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26-04-2011 | Mental health | Article

Physical HRQL linked to physical leisure activity, BMI in schizophrenia


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MedWire News: Reduced physical health-related quality of life (HRQL) in patients with schizophrenia is associated with a lack of leisure time physical activity, as well as an increased body mass index (BMI), research shows.

Writing in the journal Schizophrenia Research, Davy Vancampfort (Catholic University Leuven, Belgium) and team explain: "In patients with schizophrenia symptoms, a higher BMI, waist circumference, and subjective side effects of antipsychotic medication need to be considered in relation to their impact on HRQL.

"Also a poor social network, stigma, and neuropsychological measures including verbal ability, attention, working memory and problem-solving, and smoking severity are known to be related to impairments in HRQL."

However, they add: "Although the majority of schizophrenia patients are known to be sedentary and to have a reduced functional exercise capacity, and that the metabolic syndrome is highly prevalent in schizophrenia, it is currently unknown whether these parameters also contribute to a HRQL impairment."

To investigate, the team studied 60 patients with schizophrenia, aged an average of 38.1 years, and 40 age- and gender-matched mentally healthy individuals (controls).

Physical and mental HRQL was assessed using the 36-item Short Form health survey (SF-36), physical activity levels were assessed using the Baecke Physical Activity Questionnaire (BPAQ), functional exercise capacity was evaluated using the 6-minute walk test (6MWT), and BMI calculations were performed.

The participants also underwent metabolic and anthropometric assessments, and International Diabetes Federation criteria were used to identify the presence of the metabolic syndrome in the schizophrenia patients.

The researchers found that SF-36 physical and mental HRQL scores were significantly lower in schizophrenia patients than controls, at 64.4 versus 84.8 and 46.7 versus 88.0, respectively. Also lower in schizophrenia patients were BPAQ scores for leisure time (2.7 vs 3.1) and sports (2.3 vs 2.9), and 6MWT results (573.5 vs 710.6 m).

In addition, schizophrenia patients had a higher mean BMI than controls, at 26.7 versus 24.0 kg/m2.

Multiple regression analysis revealed that increased BMI and lack of physical exercise were significant predictors of reduced physical HRQL in schizophrenia patients, while none of the investigated factors predicted mental HRQL.

In schizophrenia patients, impaired functional exercise capacity and the presence of the metabolic syndrome (n=18) did not explain the variance in HRQL.

Vancampfort et al conclude: "Physical HRQL in patients with schizophrenia is not only related to increased BMI but also to lack of leisure time physical activity. A reduced physical HRQL in patients with the metabolic syndrome appears to be related to their greater BMI, rather than to the metabolic syndrome per se."

They add that the findings "provide further support for routinely incorporating physical activity within rehabilitation programs and clinical assessments."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Mark Cowen

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