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Meta-analysis of physical activity and effects of social function and quality of life on the physical activity in patients with schizophrenia

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Abstract

Schizophrenia patients have increased mortality and morbidity, mainly due to premature cardiovascular disease resulting from decreased physical activity (PA). However, which PA intensity is impaired in the patients and how factors such as social function and quality of life (QoL) are related to decreased PA is unknown. To assess PA, social function and QoL, the International Physical Activity Questionnaire (IPAQ), Social Functioning Scale (SFS) and Schizophrenia Quality of Life Scale (SQLS), respectively, were used in 109 schizophrenia patients and 69 healthy subjects. A meta-analysis comparing PA intensities (vigorous, moderate and light) assessed by the single PA measurement between schizophrenia patients and healthy subjects after including our case–control sample was performed. Furthermore, the effects of social function and QoL on each level of PA intensity were investigated in patients and controls. The meta-analysis in 212 schizophrenia patients and 132 healthy subjects revealed that patients showed lower total PA, particularly vigorous PA, than controls (I2 = 0, Hedges’ g = − 0.41, P = 2.80 × 10−4). The decreased total PA was correlated with impaired total SFS scores (β = 0.24, P = 2.86 × 10−3), withdrawal (β = 0.23, P = 3.74 × 10−3) and recreation (β = 0.23, P = 3.49 × 10−3) without significant heterogeneity between patients and controls. In contrast, the decreased total PA was affected by low independence–performance (β = 0.22, P = 0.034), employment/occupation (β = 0.27, P = 8.74 × 10−3), psychosocial (β = − 0.24, P = 0.021) and motivation/energy (β = − 0.26, P = 0.013), but only in patients. Similar findings were obtained for vigorous PA but not moderate or light PA. Our findings suggest that the impaired vigorous PA in schizophrenia patients may be mediated by schizophrenia-specific factors of social functioning and QoL. Understanding these factors has important implications for increasing PA participation in schizophrenia patients.

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References

  1. Simeone JC, Ward AJ, Rotella P, Collins J, Windisch R (2015) An evaluation of variation in published estimates of schizophrenia prevalence from 1990 horizontal line 2013: a systematic literature review. BMC Psychiatry 15:193

    Article  PubMed  PubMed Central  Google Scholar 

  2. Green MF (1996) What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry 153(3):321–330

    Article  CAS  PubMed  Google Scholar 

  3. Capasso RM, Lineberry TW, Bostwick JM, Decker PA, St Sauver J (2008) Mortality in schizophrenia and schizoaffective disorder: an Olmsted County, Minnesota cohort: 1950–2005. Schizophr Res 98(1–3):287–294

    Article  PubMed  Google Scholar 

  4. Walker ER, McGee RE, Druss BG (2015) Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry 72(4):334–341

    Article  PubMed  PubMed Central  Google Scholar 

  5. Alberti KG, Zimmet P, Shaw J (2006) Metabolic syndrome—a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med 23(5):469–480

    Article  CAS  PubMed  Google Scholar 

  6. Mitchell AJ, Vancampfort D, Sweers K, van Winkel R, Yu W, De Hert M (2013) Prevalence of metabolic syndrome and metabolic abnormalities in schizophrenia and related disorders—a systematic review and meta-analysis. Schizophr Bull 39(2):306–318

    Article  PubMed  Google Scholar 

  7. van Winkel R, Rutten BP, Peerbooms O, Peuskens J, van Os J, De Hert M (2010) MTHFR and risk of metabolic syndrome in patients with schizophrenia. Schizophr Res 121(1–3):193–198

    Article  PubMed  Google Scholar 

  8. van Winkel R, Moons T, Peerbooms O, Rutten B, Peuskens J, Claes S, van Os J, De Hert M (2010) MTHFR genotype and differential evolution of metabolic parameters after initiation of a second generation antipsychotic: an observational study. Int Clin Psychopharmacol 25(5):270–276

    Article  PubMed  Google Scholar 

  9. Rummel-Kluge C, Komossa K, Schwarz S, Hunger H, Schmid F, Lobos CA, Kissling W, Davis JM, Leucht S (2010) Head-to-head comparisons of metabolic side effects of second generation antipsychotics in the treatment of schizophrenia: a systematic review and meta-analysis. Schizophr Res 123(2–3):225–233

    Article  PubMed  PubMed Central  Google Scholar 

  10. Vancampfort D, Probst M, Scheewe T, De Herdt A, Sweers K, Knapen J, van Winkel R, De Hert M (2013) Relationships between physical fitness, physical activity, smoking and metabolic and mental health parameters in people with schizophrenia. Psychiatry Res 207(1–2):25–32

    Article  PubMed  Google Scholar 

  11. Blair SN, Kampert JB, Kohl HW, Barlow CE, Macera CA, Paffenbarger RS Jr, Gibbons LW (1996) Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 276(3):205–210

    Article  CAS  PubMed  Google Scholar 

  12. Zadro JR, Shirley D, Andrade TB, Scurrah KJ, Bauman A, Ferreira PH (2017) The beneficial effects of physical activity: is it down to your genes? A systematic review and meta-analysis of twin and family studies. Sports Med Open 3(1):4

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Huppertz C, Bartels M, de Zeeuw EL, van Beijsterveldt CEM, Hudziak JJ, Willemsen G, Boomsma DI, de Geus EJC (2016) Individual differences in exercise behavior: stability and change in genetic and environmental determinants from age 7 to 18. Behav Genet 46(5):665–679

    Article  PubMed  Google Scholar 

  14. Stubbs B, Firth J, Berry A, Schuch FB, Rosenbaum S, Gaughran F, Veronesse N, Williams J, Craig T, Yung AR, Vancampfort D (2016) How much physical activity do people with schizophrenia engage in? A systematic review, comparative meta-analysis and meta-regression. Schizophr Res 176(2–3): 431–40

    Google Scholar 

  15. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35(8):1381–1395

    Article  PubMed  Google Scholar 

  16. Firth J, Cotter J, Elliott R, French P, Yung AR (2015) A systematic review and meta-analysis of exercise interventions in schizophrenia patients. Psychol Med 45(7):1343–1361

    Article  CAS  PubMed  Google Scholar 

  17. Vancampfort D, Rosenbaum S, Ward PB, Stubbs B (2015) Exercise improves cardiorespiratory fitness in people with schizophrenia: a systematic review and meta-analysis. Schizophr Res 169(1–3):453–457

    Article  PubMed  Google Scholar 

  18. Holley J, Crone D, Tyson P, Lovell G (2011) The effects of physical activity on psychological well-being for those with schizophrenia: a systematic review. Br J Clin Psychol 50(1):84–105

    Article  PubMed  Google Scholar 

  19. Pajonk FG, Wobrock T, Gruber O, Scherk H, Berner D, Kaizl I, Kierer A, Muller S, Oest M, Meyer T, Backens M, Schneider-Axmann T, Thornton AE, Honer WG, Falkai P (2010) Hippocampal plasticity in response to exercise in schizophrenia. Arch Gen Psychiatry 67(2):133–143

    Article  PubMed  Google Scholar 

  20. Kimhy D, Lauriola V, Bartels MN, Armstrong HF, Vakhrusheva J, Ballon JS, Sloan RP (2016) Aerobic exercise for cognitive deficits in schizophrenia—the impact of frequency, duration, and fidelity with target training intensity. Schizophr Res 172(1–3):213–215

    Article  PubMed  Google Scholar 

  21. Vancampfort D, Knapen J, Probst M, van Winkel R, Deckx S, Maurissen K, Peuskens J, De Hert M (2010) Considering a frame of reference for physical activity research related to the cardiometabolic risk profile in schizophrenia. Psychiatry Res 177(3):271–279

    Article  PubMed  Google Scholar 

  22. Gorczynski P, Faulkner G (2010) Exercise therapy for schizophrenia. Schizophr Bull 36(4):665–666

    Article  PubMed  PubMed Central  Google Scholar 

  23. Vancampfort D, Knapen J, Probst M, Scheewe T, Remans S, De Hert M (2012) A systematic review of correlates of physical activity in patients with schizophrenia. Acta Psychiatr Scand 125(5):352–362

    Article  CAS  PubMed  Google Scholar 

  24. Faulkner G, Cohn T, Remington G (2006) Validation of a physical activity assessment tool for individuals with schizophrenia. Schizophr Res 82(2–3):225–231

    Article  PubMed  Google Scholar 

  25. Soundy A, Freeman P, Stubbs B, Probst M, Coffee P, Vancampfort D (2014) The transcending benefits of physical activity for individuals with schizophrenia: a systematic review and meta-ethnography. Psychiatry Res 220(1–2):11–19

    Article  PubMed  Google Scholar 

  26. Awad AG, Voruganti LN (2012) Measuring quality of life in patients with schizophrenia: an update. Pharmacoeconomics 30(3):183–195

    Article  PubMed  Google Scholar 

  27. Lysaker PH, Yanos PT, Outcalt J, Roe D (2010) Association of stigma, self-esteem, and symptoms with concurrent and prospective assessment of social anxiety in schizophrenia. Clin Schizophr Relat Psychoses 4(1):41–48

    Article  PubMed  PubMed Central  Google Scholar 

  28. Allison DB, Mackell JA, McDonnell DD (2003) The impact of weight gain on quality of life among persons with schizophrenia. Psychiatr Serv 54(4):565–567

    Article  PubMed  Google Scholar 

  29. Trost SG, Owen N, Bauman AE, Sallis JF, Brown W (2002) Correlates of adults’ participation in physical activity: review and update. Med Sci Sports Exer 34(12):1996–2001

    Article  Google Scholar 

  30. Pesek MB, Mihoci J, Medved K, Solinc NP (2011) Long term groups of patients with psychosis: physical activity and medical treatment. Psychiatr Danub 23(Suppl 1):S149-154

    Google Scholar 

  31. Vancampfort D, Probst M, Scheewe T, Maurissen K, Sweers K, Knapen J, De Hert M (2011) Lack of physical activity during leisure time contributes to an impaired health related quality of life in patients with schizophrenia. Schizophr Res 129(2–3):122–127

    Article  PubMed  Google Scholar 

  32. Yasuyama T, Ohi K, Shimada T, Uehara T, Kawasaki Y (2017) Differences in social functioning among patients with major psychiatric disorders: Interpersonal communication is impaired in patients with schizophrenia and correlates with an increase in schizotypal traits. Psychiatry Res 249:30–34

    Article  PubMed  Google Scholar 

  33. Ohi K, Shimada T, Kihara H, Yasuyama T, Sawai K, Matsuda Y, Oshima K, Okubo H, Nitta Y, Uehara T, Kawasaki Y (2017) Impact of familial loading on prefrontal activation in major psychiatric disorders: a near-infrared spectroscopy (NIRS) study. Sci Rep 7:44268

    Article  PubMed  PubMed Central  Google Scholar 

  34. Ohi K, Kuwata A, Shimada T, Yasuyama T, Nitta Y, Uehara T, Kawasaki Y (2017) Response to benzodiazepines and the clinical course in malignant catatonia associated with schizophrenia: a case report. Medicine (Baltimore) 96(16):e6566

    Article  Google Scholar 

  35. Ohi K, Matsuda Y, Shimada T, Yasuyama T, Oshima K, Sawai K, Kihara H, Nitta Y, Okubo H, Uehara T, Kawasaki Y (2016) Structural alterations of the superior temporal gyrus in schizophrenia: detailed subregional differences. Eur Psychiatry 35:25–31

    Article  CAS  PubMed  Google Scholar 

  36. Kay SR, Fiszbein A, Opler LA (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 13(2):261–276

    Article  CAS  PubMed  Google Scholar 

  37. Inada T, Yagi G, Miura S (2002) Extrapyramidal symptom profiles in Japanese patients with schizophrenia treated with olanzapine or haloperidol. Schizophr Res 57(2–3):227–238

    Article  PubMed  Google Scholar 

  38. Murase N, Katsumura T, Ueda C, Inoue S, Shimomitsu T (2002) Validity and reliability of Japanese version of International physical activity questionnaire. J Health Welfare Stat 49(11):1–9 (In Japanese)

    Google Scholar 

  39. Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O’Brien WL, Bassett DR Jr, Schmitz KH, Emplaincourt PO, Jacobs DR Jr, Leon AS (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32(9 Suppl):S498-504

    PubMed  Google Scholar 

  40. Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e1000097

    Article  PubMed  PubMed Central  Google Scholar 

  41. Nemoto T, Fujii C, Miura Y, Chino B, Kobayashi H, Yamazawa R, Masaaki M, Haruo K, Masafumi M (2008) Reliability and validity of the social functioning scale Japanese version (SFS-J). Jpn Bull Soc Psychiatry 17:188–195

    Google Scholar 

  42. Birchwood M, Smith J, Cochrane R, Wetton S, Copestake S (1990) The social functioning scale. The development and validation of a new scale of social adjustment for use in family intervention programmes with schizophrenic patients. Br J Psychiatry 157:853–859

    Article  CAS  PubMed  Google Scholar 

  43. Kaneda Y, Imakura A, Fujii A, Ohmori T (2002) Schizophrenia quality of life scale: validation of the Japanese version. Psychiatry Res 113(1–2):107–113

    Article  PubMed  Google Scholar 

  44. Wilkinson G, Hesdon B, Wild D, Cookson R, Farina C, Sharma V, Fitzpatrick R, Jenkinson C (2000) Self-report quality of life measure for people with schizophrenia: the SQLS. Br J Psychiatry 177:42–46

    Article  CAS  PubMed  Google Scholar 

  45. Borenstein M, Hedges L, Higgins J, Rothstein H (2005) Comprehensive meta-analysis version 2. Biostat, Englewood

    Google Scholar 

  46. Ostermann S, Herbsleb M, Schulz S, Donath L, Berger S, Eisentrager D, Siebert T, Muller HJ, Puta C, Voss A, Gabriel HW, Koch K, Bar KJ (2013) Exercise reveals the interrelation of physical fitness, inflammatory response, psychopathology, and autonomic function in patients with schizophrenia. Schizophr Bull 39(5):1139–1149

    Article  PubMed  Google Scholar 

  47. Vancampfort D, Probst M, De Herdt A, Corredeira RM, Carraro A, De Wachter D, De Hert M (2013) An impaired health related muscular fitness contributes to a reduced walking capacity in patients with schizophrenia: a cross-sectional study. BMC Psychiatry 13:5

    Article  PubMed  PubMed Central  Google Scholar 

  48. Vancampfort D, Probst M, Stubbs B, Soundy A, De Herdt A, De Hert M (2014) Associations between expiratory spirometry parameters and limitations in daily life activities in patients with schizophrenia. Gen Hosp Psychiatry 36(2):172–176

    Article  PubMed  Google Scholar 

  49. Vancampfort D, Probst M, Knapen J, Carraro A, De Hert M (2012) Associations between sedentary behaviour and metabolic parameters in patients with schizophrenia. Psychiatry Res 200(2–3): 73–8

    Google Scholar 

  50. Sullivan PF, Kendler KS, Neale MC (2003) Schizophrenia as a complex trait: evidence from a meta-analysis of twin studies. Arch Gen Psychiatry 60(12):1187–1192

    Article  PubMed  Google Scholar 

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Acknowledgements

This work was supported by the Japan Society for the Promotion of Science (JSPS) Grant-in-Aid for Young Scientists (B) (16K19784), a grant from the Uehara Memorial Foundation, and a grant from the Descente and Ishimoto Memorial Foundation for the Promotion of Sports Science. We would like to thank all individuals who participated in this study.

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Authors and Affiliations

  1. Department of Neuropsychiatry, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan

    Kazutaka Ohi, Yuzuru Kataoka, Takamitsu Shimada, Aki Kuwata, Hiroaki Okubo, Kohei Kimura, Toshiki Yasuyama, Takashi Uehara & Yasuhiro Kawasaki

  2. Medical Research Institute, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan

    Kazutaka Ohi

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  1. Kazutaka Ohi
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Ohi, K., Kataoka, Y., Shimada, T. et al. Meta-analysis of physical activity and effects of social function and quality of life on the physical activity in patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 269, 517–527 (2019). https://doi.org/10.1007/s00406-018-0903-5

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