11. tbl. 101. árg. 2015
Fræðigrein
The effects of physical activity intervention on symptoms in schizophrenia, mental well-being and body composition in young adults
Áhrif hreyfiíhlutunar á einkenni geðklofa, andlega líðan og líkamssamsetningu hjá ungu fólki
Introduction: Due to an unhealthy lifestyle, individuals with schizophrenia are at higher risk of morbidity compared to the general population. Studies have shown that physical activity can have positive effects on physical and mental health in these patients. The aim of the study was to evaluate the effects of a physical activity intervention on symptoms of schizophrenia, as well as on a number of physical and mental health variables. The aim was also to gain more understanding of the participants´ experience of the intervention with interviews.
Material and methods: Seventeen individuals between the ages of 21-31, diagnosed with schizophrenia participated in the study. They exercised under professional supervision for a minimum of two sessions per week for 20 weeks and attended weekly lectures on a healthy lifestyle. The participants answered standardized questionnaires (PANSS, DASS, Rosenberg, CORE-OM, BHS, QOLS), and physical measurements (weight, height, body mass index, resting blood pressure, waist circumference and resting heart rate) were taken before and after the intervention. Six participants were interviewed after the intervention and asked about their experience.
Results: Negative and general psychiatric symptoms, depression, anxiety and stress scores decreased significantly whereas well-being, quality of life and physical activity increased (p<0.05). Apart from resting heart rate that decreased (p<0.05), physical measurements remained unchanged at the end of the intervention.
Conclusion: The participants´ physical activity increased, their mental well-being improved, and they did not gain weight during the intervention period. Regular exercise under supervision and education about a healthy lifestyle are a beneficial adjunct to the primary treatment of people with schizophrenia.
Figure 1. Change in physical activity over the intervention period.
Table I. Mean (SD) for study variables at baseline and post measurement.
| Measurements | Baseline | Post measurement |
Effect size (Cohen´s d) |
P-value |
| Weight (kg) | 90.9 (27.9) | 89.8 (25.7) | 0.1 | 0.301 |
| Body mass index (kg/m²) | 28.7 (23.4) | 28.3 (22.1) | 0.1 | 0.420 |
| Waist (cm) | 98.5 (19.1) | 97.1 (16.9) | 0.2 | 0.225 |
| Systolic Blood pressure (mmHg) | 131.4 (19.0) | 126.6 (9.1) | 0.3 | 0.235 |
| Diastolic Blood Pressure (mmHg) | 82.6 (16.3) | 83.9 (15.5) | 0.1 | 0.710 |
| Resting pulse (bpm) | 90.3 (15.8) | 82.8 (12.0) | 0.5* | 0.000 |
|
PANSS Positive scale |
11.7 (3.7) | 10.8 (3.6) | 0.2 | 0.064 |
|
PANSS Negative scale |
19.2 (3.5) | 17.7 (4.1) | 0.4* | 0.023 |
|
PANSS General psychopathology scale |
45.5 (8.1) | 42.2 (7.8) | 0.4* | 0.006 |
| DASS Depression | 14.7 (11.2) | 5.3 (7.3) | 0.8* | 0.016 |
| DASS Anxiety | 12.0 (10.7) | 6.2 (4.6) | 0.5* | 0.037 |
|
DASS Stress |
10.5 (9.4) | 7.5 (5.9) | 0.3 | 0.060 |
|
CORE-OM Functioning |
32.7 (3.7) | 25.6 (4.1) | 1.9* | 0.029 |
|
CORE-OM Well-being |
10.0 (2.0) | 7.6 (2.6) | 1.3* | 0.02 |
|
CORE-OM Problems |
23.6 (6.0) | 17.2 (3.8) | 1.1* | 0.010 |
| QOLS | 50.0 (4.7) | 56.8 (4.7) | 1.4* | 0.001 |
| Rosenberg | 23.5 (5.6) | 25.7 (2.8) | 0.4 | 0.090 |
| BHS | 9.9 (2.0) | 9.0 (1.6) | 0.4 | 0.385 |
*p <0.05
DASS: Depression, anxiety, stress Scale; CORE-OM: The clinical outcomes in routine evaluation outcome measure; QOLS : Quality of life scale; Rosenberg self-esteem scale; BHS: Beck hopelessness scale.
Table II. Example of participants´ answer from the qualitative interviews.
| Social interaction | Anxiety / Depression | Sleep | Exercise | Confidence/ self esteem |
| “It is mostly fun like to go out and get fresh air. It´s also nice to meet new people, and I´ve already made good acquaintances and friends.“ | “I feel better about myself. The anxiety has decreased, and it´s easier to interact with other people.“ | “I find it easier to sleep and easier to sleep at the right times.´´ |
“It felt good to get stronger and to feel how the blood flow was better. It's nice to have something to do. It´s boring doing nothing the whole day.´´
|
“Just to keep your body in good shape, that improves your self-image and you feel better about yourself.“ |
| “Yes, it has helped me a lot when I start thinking about it, it is much easier to go out with the group now than a few months ago. Also, I have more interaction with people wich is in the group with me.´´ | “When I think about it, I always feel good when I´m done exercising and I am not anxious or nervous. |
“It´s much easier to fall asleep after a good workout. I also wake up more refreshed, even though I was tired.“
|
“I find it necessary because as soon as my pulse is up I feel like I´m finally alive. I feel like I´m doing something that helps me and works.“ (exercising)
|
“I´m much more confident since I lost weight and started taking better care of myself. It´s easier to go to the gym by myself, even though there are lots of people. I just feel better.“ |
|
“I experienced a high level of social anxiety, but that´s much better now.´´
|
“I feel like it reduces anxiety and like „my mind is lighter“ and I don´t worry as much. It´s hard to explain. I just feel better.. like I´m getting more oxygen to the head.“ |
“I fall asleep much easier and don´t find the need ask for sleeping pills or sedatives.“
|
“Exercising has a good influence on me, I feel more energized.“
|
“My mind is much more at ease and I have more control over my behaviour and how I respond to various things. I just feel so good. My body is not as stiff as before, and I just feel healthier.“ |