How sedentary are people with psychosis? A systematic review and meta-analysis

Abstract

ObjectiveSedentary behaviour (SB) is an independent risk factor for cardiovascular disease and mortality. We conducted a meta-analysis to investigate SB levels and predictors in people with psychosis. MethodMajor electronic databases were searched from inception till 09/2015 for articles measuring SB with a self-report questionnaire (SRQ) or objective measure (e.g. accelerometer) in people with psychosis, including schizophrenia spectrum and bipolar disorders. A random effects meta-analysis and meta regression analysis were conducted. ResultsThirteen studies were eligible including 2,033 people with psychosis (mean age 41.3 years (range 25.1-60), 63.2% male (range 35-89%), body mass index 28.7 (range 25.9-32.1). The trim and fill analysis demonstrated people with psychosis spent 660.8 minutes (95% CI 523.2-798.4, participants=2,033) or 11.0 hours (95% CI 8.72-13.3) per day being sedentary. Objective measures of SB recorded significantly higher levels (p <0.001) of SB (12.6 hours per day, 95% CI 8.97-16.2, studies=7, participants=254) compared to self-report SB (6.85 hours per day, 95% CI 4. 75-8.96, studies=6, participants=1,779). People with psychosis engaged in significantly more SB than controls (g=1.13, 95% CI 0.496-1.77, P<0.001, n psychosis = 216, n controls=159) equating to a mean difference of 2.80 (95% CI 1.47-4.1) hours per day. Multivariate meta-regression confirmed that objective measurement of SB predicted higher levels of sedentariness. ConclusionsPeople with psychosis engage in very high levels of sedentary behavior in their waking day and current SRQ may underestimate SB. Given that SB is an independent predictor of cardiovascular disease, future interventions specifically targeting the prevention of SB are warranted. Systematic review registration -PROSPERO registration number CRD420150261593

Physical activity ameliorates the association between sedentary behavior and cardiometabolic risk among inpatients with schizophrenia: A comparison versus controls using accelerometry

“…The literature suggesting the deleterious impact of sedentary behavior among people with schizophrenia is relatively sparse, although clearly there are concerns given the recently reported high levels [16]. Previous Stubbs et al [17] demonstrated among 250 people with established psychosis of similar age to the current study that higher levels of sedentary behavior were independently associated with increased C reactive protein [17].…”

“…Sedentary behavior is defined as any waking activity characterized by an energy expenditure ≤ 1.5 metabolic equivalents including tasks such as sitting or reclining posture [15]. A recent meta-analysis demonstrated that people with schizophrenia spend approximately 12.5 hours a day being sedentary which is among the highest in any population in the world [16]. Two studies have suggested that self-report sitting behavior is associated with adverse metabolic profile [17,18].…”

Sitting time, physical fitness impairments and metabolic abnormalities in people with bipolar disorder: An exploratory study

“…In an exploratory study among 60 adult outpatients with bipolar disorder, patients were sedentary for approximately 13.5h per day according to accelerometers worn over seven consecutive days (Janney et al, 2014). This is more than double the level of sedentary behavior reported in older populations (>60 years) (mean=5.3h per day) (Harvey et al, 2014) and similar to the levels found in people with psychosis (Stubbs et al, 2016). The extent to which sedentary behavior in people with bipolar disorder contributes to the previously observed physical fitness impairments (Vancampfort et al, 2015c; and metabolic abnormalities (Vancampfort et al, 2015d), both predictors for cardiovascular diseases and premature mortality (Lee et al, 2010), is unknown.…”

“…First, the present research used a self-report questionnaire to assess sitting time in volunteers, and hence may underestimate overall sitting time. Previous research in people with psychosis (Stubbs et al, 2016) already demonstrated that objective measurement of sedentary behavior predicts higher levels of sedentariness. Participants in the current study reported sitting approximately 7 hours per day, whilst total sedentary time (including lying down) was recorded as almost double (13.5 hours) in a recent study utilizing objective measurement (Janney et al, 2014).…”

Visceral obesity in the normal-weight people-comparing chronic schizophrenia and healthy control subjects

“…Among schizophrenia patients, they are highly related to obesity due to several factors such as antipsychotic medication [2], physical inactivity [3,4] and poor dietary intake [5,6]. Obesity is a well-known global burden on health and to make it worst the number tend to increase from year to year and Malaysia as a developing country is not excluded from having the same problem [7].…”