Although physical inactivity is a leading cause of death and the Surgeon General recommends regular moderate physical activity, many Americans are inactive. Because of their increased burden of obesity and diabetes, people with severe mental illness (SMI) especially may benefit from physical activity, yet little is known about the prevalence and types of physical activity in people with SMI. We surveyed outpatients with schizophrenia and affective disorders at two psychiatric centers in Maryland and compared physical activity patterns to an age-gender-race-matched national sample (National Health and Nutrition Examination Survey III) of the general population. We found that people with SMI are overall less physically active than the general population, although the proportion with recommended physical activity levels was equal. The participants with SMI were more likely to walk as their sole form of physical activity. Within the SMI group, those without regular social contact and women had higher odds of being inactive.

Medical and surgical hospitalizations for persons with schizophrenia had at least twice the odds of several types of adverse events than those for persons without schizophrenia. These adverse events were associated with poor clinical and economic outcomes during the hospital admission. Efforts to reduce these adverse events should become a research priority.

Objective Overweight and obesity are epidemic in populations with serious mental illnesses. We developed and pilot tested a behavioral weight loss intervention appropriately tailored for persons with serious mental disorders. Methods We conducted a single arm pilot study in two psychiatric rehabilitation day programs in Maryland and enrolled 63 overweight or obese adults. The six-month intervention provided group and individual weight management and group physical activity classes. The primary outcome was weight change from baseline to 6 months. Results Sixty-four percent of those potentially eligible at the centers enrolled. The mean age was 43.7 years; 56% were women, 49% were white and over half had a schizophrenia or schizoaffective disorder. One third had hypertension and one fifth had diabetes. Fifty-two (82%) completed the study; others were discharged from psychiatric centers before study completion. Average attendance across all weight management sessions was 70% (87% on days participants attended the center) and 59% for physical activity classes (74% on days participants attended the center). From a baseline mean of 210.9 lbs (SD 43.9), average weight loss for 52 participants was 4.5 pounds (SD 12.8) (p<0.014). On average, participants lost 1.9% of body weight. Mean waist circumference change was 3.1 cm (SD 5.6). Participants on average increased the distance on the six minute walk test by eight percent. Conclusion This pilot documents the feasibility and preliminary efficacy of a behavioral weight loss intervention in adults with serious mental illness who were attendees at psychiatric rehabilitation centers. The results may have implications for developing weight loss interventions in other institutional settings such as schools or nursing homes.

This study objectively measured physical activity levels in overweight and obese adults with severe mental illness and examined relationships among psychiatric symptoms, cognitive functioning and physical activity. A diverse sample (50% female, 50% African American) of overweight and obese adults (n=55) with mental illness were asked to wear accelerometers for 4 days. Study participants averaged 120 minutes/week of moderate to vigorous physical activity (MVPA); 35% had ≥ 150 minutes/week of MVPA. Only 4% accumulated ≥ 150 minutes/week of MVPA in bouts ≥ 10 minutes as per public health recommendations. Depressive symptoms, psychological distress and cognitive functioning were not associated with physical activity (p > .05). Although participants appeared to have substantial minutes of MVPA, increased physical activity bouts, or sessions, may be necessary for increased health and weight management benefits for persons with severe mental illness. Efforts are needed to increase physical activity sessions in this vulnerable population.

In a cohort of Maryland Medicaid recipients with severe mental illness followed from 1993-2001, we compared mortality to the Maryland general population including race and gender subgroups. Persons with severe mental illness died at a mean age of 51.8 years, with a standardized mortality ratio of 3.7 (95%CI, 3.6-3.7).

These findings help to complement and complete the evidence of prior studies on tobacco smoking among adolescents with behavior problems, including recent research on Central American youths. Although the magnitude of observed associations in Chile was not as great as that for the associations found in Central America, both the strength of these associations and their statistical significance were observed throughout Chile. This is the first study in Chile on potentially causal relationships such as these.

Background-In this study we estimate suspected links between youthful behavioral problems and smoking of tobacco, cannabis, and coca paste.Methods-In the Republic of Chile, school-attending youths were sampled from all 13 regions of the country, with sample size of 46,907 youths from 8 th to 12 th grades. A Generalized Estimating Equations (GEE) approach to multiple logistic regression was used to address three interdependent response variables, tobacco smoking, cannabis smoking, and coca paste smoking, and to estimate associations.Results-Drug-specific adjusted slope estimates indicate that youths at the highest levels of behavioral problems are an estimated 1.1 times more likely to have started smoking tobacco, an estimated 1.6 times more likely to have started cannabis smoking, and an estimated 2.0 times more likely to have started coca paste smoking, as compared to youths at the lowest level of behavioral problems (p< 0.01). Conclusion-InChile, there is an association linking behavioral problems with onsets of smoking tobacco and cannabis, as well as coca paste; strength of association is modestly greater for coca paste smoking.