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

Purpose People with severe mental ill health (SMI) are less physically active and more sedentary than the general population. There is limited research investigating the correlates of physical activity (PA) in people with SMI impeding development of successful interventions. This study aimed to assess the factors associated with regular participation of PA among a large sample of people with SMI. Methods The data for this study were collected from the ‘Lifestyle Health and Wellbeing’ (HWB) cohort that collected data through self-administered questionnaire from participants with SMI. Self-reported participation in regular PA was the main outcome variable. Potential predictors of PA were grouped as demographic, biological, psychological and behavioural variables. Multivariable logistic regressions were conducted considering PA participation as the dependent variable adjusted for possible correlated predictors. Results In total, 3,287 people with SMI (mean (SD) age 47.7 (14.58) years, 59% male) were included; 38% reported undertaking regular PA and 61% wanted to undertake more physical activity. Multivariable logistic regressions showed that the following factors were associated with undertaking more regular PA: being male, aged 18-65 years, having a body mass index between 18.5 and 30 kg/m2, having better self-perceived general health condition, not having a health problem that limits activity, giving higher importance to maintain a healthy lifestyle, and eating more fruit and vegetables. Conclusions Having a better self-perceived general health and placing importance on maintaining a healthy lifestyle were important predictors of regular PA. Lifestyle interventions targeting increased PA among people with SMI should be shaped by their health perception and informed by their needs

The Psychosocial Consequences of Sports Participation for Individuals with Severe Mental Illness: A Metasynthesis Review

The purpose of the current metasynthesis review was to explore the psychosocial benefits of sport and psychosocial factors which impact on sports participation for individuals with severe mental illness. AMED, CINAHL Plus, Medline, EMBASE, ProQuest Nursing & Allied Health Source, and Science Citation Index were searched from inception until January 2014. Articles included use qualitative methods to examine the psychosocial effects of sports participation in people with severe mental illness. Methodological quality was assessed using the Consolidated Criteria for Reporting Qualitative Studies and a case study tool. Included studies were analysed within a metasynthesis approach. Eight articles involving 56 patients met the inclusion criteria. The results identified the broader and direct psychosocial benefits of sport. Sport provided a ?normal? environment and interactions that were not associated with an individual?s mental illness. Sport provided individuals with a sense of meaning, purpose, belonging, identity, and achievement. Other findings are discussed. Direct psychosocial benefits are a consequence of sports participation for the vast majority of individuals with severe mental illness. Further to this, sports participation was associated with a reduction in social isolation and an increase in social confidence, autonomy, and independence

Top 10 research questions to promote physical activity in bipolar disorders: A consensus statement from the International Organization of Physical Therapists in Mental Health

Background: 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. Methods: 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. Results: 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? Limitations: We did not consult people with BD. Conclusions: 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

Barriers, attitudes, confidence, and knowledge of nurses regarding metabolic health screening and intervention in people with mental illness: A pilot study from Uganda

© 2019 Vancampfort et al. Licensee African Health Sciences. Background: People with mental illness are at an increased risk for developing cardio-metabolic disorders. Routine screening following pharmacotherapy is however unacceptably low in sub-Saharan African countries with less than 1% adequately screened. It is unknown whether this is due to a lack of adequate competences. Objectives: The aim of this pilot study was to assess the barriers, attitudes, confidence, and knowledge of nurses regarding metabolic health, prevention and treatment in Uganda. Methods: Twenty-eight nurses (39% female, 30.9±6.9 years) completed the Metabolic – Barriers, Confidence, Attitudes and Knowledge Questionnaire and the physical activity prescription rate item of the Exercise in Mental Illness Questionnaire. Results: More than 75% had a positive attitude towards metabolic screening and intervention and more than 50% were confident in providing smoking cessation advice, and physical activity and nutritional counseling. However, 57% stated that their heavy workload prevented them from doing health screening and promotion activities. There was a negative correlation (ϱ=-0.54, P=0.003) between the frequency of physical activity prescription and the perception of the inability of patients to change. Conclusion: The present findings suggest that nurses are generally supportive of metabolic health screening and intervention but their high workload prevents them from implementing metabolic health interventions

Prospective Associations of Leisure-Time Physical Activity With Psychological Distress and Well-Being: A 12-Year Cohort Study

OBJECTIVE: To investigate the associations of leisure-time physical activity with psychological distress and wellbeing, and potential mediators. METHODS: We used data from the 1970 British Cohort Study (N = 5,197 - 2,688 men), including waves 34y (2004), 42y (2012), and 46y (2016) waves. Participants reported leisure-time physical activity frequency and intensity (exposure) at age 34 (baseline), cognition (vocabulary test), body mass index, disability, mobility and pain perception (potential mediators) at age 42, and psychological distress (Malaise inventory) and wellbeing (Warwick-Edinburgh scale) at age 46. Baseline confounders included sex, country, education, employment status, alcohol use, tobacco smoking, and psychological distress. Main analyses included logistic regression and mediation models. RESULTS: Higher leisure-time physical activity intensity at baseline was associated with lower psychological distress at 46y [β: -0.038 (95%CI: -0.069 to -0.007)], but not leisure-time physical activity frequency. Baseline leisure-time physical activity frequency and intensity were associated with higher psychological well-being at 46y [frequency: β: 0.089 (95%CI: 0.002 to 0.176); intensity: β: 0.262 (95%CI: 0.123 to 0.401); and total: β: 0.041 (95%CI: 0.013 to 0.069)]. Only body mass index at 42y partially mediated the association between leisure-time physical activity frequency (15.7%) and total leisure-time physical activity (6.2%) at 34y, with psychological wellbeing at 46y. CONCLUSIONS: These findings highlight the role of leisure-time physical activity in psychological distress and wellbeing, with greater effect sizes associated with higher frequency and intensity of leisure-time physical activity. Future interventions should consider examining potential mediators of the association of leisure-time physical activity with psychological wellbeing, such as body mass index

Is Active Transport and Leisure-Time Physical Activity Associated With Inflammatory Markers in US Adults? A Cross-Sectional Analyses From NHANES

Background: To investigate the association between levels of active transport and leisure-time physical activity (LTPA) with C-reactive protein, white blood cell count, body mass index, waist circumference, and lipids in a large representative sample of adults residing in the United States. // Methods: Cross-sectional data from the National Health and Nutrition Examination Survey. Adjusted multinomial logistic regressions were carried out to quantify associations between levels of self-reported active transport (or LTPA) and quintiles of anthropometric measures and serum markers. // Results: A total of 3248 adults were included. For serum inflammatory biomarkers, the authors observed a lower likelihood of being in the top quintile groups of circulating C-reactive protein (adjusted odds ratio [aOR]: 0.60; 95% confidence interval [CI], 0.40–0.90) and white blood cell count (aOR: 0.65; 95% CI, 0.44–0.95) with engaging in low to medium levels of active transport but not with high levels of active transport. Higher levels of LTPA were associated with lower likelihood of having high levels of serum inflammatory biomarkers (aOR: 0.60; 95% CI, 0.42–0.86 in the top C-reactive protein group and aOR: 0.58; 95% CI, 0.39–0.87 in top white blood cell group). // Conclusions: Promoting active transport and/or LTPA may be a beneficial strategy to improving some, but not all, cardiometabolic health outcomes

Which clinical and biochemical predictors should be used to screen for diabetes in patients with serious mental illness receiving antipsychotic medication? A large observational study

© 2019 Mitchell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Objective We aimed to investigate which clinical and metabolic tests offer optimal accuracy and acceptability to help diagnose diabetes among a large sample of people with serious mental illness in receipt of antipsychotic medication. Methods A prospective observational study design of biochemical and clinical factors was used. Biochemical measures were fasting glucose, insulin and lipids, oral glucose tolerance testing (OGTT), hemoglobin A1c, and insulin resistance assessed with the homeostatic model (HOMA-IR) were determined in a consecutive cohort of 798 adult psychiatric inpatients receiving antipsychotics. Clinical variables were gender, age, global assessment of functioning (GAF), mental health clinicians\u27 global impression (CGI), duration of severe mental illness, height, weight, BMI and waist/hip ratio. In addition, we calculated the risk using combined clinical predictors using the Leicester Practice Risk Score (LPRS) and the Topics Diabetes Risk Score (TDRS). Diabetes was defined by older criteria (impaired fasting glucose (IFG) or OGTT) as well as2010 criteria (IFG or OGTT or Glycated haemoglobin (HBA1c)) at conventional cut-offs. Results Using the older criteria, 7.8% had diabetes (men: 6.3%; women: 10.3%). Using the new criteria, 10.2% had diabetes (men: 8.2%, women: 13.2%), representing a 30.7% increase (p = 0.02) in the prevalence of diabetes. Regarding biochemical predictors, conventional OGTT, IFG, and HbA1c thresholds used to identify newly defined diabetes missed 25%, 50% and 75% of people with diabetes, respectively. The conventional HBA1c cut-point of ≥6.5% (48 mmol/mol) missed 7 of 10 newly defined cases of diabetes while a cut-point of ≥5.7% improved sensitivity from 44.4% to up to 85%. Specific algorithm approaches offered reasonable accuracy. Unfortunately no single clinical factor was able to accurately rule-in a diagnosis of diabetes. Three clinical factors were able to rule-out diabetes with good accuracy namely: BMI, waist/hip ratio and height. A BMI \u3c 30 had a 92% negative predictive value in ruling-out diabetes. Of those not diabetic, 20% had a BMI ≥ 30. However, for complete diagnosis a specific biochemical protocol is still necessary. Conclusions Patients with SMI maintained on antipsychotic medication cannot be reliably screened for diabetes using clinical variables alone. Accurate assessment requires a two-step algorithm consisting of HBA1c ≥5.7% followed by both FG and OGTT which does not require all patients to have OGTT and FG