Sedentary behavior and psychiatric symptoms in overweight and obese adults with schizophrenia and schizoaffective disorders (WAIST Study)

Abstract

Objective Examine the association between sedentary behavior and psychiatric symptoms among overweight and obese adults with schizophrenia or schizoaffective disorders (SZO/SA). Design Randomized clinical trial; Weight Assessment and Intervention in Schizophrenia Treatment (WAIST) Study: baseline data collected 2005-2008. Setting University of Pittsburgh Medical Center, Pittsburgh, PA, USA Participants Community-dwelling adults diagnosed with SZO/SA, with mild symptom severity [Positive and Negative Syndrome Scale (PANSS)<90], who were interested in losing weight, age 18-70 years, BMI>27 kg/m2. Measurements Objectively measured sedentary behavior by accelerometry, and psychopathology assessed by PANSS. Participants wore the actigraphs for 7 consecutive days during their waking hours. Sedentary behavior was defined as ≤100 counts per minute during wear-time and excluded sleep and non-wear time. Results On average, 81% of the participant’s monitoring time or 756 mins/day was classified as sedentary behavior using accelerometry. No association was observed between sedentary behaviors and PANSS psychiatric symptoms [total (p≥0.75), positive (p≥0.81), negative (p≥0.59) and general psychopathology (p≥0.65) subscales]. No association was observed between sedentary behaviors and age, race, gender and BMI. Conclusion From a clinical and public health perspective, the amount of time (approximately 13 hours) and percentage of time (81% excluding non-wear time associated with sleeping) engaged in sedentary behavior among overweight and obese adults in this population is alarming, and points to an urgent need for interventions to decrease sedentary behaviors. The lack of associations between sedentary behavior and psychiatric symptoms may be due to a ceiling effect for sedentary behavior.

What are the top 10 physical activity research questions in schizophrenia?

“…There is a growing body of evidence demonstrating that sedentary behavior, independent of physical activity, is a distinct risk factor for multiple adverse health outcomes. Interest in the potential health risk of sedentary behavior in people with schizophrenia is growing [13,71,72]. The current evidence is conflicting, for example, while Vancampfort et al [13] found an association between greater time spent sitting and a higher body mass index, Janney et al [72] did not find such association.…”

“…Interest in the potential health risk of sedentary behavior in people with schizophrenia is growing [13,71,72]. The current evidence is conflicting, for example, while Vancampfort et al [13] found an association between greater time spent sitting and a higher body mass index, Janney et al [72] did not find such association. In the general population, there is undeniable, rigorous evidence that sedentary behavior is, independent of physical activity associated with cardiovascular disease mortality [75].…”

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

“…Ninety eight full texts were reviewed and 85 were excluded with reasons (see figure 1), with 13 unique studies meeting the eligibility criteria (Baker et al, 2014;Gomes et al, 2014;Hahn et al, 2014;Janney et al, 2014;Janney et al, 2013;Leutwyler et al, 2014;Lindamer et al, 2008;Snethen et al, 2014;Strassnig et al, 2012;Stubbs et al, 2015a;TW, 2008;Vancampfort et al, 2014;Vancampfort et al, 2012b). Full details of the search results are summarized in figure 1.…”

Improving Lifestyle Interventions for People With Serious Mental Illnesses: Qualitative Results from the STRIDE Study

“…Such interventions are helpful because they address access to and affordability of healthy foods, safe places to exercise, and education and skills that support attempts to lose weight and improve and maintain health. This type of approach may be particularly important for individuals with serious mental illnesses who are more likely to have less access to healthy foods (Drewnowski, 2012), limited autonomy over food choices when living in controlled environments (Lowndes, Angus, & Peter, 2013), poorer nutrition and sedentary lifestyles (Casagrande et al, 2011;Janney et al, 2013;Kilbourne et al, 2009), unhealthy social environments , psychiatric medications that cause weight gain (Chaggar, Shaw, & Williams, 2011;Newcomer, 2005Newcomer, , 2007, and mental health symptoms Pearsall, Hughes, Geddes, & Pelosi, 2014) and associated cognitive impairments (Vohringer et al, 2013) that may affect lifestyle change efforts.…”