aim of the current meta-analysis was to (1) determine mean CRF in PLWH and compare levels with age- and gender-matched healthy controls (HCs), (2) explore moderators of CRF, (3) and (4) explore moderators of CRF outcomes following physical activity (PA) interventions. Major electronic databases were searched systematically for articles reporting CRF expressed as maximum or peak oxygen uptake (ml/min/kg) in PLWH. A random effects meta-analysis calculating the pooled mean CRF including subgroup- and meta-regression analyses was undertaken. Across 21 eligible studies, the CRF level was 26.4ml/kg/min (95% CI=24.6 to 28.1) (n=1010 mean age=41years). There were insufficient data to compare CRF levels with HCs. A higher body mass index (β=-0.99, 95% CI=-1.93 to -0.06, P=0.04), older age (β=-0.31, 95% CI=-0.58 to -0.04, P=0.02) and the presence of lipodystrophy (β=-4.63, 95% CI=-7.88 to -1.39, P=0.005) were significant moderators of lower CRF levels. Higher CD4+ counts (β=0.004, 95% CI=0.0007 to 0.007, P=0.016), supervised interventions (P<0.001) and interventions with a lower frequency of weekly sessions (2 or 3 versus 4 times) (P<0.001) predicted a better CRF-outcome following PA. CRF levels of PLWH are among the lowest in comparison to other vulnerable populations. More research on the most optimal physical activity intervention characteristics is needed.
Publisher: Public Library of Science (PLoS)
Date: 14-11-2019
Publisher: Elsevier BV
Date: 05-2016
DOI: 10.1016/J.JAD.2016.01.046
Abstract: Research has only recently started to consider the importance and applicability of physical activity (PA) for people with bipolar disorder (BD). The aim of the current study is to highlight 10 pertinent PA research questions in people with BD. The International Organization of Physical Therapy in Mental Health executed a consultation with all National organizations (n=13) to identify the most salient questions to guide future research on PA in BD. We identified the following 10 questions: (1) What are the benefits of PA for people with BD? (2) What are the most prominent safety issues for PA prescription in BD? (3) What is the optimal PA prescription for people with BD? (4) What are the key barriers to PA among people with BD? (5) What are the most effective motivational strategies for ensuring PA adoption and maintenance in BD? (6) How do we translate PA research into community practice? (7) If one treatment goal is increased physical activity, what type of professionals are needed as part of a multidisciplinary team? (8) How do we incorporate PA as a vital sign in clinical practice? (9) How can we prevent sedentary behavior in BD? (10) What is the most appropriate PA assessment method? We did not consult people with BD. Addressing these questions is critical for developing evidence-based approaches for promoting and sustaining an active lifestyle in BD. Ultimately, achieving this will reduce the burden of cardiovascular disease and improve the quality of life of this population.
Publisher: BMJ
Date: 18-05-2020
DOI: 10.1136/BJSPORTS-2019-101242
Abstract: To assess whether physically active yoga is superior to waitlist control, treatment as usual and attention control in alleviating depressive symptoms in people with a diagnosed mental disorder recognised by the Diagnostic and Statistical Manual of Mental Disorders (DSM). Systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were obtained from online databases (MEDLINE, EMBASE, PsychINFO, CENTRAL, EMCARE, PEDro). The search and collection of eligible studies was conducted up to 14 May 2019 (PROSPERO registration No CRD42018090441). We included randomised controlled trials with a yoga intervention comprising ≥50% physical activity in adults with a recognised diagnosed mental disorder according to DSM-3, 4 or 5. 19 studies were included in the review (1080 participants) and 13 studies were included in the meta-analysis (632 participants). Disorders of depression, post-traumatic stress, schizophrenia, anxiety, alcohol dependence and bipolar were included. Yoga showed greater reductions in depressive symptoms than waitlist, treatment as usual and attention control (standardised mean difference=0.41 95% CI −0.65 to −0.17 p .001). Greater reductions in depressive symptoms were associated with higher frequency of yoga sessions per week (β=−0.44, p .01).
Publisher: Wiley
Date: 22-11-2017
DOI: 10.1111/EIP.12521
Abstract: The International Physical Activity Questionnaire (IPAQ) is a self-report tool commonly used in mental healthcare settings to assess physical activity. However, its validity has not yet been investigated in first-episode psychosis (FEP). The aim of this study was to examine the concurrent validity of the IPAQ compared with an objective real-life measure, the Sensewear Armband (SWA), in assessing moderate and vigorous physical activity (MVPA) in people with FEP. A secondary aim was to explore whether there are differences in correlates of the IPAQ vs SWA scores. In total, 19 outpatients with FEP (15 men 24.4 ± 5.1 years) wore an SWA for 5 full consecutive days, subsequently completed the IPAQ, performed a maximal cardiorespiratory fitness test and were assessed with the Positive and Negative Syndrome Scale (PANSS). There was no significant correlation between time spent in MVPA according to the IPAQ and SWA. In contrast with SWA scores, there were no significant associations between IPAQ scores and cardiorespiratory fitness levels. No correlations with PANSS scores were observed in both measures. The current results suggest that the IPAQ should be used with caution when assessing levels of MVPA in FEP. More accurate methods of measuring physical activity are needed in this population.
Publisher: BMJ
Date: 07-2020
DOI: 10.1136/BMJSEM-2020-000761
Abstract: People with mental illness die on average 15 years less than the general population, primarily to cardiometabolic disease. Lifestyle interventions are effective in reducing cardiometabolic risk but are not routinely provided to mental health consumers. Lifestyle interventions targeting mental health staff may be beneficial in changing culture surrounding physical health and subsequently improving consumer outcomes. This study examines exercise and fitness outcomes of a targeted lifestyle intervention directed at Australian mental health staff. A pragmatic single-arm intervention study was conducted within an Australian public mental health service. Mental health staff were provided a five-session in idualised lifestyle intervention (incorporating exercise and nutritional counselling) over 5 weeks. Two waves of the programme were delivered between 2015 and 2016. This paper examines the exercise and fitness outcomes of the second wave of the study. Participants were assessed at baseline and at a 16-week follow-up. The primary exercise outcome was a measurement of cardiorespiratory fitness. Secondary outcomes included self-reported physical activity and a measurement of handgrip strength. A total of 106 staff participated in this component of the study. Cardiorespiratory fitness increased significantly from baseline to follow-up (p .001). Significant improvements to physical activity occurred with decreases in sedentary time (p .0005) and increases in moderate-to-vigorous physical activity (p .005). Lifestyle interventions incorporating exercise counselling may improve the physical health of mental health staff. Such strategies may be effective in improving culture surrounding physical health and/or increasing the effectiveness of lifestyle interventions targeting mental health consumers.
Publisher: Elsevier BV
Date: 02-2022
Publisher: Springer Science and Business Media LLC
Date: 26-12-2015
DOI: 10.1007/S40279-015-0441-5
Abstract: Whilst previous meta-analyses have demonstrated that control group responses (CGRs) can negatively influence antidepressant efficacy, no such meta-analysis exists in exercise randomised controlled trials (RCTs). The aim of this study was to conduct a systematic review and meta-analysis investigating CGRs and predictors in control groups of exercise RCTs among adults with depression. Three authors acquired RCTs from a previous Cochrane review (2013) and conducted updated searches of major databases from January 2013 to August 2015. We included exercise RCTs that (1) involved adults with major depressive disorder (MDD) or depressive symptoms (2) measured depressive symptoms pre- and post-intervention using a validated measure [e.g. Hamilton Depression Scale (HAM-D)] and (3) included a non-active control group. A random effects meta-analysis calculating the standardised mean difference (SMD) together with 95 % confidence intervals (CIs) was employed to determine CGR. Across 41 studies, 1122 adults with depression were included [mean (SD) age 50 (18) years, 63 % female]. A large CGR of improved depressive symptoms was evident across all studies (SMD -0.920, 95 % CI -1.11 to -0.729). CGRs were elevated across all subgroup analyses, including high quality studies (n = 11, SMD -1.430, 95 % CI -1.771 to -1.090) and MDD participants (n = 18, SMD -1.248, 95 % CI = -1.585 to -0.911). The CGR equated to an improvement of -7.5 points on the HAM-D (95 % CI -10.30 to -4.89). In MDD participants, increasing age moderated a smaller CGR, while the percentage of drop-outs, baseline depressive symptoms and a longer control group duration moderated a larger CGR (i.e. improvement) (p < 0.05). In order to demonstrate effectiveness, exercise has to overcome a powerful CGR of approximately double that reported for antidepressant RCTS.
Publisher: Springer Science and Business Media LLC
Date: 04-08-2022
Publisher: Springer Science and Business Media LLC
Date: 27-08-2014
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.GENHOSPPSYCH.2015.11.008
Abstract: Physical activity interventions have been shown to improve the health of people with schizophrenia, yet treatment dropout poses an important challenge in this population, and rates vary substantially across studies. We conducted a meta-analysis to investigate the prevalence and predictors of treatment dropout in physical activity interventions in people with schizophrenia. We systematically searched major electronic databases from inception until August 2015. Randomized controlled trials of physical activity interventions in people with schizophrenia reporting dropout rates were included. Two independent authors conducted searches and extracted data. Random-effects meta-analysis and meta-regression analyses were conducted. In 19 studies, 594 patients with schizophrenia assigned to exercise interventions were investigated (age=37.2 years, 67.5% male, range=37.5%-100%). Trim and fill adjusted treatment dropout rate was 26.7% [95% confidence interval (CI)=19.7%-35.0%], which is more than double than in nonactive control interventions (odds ratio=2.15, 95% CI=1.29-3.58, P=.003). In the multivariate regression, qualification of the professional delivering the intervention (β=-1.06, 95% CI=-1.77 to -0.35, P=.003) moderated treatment dropout rates, while continuous supervision of physical activity approached statistical significance (P=.05). Qualified professionals (e.g., physical therapists/exercise physiologists) should prescribe supervised physical activity for people with schizophrenia to enhance adherence, improve psychiatric symptoms and reduce the onset and burden of cardiovascular disease.
Publisher: Wiley
Date: 13-07-2023
DOI: 10.1002/MHS2.30
Abstract: Parents and caregivers who participate in regular physical activity have improved physical and mental health and can influence the physical activity behaviors of children in their care. This study aimed to assess the association between psychological distress and physical activity levels of parents/caregivers in New South Wales, Australia during different COVID‐19 restriction periods. A repeat‐cross‐sectional design was adopted. Parents/caregivers involved in a government‐led children's sport and recreation voucher program were recruited to participate in an online survey as part of the program's evaluation. In response to COVID‐19, parents and caregivers' psychological distress and physical activity levels were assessed using validated items. Binary logistic regression models were used to examine the relationship between physical activity and probable mental illness, and differences across different COVID‐19 restriction periods in 2020 and 2021. In 2020, 10,990 parents/caregivers responded to survey questions and in 2021, 17,106 parents/caregivers responded. Parents/caregivers who were physically active on 7 days per week had lower odds of reporting high psychological distress (odds ratio [OR]: 0.40, 95% confidence interval [CIs]: 0.33, 0.49) than parents/caregivers physically active on fewer days per week. In 2020 9.8% of parents/caregivers ( n = 1076) reported high psychological distress, which decreased to 8% in 2021 ( n = 1366). In 2021, parents/caregivers had lower odds of reporting high psychological distress (OR: 0.79, 95% CIs: 0.72, 0.86). Socioeconomic disadvantage negatively impacted psychological distress and physical activity levels. Australian parents and caregivers who reported high psychological distress, during and after COVID‐19 restrictions, were participating in low levels of physical activity. Greater collaboration between the mental health, and sport and recreation sectors is recommended to harness the co‐benefits of physical activity throughout parenthood, particularly in low socioeconomic areas.
Publisher: BMJ
Date: 18-12-2015
Publisher: Frontiers Media SA
Date: 28-04-2020
Publisher: Springer Science and Business Media LLC
Date: 20-09-2019
DOI: 10.1007/S40279-019-01187-6
Abstract: Exercise may improve neuropsychiatric and cognitive symptoms in people with mental disorders, but the totality of the evidence is unclear. We conducted a meta-review of exercise in (1) serious mental illness (schizophrenia spectrum, bipolar disorder and major depression (MDD)) (2) anxiety and stress disorders (3) alcohol and substance use disorders (4) eating disorders (anorexia nervosa bulimia nervosa, binge eating disorders, and (5) other mental disorders (including ADHD, pre ost-natal depression). Systematic searches of major databases from inception until 1/10/2018 were undertaken to identify meta-analyses of randomised controlled trials (RCTs) of exercise in people with clinically diagnosed mental disorders. In the absence of available meta-analyses for a mental disorder, we identified systematic reviews of exercise interventions in people with elevated mental health symptoms that included non-RCTs. Meta-analysis quality was assessed with the AMSTAR/+. Overall, we identified 27 systematic reviews (including 16 meta-analyses representing 152 RCTs). Among those with MDD, we found consistent evidence (meta-analyses = 8) that exercise reduced depression in children, adults and older adults. Evidence also indicates that exercise was more effective than control conditions in reducing anxiety symptoms (meta-analyses = 3), and as an adjunctive treatment for reducing positive and negative symptoms of schizophrenia (meta-analyses = 2). Regarding neurocognitive effects, exercise improved global cognition in schizophrenia (meta-analyses = 1), children with ADHD (meta-analyses = 1), but not in MDD (meta-analyses = 1). Among those with elevated symptoms, positive mental health benefits were observed for exercise in people with pre ost-natal depression, anorexia nervosa/bulimia nervosa, binge eating disorder, post-traumatic stress disorder and alcohol use disorders/substance use disorders. Adverse events were sparsely reported. Our panoramic meta-overview suggests that exercise can be an effective adjunctive treatment for improving symptoms across a broad range of mental disorders.
Publisher: Wiley
Date: 12-2014
DOI: 10.1111/ACPS.12371
Abstract: To investigate the impact of a 12-week exercise programme in addition to usual care for post-traumatic stress disorder (PTSD). An assessor-blinded randomized controlled trial was conducted among 81 participants with a DSM-IV-TR diagnosis of primary PTSD. Participants were recruited after admission to an in-patient programme at a private hospital. Participants were randomized to receive either usual care (n=42), or exercise in addition to usual care (n=39). The exercise intervention involved three, 30-min resistance-training sessions/week and a pedometer-based walking programme. Usual care involved psychotherapy, pharmaceutical interventions, and group therapy. Primary outcome was PTSD symptoms assessed via the PTSD checklist-civilian version (PCL-C). Secondary outcomes included symptoms of depression, anthropometry, physical activity, mobility, strength, and sleep quality. Participants had a mean (SD) age of 47.8 years (12.1), 84% male. PTSD symptoms in the intervention group significantly reduced compared with the usual care group (mean difference=-5.4, 95% CI -10.5 to -0.3, P=0.04, n=58). There were significant between-group differences at follow-up for depressive symptoms, waist circumference, sleep quality, and sedentary time. This study provides the first evidence that an exercise intervention is associated with reduced PTSD and depressive symptoms, reduced waist circumference, and improved sleep quality.
Publisher: Frontiers Media SA
Date: 02-07-2021
Publisher: Elsevier BV
Date: 07-2017
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.PSYCHRES.2016.06.060
Abstract: The most significant contributor to premature mortality in patients with bipolar disorder is preventable cardiovascular diseases. This study investigated if the Physical Activity Vital Sign (PAVS) assessment (two questions which clarify if a person meets the recommended 150min of physical activity per week) can identify patients with bipolar disorder at higher risk of cardio-metabolic abnormalities. Clinical differences between those who adhere and those who did not adhere to the physical activity guidelines were investigated using an ANCOVA controlling for age and gender. Sixty-five (29♂) in- and outpatients with bipolar disorder (age=45.1±9.8years) completed the PAVS-questions, underwent full-fasting metabolic screening, and performed a six-minute walk test (6MWT). Those patients not meeting the physical activity recommendations had a higher body mass index, performed worse on the 6MWT and were at a significantly higher risk for cardio-metabolic diseases. Relative risks ranged from 1.33 for having dyslipidemia to 5.33 for hyperglycemia. The current data offer the first evidence that the PAVS assessment might be a useful vital sign in the routine assessment of in- and outpatients with bipolar disorder.
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.JAD.2015.10.019
Abstract: Exercise has established efficacy in improving depressive symptoms. Dropouts from randomized controlled trials (RCT's) pose a threat to the validity of this evidence base, with dropout rates varying across studies. We conducted a systematic review and meta-analysis to investigate the prevalence and predictors of dropout rates among adults with depression participating in exercise RCT's. Three authors identified RCT's from a recent Cochrane review and conducted updated searches of major electronic databases from 01/2013 to 08/2015. We included RCT's of exercise interventions in people with depression (including major depressive disorder (MDD) and depressive symptoms) that reported dropout rates. A random effects meta-analysis and meta regression were conducted. Overall, 40 RCT's were included reporting dropout rates across 52 exercise interventions including 1720 people with depression (49.1 years (range=19-76 years), 72% female (range=0-100)). The trim and fill adjusted prevalence of dropout across all studies was 18.1% (95%CI=15.0-21.8%) and 17.2% (95%CI=13.5-21.7, N=31) in MDD only. In MDD participants, higher baseline depressive symptoms (β=0.0409, 95%CI=0.0809-0.0009, P=0.04) predicted greater dropout, whilst supervised interventions delivered by physiotherapists (β=-1.2029, 95%CI=-2.0967 to -0.3091, p=0.008) and exercise physiologists (β=-1.3396, 95%CI=-2.4478 to -0.2313, p=0.01) predicted lower dropout. A comparative meta-analysis (N=29) established dropout was lower in exercise than control conditions (OR=0.642, 95%CI=0.43-0.95, p=0.02). Exercise is well tolerated by people with depression and drop out in RCT's is lower than control conditions. Thus, exercise is a feasible treatment, in particular when delivered by healthcare professionals with specific training in exercise prescription.
Publisher: Elsevier BV
Date: 03-2020
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.PSYCHRES.2018.12.098
Abstract: Community awareness of mental illness is crucial for helping people access mental health support. The association between ability to recognise mental health disorders and lived experience is not well examined in Australian populations. Australian adults (n = 1265) provided responses to a vignette depicting a person with depression and self-reported a previous diagnosis of depression and/or anxiety. People who had lived experience with depression and/or anxiety had significantly higher levels of this aspect of mental health literacy than people without lived experience. Public mental health literacy promotion efforts should consider incorporating insights from people with lived experience of mental illness.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.JAD.2019.11.066
Abstract: Sedentary behavior (SB) may be a risk factor for depression in middle- and old age adults. The aim of this study was to examine cross-sectional and longitudinal relationships between SB and depression in a large national s le of Irish people aged 50 and older taking into account a wide range of previously identified influential factors. Data from the Irish Longitudinal Study on Ageing survey were analyzed (wave 1: 2009-2011, wave 2: 2012-2013). Depression was assessed with the Center for Epidemiologic Studies Depression scale. Total weekday SB and control variables were self-reported. Multivariable logistic regression and mediation analysis were conducted to assess the associations. The final s le consisted of 6903 in iduals aged ≥50 years (63.6 ± 9.2years 52.1% female). After full adjustment for age, gender, social class, current smoking, physical activity, mobility, pain, cognition, chronic physical conditions, disability, anxiety, loneliness, and social network, the association between SB and depression was not statistically significant (OR=1.06 95%CI=0.60-1.89). Mediation analysis showed that the association is explained by social network (mediated percentage 23.1%), physical activity (20.3%), loneliness (13.2%), chronic physical conditions (11.1%), and disability (7.9%). Cross-sectional analysis showed that SB is significantly associated with depression even after full adjustment. SB was self-reported. Factors closely linked with SB such as social isolation, loneliness, physical inactivity, chronic physical conditions, and disability may play a major role in depression among middle-aged and older people. Lifestyle interventions focusing on reductions in depression in this population need to consider these factors.
Publisher: BMJ
Date: 15-09-2011
Publisher: BMJ
Date: 20-10-2016
Publisher: BMJ
Date: 02-2023
DOI: 10.1136/BJSPORTS-2022-106282
Abstract: To estimate the efficacy of exercise on depressive symptoms compared with non-active control groups and to determine the moderating effects of exercise on depression and the presence of publication bias. Systematic review and meta-analysis with meta-regression. The Cochrane Central Register of Controlled Trials, PubMed, MEDLINE, Embase, SPORTDiscus, PsycINFO, Scopus and Web of Science were searched without language restrictions from inception to 13 September2022 (PROSPERO registration no CRD42020210651). Randomised controlled trials including participants aged 18 years or older with a diagnosis of major depressive disorder or those with depressive symptoms determined by validated screening measures scoring above the threshold value, investigating the effects of an exercise intervention (aerobic and/or resistance exercise) compared with a non-exercising control group. Forty-one studies, comprising 2264 participants post intervention were included in the meta-analysis demonstrating large effects (standardised mean difference (SMD)=−0.946, 95% CI −1.18 to −0.71) favouring exercise interventions which corresponds to the number needed to treat (NNT)=2 (95% CI 1.68 to 2.59). Large effects were found in studies with in iduals with major depressive disorder (SMD=−0.998, 95% CI −1.39 to −0.61, k=20), supervised exercise interventions (SMD=−1.026, 95% CI −1.28 to −0.77, k=40) and moderate effects when analyses were restricted to low risk of bias studies (SMD=−0.666, 95% CI −0.99 to −0.34, k=12, NNT=2.8 (95% CI 1.94 to 5.22)). Exercise is efficacious in treating depression and depressive symptoms and should be offered as an evidence-based treatment option focusing on supervised and group exercise with moderate intensity and aerobic exercise regimes. The small s le sizes of many trials and high heterogeneity in methods should be considered when interpreting the results.
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.PSYCHRES.2018.06.022
Abstract: In people with schizophrenia several factors are associated with poor quality of life (QoL), namely, lifestyle-related factors and psychological factors. However, there has been little research on the impact of these factors on QoL. Therefore, the relation between lifestyle-related factors, psychological factors, and QoL in people with schizophrenia was assessed. A cross-sectional study was conducted among 115 patients (25% women, 50% inpatients). QoL was measured by World Health Organisation Quality of Life- Brief Version. Lifestyle-related factors were assessed, namely physical activity (International Physical Activity Questionnaire- Short Form), sleep quality (Pittsburgh Sleep Quality Index) and dietary intake (Mediterranean Diet score). Psychological factors such as self-esteem (Rosenberg Self-Esteem Scale) and autonomous motivation (Behavioural Regulation Questionnaire- version 3) were also measured. Regression analyses were performed to identify significant predictors of QoL. Results showed that self-esteem predicted better global, physical, psychological and environmental QoL. Physical activity predicted better global and physical QoL, while sedentary time predicted poor social and environmental QoL. Identifying predictors of QoL has implication for the effective design and delivery of lifestyles interventions, including physical activity, dietary education and smoking cessation in people with schizophrenia. Adopting healthy lifestyles may lead to improved physical health, psychological well-being and QoL in this population.
Publisher: Springer Science and Business Media LLC
Date: 09-07-2019
Publisher: SAGE Publications
Date: 2023
DOI: 10.1177/20552076221149294
Abstract: Emergency service workers are at risk of experiencing poor mental health due to repeated exposure to potentially traumatic events. Promoting healthy lifestyle factors may help improve health outcomes and quality of life among this population. This study aimed to evaluate the efficacy of a 10-week physical activity (PA) and diet programme delivered via Facebook for sedentary emergency service workers and their support partners on levels of psychological distress. We delivered a 10-week intervention via a private Facebook group facilitated by exercise physiologists, a dietitian and peer-facilitators. Weekly education modules and telehealth calls were delivered, and participants were provided with a PA tracking device (Fitbit accelerometer). A stepped-wedge design was applied to compare levels of psychological distress (K6) during baseline, to intervention by comparing slopes of change. Secondary pre–post outcomes included mental health symptoms, PA, quality of life, social support to exercise, sleep quality and suicidal ideation. In total, N=90 participants ( n=47 emergency service workers and n=43 support partners) were recruited in 4 cohorts (aged 42.3±11.5 years, 51% male). Levels of psychological distress did not change significantly during the baseline (control) slope and reduced significantly during the first 6 weeks of intervention (intervention slope 1). The slopes were significantly different, b=−0.351, p = 0.003 (i.e. the trajectories of change) and improvements plateaued until follow up. Retention was high (92%) and improvements in mental health symptoms, minutes of PA, sedentary time and quality of life were significant. Our intervention delivered via social media is feasible and associated with reduced levels of psychological distress among emergency service workers and support partners. Australian New Zealand Clinical Trials Registry (ACTRN): 12619000877189.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.ORCP.2019.02.003
Abstract: Severe mental illness is characterised by a 15-year mortality gap driven by cardiometabolic disease. Antipsychotic treatment leads to increased appetite and rapid weight gain. The 12-week lifestyle pilot intervention improved dietary intake and prevented antipsychotic-induced weight gain. Here we report two-year outcomes. Participants were exposed to an extended program. Weight and waist circumference were measured, and food frequency questionnaire completed. Diet quality was higher, and discretionary food intake was 40% lower, at two-years compared to baseline. Weight and waist-circumference did not increase. This pilot study demonstrated sustained effectiveness of a dietetic intervention in youth with first-episode psychosis with improvements in diet quality and no increase in weight secondary to antipsychotic medication initiation.
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.JAD.2016.10.050
Abstract: Low levels of physical activity (PA) and sedentary behavior (SB) are independent risk factors for cardiovascular disease and premature mortality in people with major depressive disorder (MDD). Investigate levels of PA and SB and their predictors in people with MDD. Electronic databases were searched from inception till 04/2016 for articles measuring PA and SB with a self-report questionnaire (SRQ) or objective measure (e.g. accelerometer) in people with MDD. Random-effects meta-analyses and meta-regression analyses were conducted. Twenty-four eligible studies were identified including 2901 people with MDD (78.4% female, mean age=54 years range: 21-77 years). People with MDD spent 126.0min (95%CI=91.9-160.1) per day engaging in all types of PA and spent 8.5hours (95%CI=7.51-9.62) during their waking day being sedentary. Compared to controls, people with MDD spent less time in total PA (SMD=-0.25, 95%CI=-0.03 to 0.15) and moderate to vigorous PA (SMD=-0.30, 95%CI=-0.40 to 0.21) and engaged in higher levels of SB (SMD=0.09, 95%CI=0.01-0.18). The proportion of people with MDD not meeting the recommended PA guidelines was 67.8% (n=13 studies), which was higher in studies relying on objective versus self-report measures (85.7% v 62.1%, p=0.04). People with MDD were more likely than controls to not meeting the recommended PA guidelines (OR = 1.50, 95%CI = 1.10–2.10). Heterogeneity was evident in most analyses. Adults with MDD engage in low levels of PA and high levels of SB. PA and SB are independent predictors of mortality, therefore, future lifestyle interventions targeting both the prevention of SB and adoption and maintenance of PA are warranted.
Publisher: Springer Science and Business Media LLC
Date: 18-01-2017
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.SCHRES.2017.06.025
Abstract: People with schizophrenia engage in low levels of physical activity (PA). However, few large-scale studies have investigated the factors that may influence PA participation in in iduals with psychosis and data from low- and middle-income countries (LMICs) is especially scarce. Thus, we investigated PA correlates in a large s le of people with a psychosis diagnosis across 47 LMICs. Cross-sectional data from the World Health Survey, restricting to those with a self-reported lifetime diagnosis of schizophrenia sychotic disorder, was analyzed. PA was assessed by the International Physical Activity Questionnaire (IPAQ) and participants were dichotomized into those that do and do not (low PA) meet the minimum recommended PA weekly targets (≥150min). A range of socio-demographic, health behavior, and mental and physical health variables were examined using random effects logistic regression. Overall 2407 people (mean 42.0years, 41.5% males) with schizophrenia sychosis were included. The prevalence of low PA was 39.2% (95%CI=37.0%-41.2%). Male sex (odds ratio (OR)=1.33), increasing age, unemployment (vs. employed OR=2.50), urban setting (vs. rural OR=1.75), inadequate fruit consumption (vs. adequate fruit intake OR=3.03), depression (OR=1.33), sleep/energy disturbance, and mobility limitations were significantly associated with low PA. Marital status, education, wealth, smoking, vegetable and alcohol consumption, anxiety, cognition, pain, and chronic medical conditions were not significant correlates. PA is influenced by a range of factors among people with psychosis. These correlates should be considered in interventions aiming to facilitate PA in psychotic in iduals living in LMICs.
Publisher: Wiley
Date: 18-09-2020
DOI: 10.1111/EIP.12871
Abstract: Youth with at-risk mental states (ARMS) have low levels of physical activity (PA), reduced fitness levels and experience poor sleep quality. These lifestyle factors exacerbate mental health symptoms and increase cardiometabolic disease risk. PA interventions can help prevent this decline in physical health whilst reducing mental health symptom severity. Whether PA interventions are feasible and acceptable amongst youth with ARMS is unclear. This study evaluated the feasibility and acceptability of headspace Active, a pragmatic PA program offered to 14 to 25 year olds with ARMS. The 12-week exercise physiologist-led intervention was conducted in adjunct to usual care. Feasibility was determined by number of referrals, attendance, engagement in exercise sessions and dropout from the intervention. Acceptability was assessed by a 10-item questionnaire. Secondary outcomes included anthropometry, cardiorespiratory fitness and strength. Subjective PA levels, symptoms of depression and anxiety, sleep, motivation and quality of life were also assessed. Within 12 months, 77% of referrals completed the 12-week intervention (n = 20), with six dropouts. Of the 20 "completers", 95% attended at least five sessions over the 12-week intervention. Participants found the program highly acceptable (mean = 41.2/50 on the 10-item acceptability questionnaire) and experienced significant improvements in PA, strength, motivation, depressive symptoms and sleep quality post-intervention. No changes in anthropometry were observed. Results suggest headspace Active was feasible and acceptable and was associated with improvements in physical and mental health outcomes among ARMS youth. Given the potential scalability of this real-world PA program to other youth mental health settings, these data have implications for best practice implementation of PA interventions for in iduals with emerging mental illness.
Publisher: Emerald
Date: 27-06-2020
DOI: 10.1108/JMHTEP-01-2020-0006
Abstract: Physical activity is increasingly recognised as critical to improving physical and mental health (MH). Understanding the education and training requirements of exercise professionals will support better integration of these emerging MH professionals within the multidisciplinary MH team. The purpose of this study was to determine the exposure to, knowledge and attitudes of final year exercise physiology students towards people with mental illness (MI). Student exposure to and knowledge and attitudes of people living with MH were assessed via a 24-item online questionnaire. In total, n = 63 out of 78 eligible students participated (81%). Of the participants, 81% ( n = 51) showed a favourable attitude towards people with MI and 68% ( n = 43) of participants had good knowledge of topics relating to MI. Significant correlations existed between the total score for attitude and any exposure to MH issues and having undertaken placement as part of university training and knowledge and total scores. Further training and education are needed to better equip exercise physiology graduates to work with people with MI. This is the first study to examine the attitudes and knowledge of exercise physiology students towards people living with MI and their association with exposure to MI. Given the growing number of exercise professionals being integrated into multidisciplinary MH teams, this study may help to direct the delivery of associated training and education services.
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.JAD.2015.10.010
Abstract: Cardiorespiratory fitness (CRF) is an independent predictor of cardiovascular disease and all-cause mortality. CRF improves in response to exercise interventions, yet the effectiveness of such interventions to improve CRF among people with depression is unclear. We conducted a systematic review and meta-analysis to evaluate whether CRF improves in people with depression in exercise randomized control trials (RCTs). Three authors identified RCTs from a recent Cochrane review and conducted updated searches of major electronic databases. We included RCTs of exercise interventions in people with depression (including major depressive disorder (MDD) and above-threshold depressive symptoms) that reported CRF (defined as predicted maximal oxygen uptake (VO2max predicted) or peak oxygen uptake (VO2peak)) versus a control condition. A random effects meta-analysis was conducted. Seven unique RCTs including 8 aerobic exercise interventions for depression were eligible, including 293 people allocated to exercise (mean age=40.3 years, range=27.2-64.7 years and 35-100% female) and 205 allocated to control conditions. Across all studies exercise results in a significant increase in CRF (g=0.64, 95%CI=0.32-0.96, p<0.001) equating to a mean increase of 3.05 ml/kg/min. Results remained significant when restricted to MDD only (N=5, g=0.41, 95%CI=0.18-0.64, p<0.001) and in high quality studies (N=5, g=0.60, 95%CI=0.19-1.00, p=0.004). People with depression can achieve clinically relevant improvements in CRF in response to exercise interventions. Targeting 'fitness' rather than 'fatness' may be another feasible intervention strategy in this population.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.PSYCHRES.2019.112601
Abstract: There is a mortality gap of 15 to 20 years for people with severe mental illness (SMI - psychotic spectrum, bipolar, major depressive disorders). Modifiable risk factors include inactivity and low cardiorespiratory fitness (CRF). Exercise can improve mental and physical outcomes optimal type and intensity of exercise for people with SMI has yet to be determined. High Intensity Interval training (HIIT) is an exercise with distinct cardio-metabolic advantages in other disease populations compared to traditional moderate intensity continuous training (MCT). We investigated the feasibility and efficacy of HIIT for people with SMI. Major electronic databases were searched, identifying HIIT studies for adults experiencing SMI.Data on feasibility, safety, study design, s le characteristics, and physical and psychological outcomes were extracted and systematically reviewed. Meta-analyses were conducted within group, pre and post HIIT interventions, and between group, to compare HIIT with control conditions. Nine articles were identified including three pre ost studies, one non randomised and five randomised trials, (366 participants, 45.1% female). HIIT appears as feasible as MCT, with few safety concerns. Following HIIT, there was a moderate improvement in CRF and depression. There was no difference between HIIT and MCT for adherence or CRF.HIIT improved depression more than MCT.
Publisher: Wiley
Date: 27-08-2019
DOI: 10.1002/GPS.5202
Publisher: Elsevier BV
Date: 03-2020
Publisher: Informa UK Limited
Date: 24-07-2019
DOI: 10.1080/01612840.2019.1642426
Abstract: The purpose of this study was to examine the dietary intake of both inpatients and outpatients with schizophrenia in the Portuguese population as a potential key contributing factor to the poor physical health profiles, and understand the relationship of diet quality to other lifestyle factors. Participants of this cross-sectional study completed a semi quantitative food frequency questionnaire. Diet quality was determined by adherence to the Mediterranean Diet. In addition participants completed the International Physical Activity Questionnaire-Short-Form and Pittsburgh Sleep Quality Index. Tobacco smoking was assessed through a series of general questions. A total of 100 patients (50% inpatients and 28% female) with schizophrenia were included in the final analysis. Patients reported a high consumption of caffeine, while deficits were evident for fibre and folate intakes, when compared to the European Food Safety Authority recommendations. Both inpatients and outpatients reported poor to moderate diet quality. Smokers reported poorer diet quality when compared to non-smokers (
Publisher: SAGE Publications
Date: 06-06-2017
Abstract: Evaluation of physical activity (PA) programs among populations with severe mental illness (SMI) has predominately focused on efficacy and therapeutic benefits. There is now strong evidence to support the benefits of PA in people with SMI. What remains is a gap in the implementation of pragmatic and sustainable PA interventions in mental-health settings. The current paper provides ex les of interventions that have been successfully implemented in Australian settings, identifies key components of successful PA interventions and outlines practical strategies that can assist with widespread implementation of PA interventions in mental-health settings. There is an emergence of PA interventions being imbedded within a variety of mental-health settings. These interventions vary in terms of mode and intensity of service delivery. Yet, all aim to increase PA and reduce sedentary behaviour. Adopting the identified strategies may help facilitate successful implementation and increase access to PA interventions for mental-health service users.
Publisher: Cambridge University Press (CUP)
Date: 16-02-2017
DOI: 10.1017/S0033291717000022
Abstract: When used as an adjunctive with antipsychotics, certain vitamins and minerals may be effective for improving symptomatic outcomes of schizophrenia, by restoring nutritional deficits, reducing oxidative stress, or modulating neurological pathways. We conducted a systematic review of all randomized controlled trials (RCTs) reporting effects of vitamin and/or mineral supplements on psychiatric symptoms in people with schizophrenia. Random-effects meta-analyses were used to calculate the standardized mean difference between nutrient and placebo treatments. An electronic database search in July 2016 identified 18 eligible RCTs, with outcome data for 832 patients. Pooled effects showed that vitamin B supplementation (including B6, B8 and B12) reduced psychiatric symptoms significantly more than control conditions [ g = 0.508, 95% confidence interval (CI) 0.01–1.01, p = 0.047, I 2 = 72.3%]. Similar effects were observed among vitamin B RCTs which used intention-to-treat analyses ( g = 0.734, 95% CI 0.00–1.49, p = 0.051). However, no effects of B vitamins were observed in in idual domains of positive and negative symptoms (both p 0.1). Meta-regression analyses showed that shorter illness duration was associated with greater vitamin B effectiveness ( p = 0.001). There were no overall effects from antioxidant vitamins, inositol or dietary minerals on psychiatric symptoms. There is preliminary evidence that certain vitamin and mineral supplements may reduce psychiatric symptoms in some people with schizophrenia. Further research is needed to examine how the benefits of supplementation relate to nutrient deficits and the impact upon underlying neurobiological pathways, in order to establish optimal nutrient formulations for improving clinical outcomes in this population. Future studies should also explore the effects of combining beneficial nutrients within multi-nutrient formulas.
Publisher: SAGE Publications
Date: 23-06-2014
Publisher: Wiley
Date: 02-10-2022
DOI: 10.5694/MJA2.51705
Publisher: Elsevier BV
Date: 06-2016
DOI: 10.1016/J.JAD.2016.02.060
Abstract: Obstructive sleep apnea (OSA) is a health hazard since it is associated with neurocognitive dysfunction and cardio-metabolic diseases. The prevalence of OSA among people with serious mental illness (SMI) is unclear. We searched major electronic databases from inception till 06/2015. Articles were included that reported the prevalence of OSA determined by polysomnography (PSG) or an apnea-hypopnea index (AHI) >5 events/hr, in people with major depressive disorder (MDD), bipolar disorder (BD) or schizophrenia. A random effects meta-analysis calculating the pooled prevalence of OSA and meta-regression of potential moderators were performed. Twelve articles were included representing 570,121 participants with SMI (mean age=38.3 years (SD=7.5)), 45.8% male (range=32-80.4) and mean body mass index (BMI) 25.9 (SD=3.7). The prevalence of OSA in SMI in clinical studies was 25.7% (95% CI 13.9 to 42.4%, n=1,535). Higher frequencies of OSA were seen in MDD (36.3%, 19.4-57.4%, n=525) than in BD (24.5%, 95% CI 10.6-47.1, n=681) and schizophrenia (15.4%, 95% CI 5.3-37.1%, n=329). The prevalence of OSA in 568,586 people with SMI from population cohort studies was 10.7% (95% CI 2.4-37.0%) and 19.8% (95% CI 2.5-70.0%) in 358,853 people with MDD. Increasing age (β=0.063, 95% CI 0.0005-0.126, p=0.04, N=10) and BMI predicted increased prevalence of OSA (β=0.1642, 95% CI 0.004-0.3701, p=0.04, N=9). People with SMI (particularly MDD) have a high prevalence of OSA. Screening for and interventions to manage OSA in SMI including those focused on reducing BMI are warranted.
Publisher: Springer Science and Business Media LLC
Date: 31-07-2023
DOI: 10.1186/S40359-023-01257-5
Abstract: Mental illnesses stigma is a universal and transcultural phenomenon. While mental illnesses stigma is pervasive in Bangladesh, very little research exists on stigma toward mental illnesses among indigenous communities. This study aimed to investigate the prevailing stigma and the risk factors among different indigenous communities in the Chattogram Hill Tracts (CHT) in Bangladesh. A cross-sectional survey was carried out and participants were recruited purposively from Rangamati, a South-Eastern district of Bangladesh in the CHT. Participants from various indigenous communities including Chakma, Marma, Rakhine, Tripura, and Pangkhua were recruited. The 28- item Bangla translated version of the Mental Illnesses Stigma Scale was used. Independent-s les t-test, ANOVA, and multiple regression were performed. The results indicate evidence of a gender difference with females reporting more stigma than their male counterparts. Age, gender, socioeconomic status, and monthly income are associated with stigma among indigenous people. Further analyses of the subscales indicated significant differences among sociodemographic variables. The results provide an insight into the prevailing stigma and associate risk factors among indigenous communities. The results may help inform anti-stigma interventions targeting indigenous communities in Bangladesh.
Publisher: Elsevier BV
Date: 02-2021
Publisher: Springer Science and Business Media LLC
Date: 16-02-2021
DOI: 10.1186/S12889-021-10394-8
Abstract: Physical activity (PA) is a modifiable risk factor for postnatal depression (PND) and programs are needed to enhance PA amongst women at risk of PND. Key stakeholder involvement in informing development and implementation of such programs is vital. However, little research demonstrates key stakeholder insights to inform the design and delivery of PA programs for improving PND. The aim of this study was to explore key stakeholder perspectives on the design and delivery of a home-based PA program for mothers with PND symptoms to inform future real-world implementation and scale-up. A descriptive qualitative study was undertaken whereby semi-structured interviews were conducted with representatives from various key stakeholder organisations involved in postnatal PA and/or mental health, public health and policy in Australia ( n = 11). Interviews were conducted between September to November 2019 and explored stakeholder perceptions on the design and delivery of a home-based PA program for mothers with PND symptoms. The interview schedule was informed by both the Consolidated Framework for Implementation Research (CFIR) and the PRACTical planning for Implementation and Scale-up (PRACTIS) guide. Data were analysed thematically using both deductive and inductive coding. The relative priority of PND and PA was high for most organisations involved, although none implemented PA programs supporting women at risk of PND. Most stakeholders perceived the program as appealing due to addressing barriers to postnatal PA, although identified some feasibility issues regarding funding and delivery mechanisms. Suggestions for program adaptations included an equity focus (e.g. providing socioeconomically disadvantaged women with a greater program dose translating web-app based content into various languages). Planned components of the program were suggested to align (i.e. relative advantage ) with existing initiatives (e.g. equipment hire for nurseries scheme) and screening systems for PND (timing of referral). Perceived barriers to scale-up included logistics/cost of equipment, organisational capacity demands and safety risks/liability. Perceived enablers to scale-up included linking the program with ‘adjunct’ programs and services. While the program was appealing and most organisations could see a role in endorsing and/or referring to the program, funding and delivery mechanisms still need to be identified.
Publisher: Wiley
Date: 10-10-2015
DOI: 10.1111/ACPS.12350
Publisher: Springer Science and Business Media LLC
Date: 05-12-2018
DOI: 10.1007/S10597-018-0353-6
Abstract: The current study examined the impact of sedentary behaviour (SB) on quality of life (QoL) in people with psychotic disorders. Thirty-six Ugandan women (mean age = 33.9 ± 8.0 years) and 23 men (37.4 ± 11.8 years) with a DSM 5 diagnosis of psychosis completed the World Health Organization Quality of Life-Brief version and Simple Physical Activity Questionnaire (SIMPAQ). Medication use, physical co-morbidities, weight, height, blood pressure and smoking habits were recorded. Multiple regression analyses were undertaken. Variability in SIMPAQ sedentary and walking scores explained 56% of the variability in psychological QoL, while variability in SIMPAQ walking explained 46% of the variability in physical QoL. Health care professionals should not only consider increasing physical activity but also reducing SB to improve QoL in their patients.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2015
Publisher: Medknow
Date: 2019
Publisher: JMIR Publications Inc.
Date: 12-08-2020
Abstract: irst responders (eg, police, firefighters, and paramedics) are at high risk of experiencing poor mental health. Physical activity interventions can help reduce symptoms and improve mental health in this group. More research is needed to evaluate accessible, low-cost methods of delivering programs. Social media may be a potential platform for delivering group-based physical activity interventions. his study aims to examine the feasibility and acceptability of delivering a mental health–informed physical activity program for first responders and their self-nominated support partners. This study also aims to assess the feasibility of applying a novel multiple time series design and to explore the impact of the intervention on mental health symptoms, sleep quality, quality of life, and physical activity levels. e co-designed a 10-week web-based physical activity program delivered via a private Facebook group. We provided education and motivation around different topics weekly (eg, goal setting, overcoming barriers to exercise, and reducing sedentary behavior) and provided participants with a Fitbit. A multiple time series design was applied to assess psychological distress levels, with participants acting as their own control before the intervention. n total, 24 participants (12 first responders and 12 nominated support partners) were recruited, and 21 (88%) completed the postassessment questionnaires. High acceptability was observed in the qualitative interviews. Exploratory analyses revealed significant reductions in psychological distress during the intervention. Preintervention and postintervention analysis showed significant improvements in quality of life ( i P /i =.001 Cohen i d /i =0.60) total depression, anxiety, and stress scores ( i P /i =.047 Cohen i d /i =0.35) and minutes of walking ( i P /i =.04 Cohen i d /i =0.55). Changes in perceived social support from family ( i P /i =.07 Cohen i d /i =0.37), friends ( i P /i =.10 Cohen i d /i =0.38), and sleep quality ( i P /i =.28 Cohen i d /i =0.19) were not significant. he results provide preliminary support for the use of social media and a multiple time series design to deliver mental health–informed physical activity interventions for first responders and their support partners. Therefore, an adequately powered trial is required. ustralian New Zealand Clinical Trials Registry (ACTRN): 12618001267246 anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001267246.
Publisher: BMJ
Date: 02-2020
DOI: 10.1136/BMJOPEN-2019-035549
Abstract: There is growing interest in the relationship between sedentary behaviour and mental distress among adolescents, but the majority of studies to date have relied on self-reported measures with poor validity. Consequently, current knowledge may be affected by various biases. The aim of this study was to investigate the cross-sectional and longitudinal association between (1) objectively measured sedentary time and (2) self-reported screen time with mental distress among adolescents participating in The Tromsø Study: Fit Futures, in order to see if the association is dependent on mode of measurement of sedentary behaviour. Prospective study. S le drawn from upper secondary school students (mean age 16.3 years at baseline) from two municipalities in Northern Norway participating in The Tromsø Study: Fit Futures 1 and 2. 686 adolescents (54.5% female), with complete self-reported and accelerometer data after multiple imputation. Mental distress assessed via the Hopkins Symptom Checklist-10 (HSCL-10). Minutes in sedentary behaviour measured by accelerometer showed no significant relationship with mental distress in neither crude, partly adjusted nor multiple adjusted hierarchic linear regression analyses. Self-reported screen time was positively associated with mental distress in all analyses (multiple adjusted, B=0.038, p=0.008, 95% CI 0.010 to 0.066). However, the effect was small. Self-reported screen time was associated with slightly elevated mental distress 2 years later, whereas objectively measured minutes in sedentary behaviour was not, indicating a discrepancy in the results depending on measurement methods.
Publisher: EDITORA SCIENTIFIC
Date: 18-07-2016
Publisher: Physicians Postgraduate Press, Inc
Date: 31-03-2014
DOI: 10.4088/JCP.13R08765
Publisher: Elsevier BV
Date: 11-2019
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.JAD.2017.08.070
Abstract: A potential approach to suicide prevention that has not been closely examined, but which holds promise in terms of widespread dissemination without major side-effects, is physical activity (PA). This systematic review and meta-analysis set out to: (a) explore associations between PA and suicidal ideation (SI) levels, and (b) investigate the effect of PA interventions on SI. Major electronic databases were searched from inception up to 05/2017 to identify quantitative studies reporting an association between PA and SI. A quantitative correlates synthesis and random effects meta-analysis were conducted. Fourteen of 21 studies in adults (67%) (n = 130,737), 7/14 (50%) in adolescents (n = 539,170) and 2/3 (67%) in older adults (n = 50,745) found a significant negative association between PA- and SI-levels. Pooled adjusted meta-analysis of 14 effect sizes over eight studies and 80,856 people found that those who were "active" versus those who were "inactive" were less likely to have SI (OR = 0.87, 95%CI = 0.76-0.98). Additionally, meeting PA guidelines conferred a significant protective effect against SI (OR = 0.91, 95%CI = 0.51-0.99, P = 0.03 N studies = 3, n people = 122,395), while not meeting guidelines was associated with increased SI (OR = 1.16, 95%CI = 1.09-1.24, P < 0.001 N = 4, n = 78,860). Data from the intervention studies (N = 3, n = 121) was mixed and limited. Our findings are based mainly on cross-sectional studies, while the majority of studies did not include a rigorous physical activity assessment. The current study suggests that higher PA levels are associated with lower SI. However, the associations observed need to be confirmed in prospective observational studies and controlled trials.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.JAD.2016.10.028
Abstract: Despite the known benefits of physical activity (PA) among people with anxiety, little is known about PA levels in people with anxiety at the population level. This study explored the global prevalence of anxiety and its association with PA. Cross-sectional, community-based data from the World Health Survey was analyzed. Prevalence of anxiety was estimated for 237,964 in iduals (47 countries). PA was categorized as low, moderate, and high based on the International Physical Activity Questionnaire (short form). The association between PA and anxiety was assessed by multivariable logistic regression. The overall global prevalence of anxiety was 11.4% (47 countries). Across 38 countries with available data on PA, 62.5%, 20.2%, and 17.3% of the s le engaged in high, moderate, and low levels of PA respectively. The prevalence of low physical activity in those with and without anxiety was 22.9% vs. 16.6% (p<0.001) (38 countries, n=184,920). In the pooled model adjusted for socio-demographics, depression, and country, in iduals engaging in low PA (vs. high PA) had 1.32 (95% CI=1.17-1.47) times higher odds for anxiety than those with high PA. Female sex, older age, lower education and wealth, and depression were also associated with low PA. At the in idual country level, there was a significant positive association between low PA and anxiety in 17 of the 38 countries. Low PA levels are associated with increased prevalence of anxiety. There is a need for longitudinal research to establish the directionality of the relationships observed.
Publisher: Elsevier BV
Date: 05-2015
Publisher: Elsevier BV
Date: 03-2022
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.JAD.2016.05.020
Abstract: Mortality rates are approximately two to three times higher in people with bipolar disorder (BD) than in general population. Lack of physical activity (PA) and sedentary behavior (SB) are independent risk factors for cardiovascular disease and premature mortality. We conducted a meta-analysis to investigate PA and SB levels and its predictors in BD. Major electronic databases were searched from inception till 02/2016 for articles measuring PA and SB with a self-report questionnaire (SRQ) or objective measure (e.g. accelerometer) in BD. A random effects meta-analysis and meta-regression analysis were conducted. Six studies were eligible including 279 (129♂) people with BD (mean age=43.9 years range: 32.0-51.5 years). The trim and fill analysis demonstrated people with BD spent in total 210.1min (95%CI=146.3-273.9min) per day being physically active and 613.3min (95%CI=389.9-836.6min) during waking hours being sedentary. No significant difference in total PA per day was observed between people with BD and controls (g=-0.62, 95% CI=-1.55 to 0.31, I(2)=88.5%, n BD =82, n controls =86). Objective measures of PA recorded significantly lower levels (P=0.03) compared to self-report PA. Meta-regression demonstrated that older age and a higher body mass index predicted lower PA levels. Only a limited number of studies were identified assessing SB in people with BD. Adults with BD engage in high levels of sedentary behavior during waking hours. Given that sedentary behavior is an independent predictor of cardiovascular disease, future lifestyle interventions specifically targeting the prevention of sedentary behavior are warranted.
Publisher: Springer Science and Business Media LLC
Date: 22-07-2011
Publisher: Elsevier BV
Date: 04-2014
Publisher: MDPI AG
Date: 21-04-2021
Abstract: Emergency service workers (ESWs) are at high risk of experiencing poor mental health, including posttraumatic stress disorder (PTSD). Programs led by ex-service organizations may play an unrecognized but critical role in mental health prevention and promotion. Behind the Seen (BTS) is an Australian ex-service organization that runs workshops to raise awareness and facilitate conversations around the mental health of ESWs. The purpose of the study is to conduct a qualitative evaluation of workshop participants’ experiences, to understand the acceptability and perceived usefulness over the immediate- (within 1 month), intermediate- (6 months) and longer-terms (12 months). Participants (n = 59 ESWs) were recruited using purposive s ling across five fire and rescue services in metropolitan, regional, and rural locations. Focus groups methodology was used for data collection and data were analyzed using iterative categorization techniques. Participants reported (i) a high perceived need for education about PTSD, (ii) highly salient aspects of the presentation that made for a positive learning experience, including the importance of the lived experiences of the facilitators in the learning process, (iii) key features of changes to intentions, attitudes, and behavior, and (iv) major aspects of the organizational context that affected the understanding and uptake of the program’s key messages. BTS was perceived as an acceptable means of delivering mental health, PTSD, and help-seeking information to ESWs. The program is a promising candidate for scaling-up and further translation.
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.PSYCHRES.2015.05.042
Abstract: The physical health of people with bipolar disorder is poorer in comparison to the general population, with an increased prevalence of cardiovascular and metabolic diseases. Due to the established beneficial effects, there is growing interest in the promotion of physical activity and in particular the accurate measurement of physical fitness in this population. Currently, no existing measures of physical fitness used in the general population have been tested for validity and reliability among people with bipolar disorder. Therefore, we examined the reproducibility, feasibility and correlates of the Eurofit test battery in people with bipolar disorder. From 24 men (43.0±13.0 years) and 22 women (43.9±10.2 years) with bipolar disorder two trials of the Eurofit test, administered within three days, were analyzed. All Eurofit items showed good reproducibility with intraclass correlation coefficients ranging from 0.71 for the whole body balance test to 0.98 for the handgrip force test. Significant correlations with Eurofit test items were found with age, illness duration, body mass index, smoking behavior, mean daily lithium dosage, and depressive and lifetime hypomanic symptoms. The current study demonstrates that the Eurofit test can be recommended for evaluating the physical fitness of inpatients with bipolar disorder.
Publisher: Springer Science and Business Media LLC
Date: 06-03-2020
DOI: 10.1186/S12888-020-2473-0
Abstract: Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness. The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Patients with a DSM or ICD mental illness diagnoses were recruited and completed the SIMPAQ on two occasions, one week apart. Participants wore an Actigraph accelerometer and completed brief cognitive and clinical assessments. Evidence of SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1010 participants. The SIMPAQ had good test-retest reliability. Correlations for moderate-vigorous physical activity was comparable to studies conducted in general population s les. Evidence of validity for the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had stronger evidence of validity. This alternative method is recommended for use in future studies employing the SIMPAQ. The SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals.
Publisher: BMJ
Date: 28-05-2020
Publisher: JMIR Publications Inc.
Date: 07-12-2021
Abstract: mergency service workers are at an increased risk of experiencing poor mental health due to prolonged, repeated exposure to potentially traumatic events. Promoting healthy lifestyle behaviours including physical activity and diet may help to mitigate some the consequences of emergency service work. his study aimed to evaluate the impact of an online physical activity and diet intervention on levels of psychological distress among emergency service workers and their nominated support partner e.g., spouse, family member close friend. e delivered a 10-week physical activity program via a private Facebook group. The Facebook group was co-facilitated by exercise physiologists, a dietitian and peer-facilitators. Weekly modules on overcoming barriers to exercise, self-monitoring of activity and nutrition were delivered. Participants could also join weekly group telehealth calls and were provided with a physical activity tracking device. A stepped-wedge design was applied to compare levels of psychological distress (Kessler-6) during baseline, to intervention by comparing slopes of change. Visual inspection of the data was used to identify the location for a knot point. Then separate slopes were modelled for a) baseline b) intervention slope 1 c) intervention slope 2 d) change in level of knot points. Secondary outcomes included a pre-post assessment of mental health symptoms, physical activity levels, quality of life, social support to exercise, sleep quality and suicidal ideation. n total, N=90 participants (n=47 emergency service workers and n=43 support partners) were recruited in 4 separate cohorts (mean age 42.3(SD=11.5) years, 51% male). Levels of psychological distress did not change significantly during the baseline (control) slope, while during the first 6 weeks of intervention (intervention slope 1) levels reduced significantly. The interaction between baseline and intervention slopes were significant, b=-0.351, p = 0.003, (i.e., the trajectories of change were significantly different) and improvements plateaued until the 4-week follow up (intervention slope 2). Participation was associated with improvements in mental health symptoms, weekly minutes of physical activity, sedentary time and quality of life. Retention in the intervention was high (92%). 10-week physical activity intervention delivered via social media is feasible and effective in improving psychological distress among emergency service workers and their support partners. Future research should consider investigating the factors mediating changes in health behaviours and outcomes. ustralian New Zealand Clinical Trials Registry (ACTRN): 12619000877189. R2-10.1136/bmjopen-2019-030668
Publisher: Informa UK Limited
Date: 22-12-2015
DOI: 10.1080/10640266.2015.1123988
Abstract: Despite emerging evidence illustrating the benefits of physical activity for people with binge eating disorder, engaging this population in physical activity is challenging. The International Organization of Physical Therapists in Mental Health (IOPTMH) set out to summarize, appraise, and strengthen the direction of physical activity endeavors. This process led to the identification of 10 important research questions which are discussed. Addressing these 10 research questions is critical for developing evidence-based approaches for promoting and sustaining an active lifestyle in people with binge eating disorder.
Publisher: SAGE Publications
Date: 03-06-2015
Publisher: Public Library of Science (PLoS)
Date: 07-09-2018
Publisher: Wiley
Date: 25-11-2021
DOI: 10.1111/APA.15657
Publisher: Cambridge University Press (CUP)
Date: 04-04-2016
DOI: 10.1017/S0007114516001033
Abstract: Severe mental illness is characterised by a 20-year mortality gap due to cardiometabolic disease. Poor diet in those with severe mental illness is an important and modifiable risk factor. The present study aimed to (i) examine baseline nutritional intake in youth with first-episode psychosis (FEP), (ii) evaluate the feasibility and acceptability of nutritional intervention early in FEP and (iii) to evaluate the effectiveness of early dietary intervention on key nutritional end points. Participants were recruited over a 12-month period from a community-based programme specifically targeting young people aged 15–25 years with newly diagnosed FEP. In idual dietetic consultations and practical group sessions were offered as part of a broader lifestyle programme. Dietary assessments were conducted before and at the end of the 12-week intervention. Participants exceeded recommended energy and Na intakes at baseline. Retention within the nutrition intervention was 67 %, consistent with other interventions offered to FEP clients. There was a 47 % reduction in discretionary food intake (−94 g/d, P ·001) and reductions in daily energy (−24 %, P ·001) and Na (−26 %, P ·001) intakes. Diet quality significantly improved, and the mean change was 3·6 (95 % CI 0·2, 6·9, P ·05), although this finding was not significant after Bonferroni’s correction. Increased vegetable intake was the main factor contributing to improved diet quality. Nutrition intervention delivered shortly after initiation of antipsychotic medication is feasible, acceptable and effective in youth with FEP. Strategies to prevent weight gain and metabolic decline will contribute to prevent premature cardiometabolic disease in this vulnerable population.
Publisher: Wiley
Date: 15-08-2021
DOI: 10.1002/HPJA.377
Abstract: 1) Describe the dietary intake of mental health staff within South Eastern Sydney Local Health District and 2) Evaluate the impact of an in idualised staff lifestyle program on the following nutrition parameters (i) energy, (ii) core food groups and (iii) discretionary foods. This was a pragmatic single‐arm intervention study, conducted for all staff working in a public mental health service, in Sydney, Australia. A five‐session in idualised lifestyle intervention delivered over 5 weeks incorporated nutritional counselling delivered by a dietitian. Participants were assessed at baseline, following the intervention, and at follow‐up using diet history to assess dietary intake. Eighty‐eight staff completed the dietary intervention and follow‐up. An intake of core food groups significantly below national recommendations was reported for total vegetables (−1.75 ± 0.14 serves, P .001), fruit (−0.29 ± 0.11 serves, P = .01), grains (−1.25 ± 0.20 serves, P .001) and dairy servings (−1.00 ± 1.08 serves, P .001), and protein‐based foods were significantly above national recommendations (0.2 ± 0.09 serves, P = .03). At completion of the program, energy from discretionary foods was reduced by 460 kJ (95% CI −635 to −285, P .001), and the serves of total vegetables (0.91 serves, 95% CI 0.59‐1.22, P .001) and dairy (0.31 serves, 95% CI 0.11‐0.50, P .001) were increased significantly. A workplace‐based well‐being program for staff working in the mental health setting coincided with dietary improvements. Mental health staff can act as positive role models for clients to promote developing positive physical health behaviours.
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.PSYCHRES.2017.08.034
Abstract: Young people experiencing psychotic illness engage in low amounts of physical activity have poor fitness levels and poor sleep quality. This study aimed to determine the prevalence of these modifiable cardiometabolic risk factors among in iduals with at-risk mental states (ARMS), who are at increased risk of developing psychosis. A cross-sectional study was conducted in a community-based youth mental health service. Thirty participants (23%♀, 21.3 ± 1.7 years old) were recruited, 10 with ARMS, 10 with first-episode psychosis (FEP) and 10 healthy volunteers. Physical activity levels were assessed using self-report and objective measures. Aerobic capacity, upper body strength, hamstring flexibility, forearm grip strength and core endurance were assessed. Sleep quality, depression and anxiety were measured by self-report questionnaire. The ARMS group did not differ significantly on anthropometric measures from FEP or healthy volunteers. They engaged in significantly less physical activity (p < 0.05) and had poorer sleep quality (p < 0.05) than healthy volunteers. Our results are consistent with other studies that found that youth with ARMS are at greater cardiometabolic risk. Interventions aimed at improving these modifiable risk factors may assist with preventing the decline in physical health associated with the development of psychiatric illness.
Publisher: Informa UK Limited
Date: 17-06-2020
Publisher: Elsevier BV
Date: 10-2019
Publisher: Oxford University Press (OUP)
Date: 24-08-2016
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.ADDBEH.2019.106104
Abstract: Adolescents spend a high proportion of their leisure time in sedentary behavior, which is associated with adverse physical and mental health outcomes. Exploring factors associated with leisure-time sedentary behavior (LTSB) is important for the development of targeted interventions. The aim of this study was to explore associations between cannabis use and LTSB in adolescents from 24 low- and middle-income countries. Data from the Global School-based Student Health Survey were analyzed. Data on past month cannabis use and LTSB during a typical day were collected. Multivariable logistic regressions were conducted to assess the associations. Among 94,035 adolescents aged 12-15 years [age = 13.7 ± SD 0.9 years 49.2% female], the prevalence of high LTSB (≥3 h/day) was 26.6%, while 2.8% used cannabis at least once in the past 30 days. In adjusted analyses, compared to those who did not consume cannabis in the past 30 days, the OR (99%CI) for high LTSB among those who used cannabis 1-2 times, 3-9 times, 10-19 times, and ≥20 times were 0.89 (0.58-1.35), 1.96 (1.26-3.07), 1.97 (0.71-5.47), and 2.34 (0.95-5.78), respectively (test for trend p < 0.01). Our data suggest that frequent cannabis use is associated with increased odds for being more sedentary in adolescence. Future longitudinal data are required to confirm/refute the findings to inform public health c aigns.
Publisher: Oxford University Press (OUP)
Date: 11-08-2016
Publisher: Ordem dos Medicos
Date: 31-05-2017
DOI: 10.20344/AMP.8436
Abstract: N/A.
Publisher: Elsevier BV
Date: 07-2015
DOI: 10.1016/J.PSYCHRES.2015.04.021
Abstract: There is a need for theoretically-based research on the motivational processes linked to the adoption and maintenance of an active lifestyle in people with affective disorders. Within the Self-Determination Theory (SDT) framework, we investigated the SDT tenets in people with major depressive disorder or bipolar disorder by examining the factor structure of the Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2) and by investigating associations between motivation, the Positive and Negative Affect Scale (PANAS) and International Physical Activity Questionnaire (IPAQ) scores. A total of 165 patients (105 ♀) (45.6 ± 14.2 years) agreed to participate. An exploratory factor analysis demonstrated sufficient convergence with the original factor for amotivation, and external and introjected regulation. The items of identified and intrinsic regulation loaded on the same factor, which was labelled autonomous regulation. Significant correlations were found between the total IPAQ score and the subscales amotivation, external regulation, introjected regulation and autonomous regulation. The relative autonomy index (RAI) was associated with the PANAS scores. Differences in RAI were found between physically inactive and active participants. Our results suggest that in people with affective disorders the level of autonomous motivation may play an important role in the adoption and maintenance of health promoting behaviours.
Publisher: Elsevier BV
Date: 04-2015
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.PSYCHRES.2016.12.020
Abstract: The literature regarding exercise for people with established anxiety disorders is equivocal. To address this issue, we conducted a systematic review and meta-analysis investigating the benefits of exercise compared to usual treatment or control conditions in people with an anxiety and/or stress-related disorders. Major electronic databases were searched from inception until December/2015 and a random effect meta-analysis conducted. Altogether, six randomized control trials (RCTs) including 262 adults (exercise n=132, 34.74 [9.6] years control n=130, 37.34 [10.0] years) were included. Exercise significantly decreased anxiety symptoms more than control conditions, with a moderate effect size (Standardized Mean Difference=-0.582, 95%CI -1.0 to -0.76, p=0.02). Our data suggest that exercise is effective in improving anxiety symptoms in people with a current diagnosis of anxiety and/ or stress-related disorders. Taken together with the wider benefits of exercise on wellbeing and cardiovascular health, these findings reinforce exercise as an important treatment option in people with anxiety/stress disorders.
Publisher: Frontiers Media SA
Date: 27-07-2018
Publisher: BMJ
Date: 18-09-2018
Publisher: BMJ
Date: 09-2019
DOI: 10.1136/BMJOPEN-2019-030668
Abstract: First responders (police, fire and ambulance officers) are at a significantly increased risk of experiencing poor mental health, including depression and post-traumatic stress disorder. These conditions are associated with high rates of cardiovascular disease, in part due to low levels of physical activity (PA) and high levels of sedentary behaviour. Using a person’s social support system may be an effective solution to help increase PA levels to improve mental and physical health outcomes. We will examine the efficacy of a group-based online intervention in increasing PA in first responders and their support partners, iteratively codesigned with advisors with lived experience of mental illness among first responders. This study will recruit a convenience s le of self-identified sedentary first responders and their self-selected support partners to a 10-week PA programme delivered through a private Facebook group. We will deliver education on predetermined topics related to PA and diet and provide participants with an activity tracker (Fitbit). A stepped-wedged design will be applied to compare multiple baselines to intervention and follow-up phases within subjects. Five cohorts of n=20 will be recruited, with each cohort randomised to a different baseline length. Our primary outcome will be psychological distress (Kessler-6). Secondary outcomes include feasibility, self-report and objective PA data (Simple Physical Activity Questionnaire and Fitbit accelerometry), depression and anxiety (Depression Anxiety and Stress Scale-21 items), post-traumatic stress disorder symptoms (PTSD Checklist for DSM-5), quality of life Assessment of Quality of Life-6 dimensions, sleep quality (The Pittsburgh Sleep Quality Index), suicidal ideation (Suicidal Ideation Attributes Scale) and social support for exercise. The mobile data collection platform MetricWire will be used. Ethical approval was obtained from the University of New South Wales, Deupty Vice-Chancellor Research, Human Research Ethics Committee on 3 June 2019, HC180561. Findings will be published in peer-reviewed journals and disseminated at national conferences. ACTRN12619000877189.
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.PSYCHRES.2015.10.017
Abstract: People with PTSD experience high levels of cardiovascular disease and comorbid mental health problems. Physical activity (PA) is an effective intervention in the general population. We conducted the first systematic review and meta-analysis to determine the effect of PA on PTSD. We searched major electronic databases from inception till 03/2015 for RCTs of PA interventions among people with PTSD. A random effects meta-analysis calculating hedges g was conducted. From a potential of 812 hits, four unique RCTs met the inclusion criteria (n=200, mean age of participants 34-52 years). The methodological quality of included trials was satisfactory, and no major adverse events were reported. PA was significantly more effective compared to control conditions at decreasing PTSD and depressive symptoms among people with PTSD. There was insufficient data to investigate the effect on anthropometric or cardiometabolic outcomes. Results suggest that PA may be a useful adjunct to usual care to improve the health of people with PTSD. Although there is a relative paucity of data, there is reason to be optimistic for including PA as an intervention for people with PTSD, particularly given the overwhelming evidence of the benefits of PA in the general population. Robust effectiveness and implementation studies are required.
Publisher: Elsevier BV
Date: 03-2020
Publisher: Hindawi Limited
Date: 17-10-2018
DOI: 10.1002/DA.22851
Abstract: Exercise is a well-established treatment for depression, and its use in clinical care is supported by consumers and clinicians. However, whether public health messages regarding the benefits of exercise for depression have translated to public knowledge remains unknown. This study aims to examine the community's mental health literacy, and views regarding exercise delivery for people with depression. A vignette was presented as part of the telephone-based 2017 National Social Survey (n = 1,265). Interviewees identified what (if anything) was wrong with the person described, who they should seek help from, whether exercise might be beneficial, and how exercise should be delivered for the person described in the vignette. Results are reported using descriptive statistics. From 1,265 respondents (response rate = 24%, n = 598 males, mean age 54.7 years [range 18-101]), almost two-thirds correctly identified the condition described in the vignette as depression. There was widespread support for seeking help from a general practitioner. Exercise was well supported in the treatment of the person described in the vignette, with general practitioners and accredited exercise physiologists highlighted as persons to consult regarding exercise. Views regarding the type of program were consistent with current best practice recommendations. Australian adults demonstrate a high level of exercise and mental health literacy. The high level of support for accredited exercise physiologists is evidence of the effectiveness of health promotion c aigns from peak exercise professional agencies.
Publisher: Wiley
Date: 06-2016
DOI: 10.1002/WPS.20309
Publisher: SAGE Publications
Date: 10-07-2016
Abstract: The aim is to identify the role and scope of Accredited Exercise Physiologist (AEP) services in the mental health sector and to provide insight as to how AEPs can contribute to the multidisciplinary mental health team. A modified Delphi approach was utilised. Thirteen AEPs with experience in mental health contributed to the iterative development of a national consensus statement. Six mental health professionals with expertise in psychiatry, mental health nursing, general practice and mental health research participated in the review process. Reviewers were provided with a template to systematically provide feedback on the language, content, structure and relevance to their professional group. This consensus statement outlines how AEPs can contribute to the multidisciplinary mental health team, the aims and scope of AEP-led interventions in mental health services and ex les of such interventions, the range of physical and mental health outcomes possible through AEP-led interventions and common referral pathways to community AEP services. AEPs can play a key role in the treatment of in iduals experiencing mental illness. The ersity of AEP interventions allows for a holistic approach to care, enhancing both physical and mental health outcomes.
Publisher: Informa UK Limited
Date: 11-11-2020
No related grants have been discovered for Simon Rosenbaum.