Skip to main content

Advertisement

SpringerLink
Log in

Quality Assessment of Physical Activity Recommendations Within Clinical Practice Guidelines for the Prevention and Treatment of Cardio-metabolic Risk Factors in People With Schizophrenia

  • Original Paper
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

The aim of this review was to assess the quality of physical activity recommendations within clinical practice guidelines for the prevention and treatment of the cardio-metabolic risk factors in schizophrenia. Several databases were searched from their inception through July 2010. The Appraisal of Guidelines for Research and Evaluation instrument was used for the quality assessment. Twelve recommendations met all the in- and exclusion criteria. The overall agreement of the quality assessment using the intraclass correlation coefficient was 0.90. Comparison identified considerable variation in the quality of the content. Based on quality assurance standards, only one of 12 guidelines was recommended. Differences on in-depth analysis suggest a lack of consistency in relation to information about the potential role of physical activity in reducing cardiometabolic risks in schizophrenia. High quality recommendations are highly needed along with specific practical advice for persons with schizophrenia, family members and health care professionals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • AGREE Collaboration. (2003). Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: The AGREE project. Quality and Safety in Health Care, 12, 18–23.

    Article  Google Scholar 

  • Allison, D. B., Mackell, J. A., & McDonnell, D. D. (2003). The impact of weight gain on quality of life among persons with schizophrenia. Psychiatric Services, 3, 565–567.

    Article  Google Scholar 

  • American Diabetes Association. (2004). Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care, 27, 596–601.

    Article  Google Scholar 

  • Barnett, A. H., Mackin, P., Chaudhry, I., Farooqi, A., Gadsby, R., Heald, A., et al. (2007). Minimising metabolic and cardiovascular risk in schizophrenia: Diabetes, obesity and dyslipidaemia. Journal of Psychopharmacology, 21, 357–373.

    Article  PubMed  CAS  Google Scholar 

  • Brown, S. (1997). Excess mortality of schizophrenia: A meta-analysis. British Journal of Psychiatry, 171, 502–508.

    Article  PubMed  CAS  Google Scholar 

  • Bobes, J., Arango, C., Garcia-Garcia, M., & Rejas, J. (2010). Healthy lifestyle habits and 10-year cardiovascular risk in schizophrenia spectrum disorders: An analysis of the impact of smoking tobacco in the CLAMORS schizophrenia cohort. Schizophrenia Research, 119, 101–109.

    Article  PubMed  Google Scholar 

  • Capasso, R. M., Lineberry, T. W., Bostwick, J. M., Decker, P. A., & St Sauver, J. (2008). Mortality in schizophrenia and schizoaffective disorder: An Olmsted County, Minnesota cohort: 1950–2005. Schizophrenia Research, 98, 287–294.

    Article  PubMed  Google Scholar 

  • De Hert, M., Dekker, J., Wood, D., Kahl, K., & Müller, H. (2009a). Cardiovascular disease and diabetes in people with severe mental illness: Position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology. European Psychiatry, 24, 412–424.

    Article  PubMed  Google Scholar 

  • De Hert, M., Schreurs, V., Vancampfort, D., & van Winkel, R. (2009b). Metabolic syndrome in people with schizophrenia: A review. World Psychiatry, 8, 15–22.

    Google Scholar 

  • De Nayer, A., De Hert, M., Scheen, A., Van Gaal, L., & Peuskens, J. (2005). Conference report: Belgian consensus on metabolic problems associated with atypical antipsychotics. Encephale, 33, 197–202.

    Article  Google Scholar 

  • Delgado-Noguera, M., Tort, S., Bonfill, X., Gich, I., & Alonso-Coello, P. (2009). Quality assessment of clinical practice guidelines for the prevention and treatment of childhood overweight and obesity. European Journal of Pediatrics, 168, 789–799.

    Article  PubMed  Google Scholar 

  • Dinan, T. G. (2004). Schizophrenia and diabetes 2003: An expert consensus meeting. Introduction. British Journal of Psychiatry, 47, 53–54.

    Google Scholar 

  • Faulkner, G. (2005). Exercise as an adjunct treatment for schizophrenia. In G. Faulkner & A. Taylor (Eds.), Exercise, health and mental health: Emerging relationships (pp. 27–45). London: Routledge.

    Google Scholar 

  • Faulkner, G., & Biddle, S. (1999). Exercise as an adjunct treatment for schizophrenia: A review of the literature. Journal of Mental Health, 8, 441–457.

    Article  Google Scholar 

  • Fleischhacker, W. W., Cetkovich-Bakmas, M., De Hert, M., Hennekens, C. H., Lambert, M., Leucht, S., et al. (2008). Comorbid somatic illnesses in patients with severe mental disorders: Clinical, policy, and research challenges. Journal of Clinical Psychiatry, 69, 514–519.

    Article  PubMed  Google Scholar 

  • Gorczynski, P., & Faulkner, G. (2010). Exercise therapy for schizophrenia. Schizophrenia Bulletin, 36, 665–666.

    Article  PubMed  Google Scholar 

  • Gothefors, D., Adolfsson, R., Attvall, S., Erlinge, D., Jarbin, H., Lindström, K., et al. (2010). Swedish clinical guidelines-Prevention and management of metabolic risk in patients with severe psychiatric disorders. Nordic Journal of Psychiatry, doi:10.3109/08039488.2010.500397.

  • Graham, I., Atar, D., Borch-Johnsen, K., Boysen, G., Burell, G., Cifkova, R., et al. (2007). European guidelines on cardiovascular disease prevention in clinical practice: Executive summary. Atherosclerosis, 194, 1–45.

    Article  PubMed  CAS  Google Scholar 

  • Hennekens, C. H., Hennekens, A. R., Hollar, D., & Casey, D. E. (2005). Schizophrenia and increased risks of cardiovascular disease. American Heart Journal, 150, 1115–1121.

    Article  PubMed  Google Scholar 

  • Institute of Medicine. (1992). Guidelines for clinical practice: From development to use. Washington DC: National Academy Press.

    Google Scholar 

  • Kilbourne, A. M., Morden, N. E., Austin, K., Ilgen, M., McCarthy, J. F., Dalack, G., et al. (2009). Excess heart-disease-related mortality in a national study of patients with mental disorders: Identifying modifiable risk factors. General Hospital Psychiatry, 31, 555–563.

    Article  PubMed  Google Scholar 

  • Lambert, T. J., & Chapman, L. H. (2004). Diabetes, psychotic disorders and antipsychotic therapy: A consensus statement. The Medical Journal of Australia, 181, 544–548.

    PubMed  Google Scholar 

  • Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.

    Article  PubMed  CAS  Google Scholar 

  • Laursen, T. M., Munk-Olsen, T., Nordentoft, M., & Mortensen, P. B. (2007). Increased mortality among patients admitted with major psychiatric disorders: A register-based study comparing mortality in unipolar depressive disorder, bipolar affective disorder, schizoaffective disorder, and schizophrenia. Journal of Clinical Psychiatry, 68(6), 899–907.

    Article  PubMed  Google Scholar 

  • Leucht, S., Burkard, T., Henderson, J., Maj, M., & Sartorius, N. (2007). Physical illness and schizophrenia: A review of the literature. Acta Psychiatrica Scandinavica, 116, 317–333.

    Article  PubMed  CAS  Google Scholar 

  • Lindamer, L. A., McKibbin, C., Norman, G. J., Jordan, L., Harrison, K., Abeyesinhe, S., et al. (2008). Assessment of physical activity in middle-aged and older adults with schizophrenia. Schizophrenia Research, 104, 294–301.

    Article  PubMed  Google Scholar 

  • MacDermid, J. C., Brooks, D., Solway, S., Switzer-McIntyre, S., Brosseau, L., & Graham, I. D. (2005). Reliability and validity of the AGREE instrument used by physical therapists in assessment of clinical practice guidelines. BMC Health Services Research, 5, 18.

    Article  PubMed  Google Scholar 

  • Marder, S. R., Essock, S. M., Miller, A. L., Buchanan, R. W., Casey, D. E., Davis, J. M., et al. (2004). Physical health monitoring of patients with schizophrenia. American Journal of Psychiatry, 161, 1334–1349.

    Article  PubMed  Google Scholar 

  • McAlister, F. A., van Diepen, S., Padwal, R. S., Johnson, J. A., & Majumdar, S. R. (2007). How evidence-based are the recommendations in evidence-based guidelines? PLoS Medicine, 4, 250.

    Article  Google Scholar 

  • Melkersson, K. I., Dahl, M. L., & Hulting, A. L. (2004). Guidelines for prevention and treatment of adverse effects of antipsychotic drugs on glucose-insulin homeostasis and lipid metabolism. Psychopharmacology, 175, 1–6.

    Article  PubMed  CAS  Google Scholar 

  • Mitchell, A. J., Malone, D., & Doebbeling, C. C. (2009). Quality of medical care for people with and without comorbid mental illness and substance misuse: Systematic review of comparative studies. British Journal of Psychiatry, 194, 491–499.

    Article  PubMed  Google Scholar 

  • Poulin, M. J., Cortese, L., Williams, R., Wine, N., & McIntyre, R. S. (2005). Atypical antipsychotics in psychiatric practice: Practical implications for clinical monitoring. Canadian Journal of Psychiatry, 50, 555–562.

    Google Scholar 

  • Richardson, C. R., Faulkner, G., McDevitt, J., Skrinar, G., Hutchinson, D., & Piette, J. (2005). Integrating physical activity into mental health services for persons with serious mental illness. Psychiatric Services, 56, 324–331.

    Article  PubMed  Google Scholar 

  • Roick, C., Fritz-Wieacker, A., Matschinger, H., Fritz-Wieacker, A., Riedel-Heller, S., & Frühwald, S. (2007). Health habits of patients with schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 42, 268–276.

    Article  PubMed  Google Scholar 

  • Rummel-Kluge, C., Komossa, K., Schwarz, S., et al. (2010). Head-to-head comparisons of metabolic side effects of second generation antipsychotics in the treatment of schizophrenia: A systematic review and meta-analysis. Schizophrenia Research, doi:10.1016/j.schres.2010.07.012.

  • Sáiz Ruiz, J., Bobes García, J., Vallejo Ruiloba, J., Giner Ubago, J., García-Portilla González, M. P., Grupo de Trabajo sobre la Salud Física del Paciente con Esquizofrenia, et al. (2008). Consensus on physical health of patients with schizophrenia from the Spanish societies of psychiatry and biological psychiatry. Actas Españoles de Psiquiatría, 36, 251–264.

    Google Scholar 

  • Shekelle, P. G., Woolf, S. H., Eccles, M., & Grimshaw, J. (1999). Clinical guidelines: Developing guidelines. BMJ, 318, 593–596.

    Article  PubMed  CAS  Google Scholar 

  • Stone, J. A., Austford, L., Parker, J. H., Gledhill, N., Tremblay, G., Arthur, H. M., et al. (2008). AGREEing on Canadian cardiovascular clinical practice guidelines. The Canadian Journal of Cardiology, 24, 753–757.

    Article  PubMed  Google Scholar 

  • Strassnig, M., Brar, J. S., & Ganguli, R. (2003). Body mass index and quality of life in community-dwelling patients with schizophrenia. Schizophrenia Research, 62, 73–76.

    Article  PubMed  Google Scholar 

  • Usher, K., Foster, K., & Park, T. (2006). The metabolic syndrome and schizophrenia: The latest evidence and nursing guidelines for management. Journal of Psychiatric and Mental Health Nursing, 13, 730–734.

    Article  PubMed  CAS  Google Scholar 

  • Vancampfort, D., Knapen, J., De Hert, M., van Winkel, R., Deckx, S., Maurissen, K., et al. (2009). Physical activity interventions for people with schizophrenia: A critical review. Physical Therapy Reviews, 14, 388–398.

    Article  Google Scholar 

  • Vancampfort, D., Knapen, J., Probst, M., van Winkel, R., Deckx, S., Maurissen, K., et al. (2010). Considering a frame of reference for physical activity research related to the cardiometabolic risk profile in schizophrenia. Psychiatry Research, 177, 271–279.

    Article  PubMed  Google Scholar 

  • Vancampfort, D., Sweers, K., Probst, M., Maurissen, K., Knapen, J., Minguet, P., et al. (2011). The association of metabolic syndrome with physical activity performance in patients with schizophrenia. Diabetes & Metabolism. doi:10.1016/j.diabet.2010.12.007.

  • van Winkel, R., Rutten, B. P., Peerbooms, O., Peuskens, J., van Os, J., & De Hert, M. (2010). MTHFR and risk of metabolic syndrome in patients with schizophrenia. Schizophrenia Research, 121(1–3), 193–198.

    Article  PubMed  Google Scholar 

  • Woolf, S. H., Grol, R., Hutchinson, A., Eccles, M., & Grimshaw, J. (1999). Clinical guidelines: Potential benefits, limitations, and harms of clinical guidelines. BMJ, 318, 527–530.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Vicky Mercken for her assistance in the literature search. Marc De Hert has been a consultant for, received grant/research support and honoraria from, and been on the speakers/advisory boards of AstraZeneca, Lundbeck JA, Janssen-Cilag, Eli Lilly, Pfizer, Sanofi and Bristol-Myers Squibb.

Conflict of interest

The other authors declare that they have no conflicts of interest related to this study.

Author information

Authors and Affiliations

  1. University Psychiatric Centre Catholic University Leuven, Campus Kortenberg, Leuvensesteenweg 517, 3070, Kortenberg, Belgium

    Davy Vancampfort, Kim Sweers, Michel Probst, Jan Knapen & Marc De Hert

  2. Faculty of Kinesiology and Rehabilitation Sciences, Catholic University Leuven, Tervuursevest 101, 3001, Heverlee, Belgium

    Davy Vancampfort, Michel Probst & Jan Knapen

  3. Department of Psycho-oncology, University of Leicester and Leicestershire Partnership Trust, Leicester, LE5 0TD, UK

    Alex J. Mitchell

Authors
  1. Davy Vancampfort
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kim Sweers
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michel Probst
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alex J. Mitchell
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jan Knapen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marc De Hert
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Davy Vancampfort.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vancampfort, D., Sweers, K., Probst, M. et al. Quality Assessment of Physical Activity Recommendations Within Clinical Practice Guidelines for the Prevention and Treatment of Cardio-metabolic Risk Factors in People With Schizophrenia. Community Ment Health J 47, 703–710 (2011). https://doi.org/10.1007/s10597-011-9431-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-011-9431-8

Keywords

Search

Navigation