A large international study of more than 200,000 people in nearly 50 countries has revealed that people with psychosis engage in low levels of physical activity, and men with psychosis are over two times more likely to miss global activity targets compared to people without the illness.
The research, led by King's College London and the South London and Maudsley (SLaM) NHS Foundation Trust, also offers important insights into the barriers that prevent people with psychosis from engaging in regular physical activity. This data will inform interventions aimed at helping people with psychosis to be more active and ultimately, to improve their mental and physical health.
People with psychosis die up to 15 years before the general population, largely due to cardiovascular disease. Although pursuing an active lifestyle is thought to be just as effective in preventing cardiovascular disease as medication (e.g. statins), a number of small studies have suggested that people with psychosis tend to engage in low levels of physical activity.
To stay healthy, the World Health Organization (WHO) recommends that adults aged 18-64 should do at least 150 minutes of moderate-intensity physical activity throughout the week, including walking, cycling, household chores or sport. Physical inactivity is the fourth leading cause of avoidable death and is as harmful as smoking, according to the WHO.
The researchers from King's sought to examine whether people with psychosis are meeting the WHO's recommended levels of physical activity.
In their study, published today in Schizophrenia Bulletin, the researchers collected data from the World Health Survey, which comprises more than 200,000 people aged 18-64 from nearly 50 low-and-middle-income countries. These individuals, who were living in their local communities at the time of the study, were divided into three groups: people with a diagnosis of psychosis, those with psychotic symptoms but no diagnosis and a control group (of people with no diagnosis of psychosis and no symptoms in the past 12 months). The participants were interviewed to ascertain who had/had not met recommended levels of physical activity.
Overall, people with psychosis were 36 per cent more likely not to meet the recommended physical activity levels compared to controls. When the researchers looked at men only, those with psychosis were over two times more likely not to meet the recommended levels compared to people in the control sample.
When examining potential barriers to physical activity, the researchers found that mobility difficulties, pain, depression and cognitive impairment explained low levels of physical activity in people with psychosis. These insights will be used to guide the 'Walk this Way' study at King's College London, funded and led by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London.
Dr Brendon Stubbs from King's College London and the South London and Maudsley NHS Foundation Trust (SLaM), said: 'Understanding and overcoming these barriers could be an important strategy to help people with psychosis be more active, and potentially to reduce their risk of cardiovascular disease.
'Our Walk this Way study is the first to specifically target the reduction of a sedentary lifestyle, and an increase in activity levels, in people with psychosis. We will investigate whether health coaching and providing people with pedometers can increase daily activity levels and hope that if successful, this programme will be offered more widely to people with psychosis.'
Dr Fiona Gaughran, also of King's College London and SLaM, said: 'People with psychosis have high levels of cardiovascular risk and die earlier as a result. Since physical activity is a key protective factor for cardiovascular disease, our finding that men with psychosis are particularly inactive means that they may benefit most from interventions to increase physical activity and reduce social isolation.
'It is unclear why men with psychosis showed such low levels of physical activity, although perhaps the earlier onset of illness typically seen in males means that lifestyle habits may have been altered over time by aspects of the illness or its management, such as negative symptoms, sedating medications or hospital admissions. Our data suggests that depression may also be important, which makes sense. Understanding these factors and what we might do about them is an important area for future research.'
Notes to editors
For further media information please contact Jack Stonebridge, Press Officer, Institute of Psychiatry, Psychology & Neuroscience, King's College London email@example.com/ 020 7848 5377 or 07718697176.
Find out more about the 'Walk this Way' study: http://www.clahrc-southlondon.nihr.ac.uk/psychosis/physical-health
About King's College London - http://www.kcl.ac.uk
King's College London is one of the top 20 universities in the world (2015/16 QS World University Rankings) and among the oldest in England. King's has more than 26,500 students (of whom nearly 10,400 are graduate students) from some 150 countries worldwide, and nearly 6,900 staff. The university is in the second phase of a £1 billion redevelopment programme which is transforming its estate.
King's has an outstanding reputation for world-class teaching and cutting-edge research. In the 2014 Research Excellence Framework (REF) King's was ranked 6th nationally in the 'power' ranking, which takes into account both the quality and quantity of research activity, and 7th for quality according to Times Higher Education rankings. Eighty-four per cent of research at King's was deemed 'world-leading' or 'internationally excellent' (3* and 4*). The university is in the top seven UK universities for research earnings and has an overall annual income of more than £600 million.
King's has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine, nursing and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar.
King's College London and Guy's and St Thomas', King's College Hospital and South London and Maudsley NHS Foundation Trusts are part of King's Health Partners. King's Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world's leading research-led universities and three of London's most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services. For more information, visit: http://www.kingshealthpartners.org.
About the NIHR - http://www.nihr.ac.uk
The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world.