A somewhat novel but well-powered study has taken a look at how often low physical activity is seen among people with psychotic symptoms or a diagnosed psychosis disorder. Since cardiovascular and metabolic diseases are one of the driving forces behind why those with psychotic illness die earlier than the general population, investigating the nature of physical activity among this group could lead to improvements in treatment recommendations.
In Brief: Psychosis
Psychosis is a symptom that involves losing touch with some element of reality. This is usually characterized by hallucinations, delusions, catatonia, or disorganized thoughts that can render writing and speech unintelligible. Different types of psychosis are tied to different mental disorders or psychological problems such as schizophrenia, bipolar disorder, PTSD, sleep deprivation, sudden periods of high stress (“mental breakdown” or “nervous break”), and so on.
The researchers looked at 204,186 participants aged 18-64. The participants were divided into three goups: those who had no psychosis diagnosis and had no psychosis symptoms within the past year, those who have experienced psychotic symptoms but lack a diagnosis (“subclinical psychosis”) and those who both have a diagnosis and experience psychotic symptoms. These individuals were assessed for whether they complied with the recommended 150 minutes of moderate-to-vigorous physical activity per week, as well as possible reasons behind low physical activity (if any).
It was found that there was a prevalence of low physical activity in 27% of the control group, 24.3% of the subclinical group, and in 33% of the diagnosed group. This difference was strongest among males of the diagnosed group, with females showing a much weaker association. The reason for this discrepancy is theorized to be related to how men tend to experience early-onset mental illness more frequently than women and because men often have higher burdens of negative symptoms from their conditions.
When the men were looked at for the reasons behind their low physical activity, it was found that mobility difficulties, self-care problems, depression, pain and discomfort, cognitive difficulties, sleep and energy disruptions, and vision problems made up the primary reasons behind the inactivity.
As for why the diagnosed group would show noticeably less physical activity but the subclinical group did not, the researchers also offer some thoughts. For instance, the intensity and/or frequency of psychotic would be lower among the subclinical group. Subclinical, after all, means symptoms are not disruptive or overt enough to drive someone to a doctor or otherwise bring themselves to medical attention. Since someone with a psychotic diagnosis is much more likely to be on medication for their condition, it is also proposed that side effects from therapeutic drugs, like sedation, could be involved as well.
What This Means
This study is a good launch point for finding ways to help those with psychotic symptoms overcome low physical activity. It has identified that there is a problem, made note of who is most affected by that problem, and even found a few of the obstacles that are allegedly (it was a survey, after all) keeping patients from getting their needed exercise. Not a bad bit of work, all things considered.
Stubbs, B., et. al., “Physical Activity Levels and Psychosis: A Mediation Analysis of Factors Influencing Physical Activity Target Achievement Among 204 186 People Across 46 Low-and-Middle-Income Countries,” Schizophrenia Bulletin, 2016; 10.1093/schbul/sbw11.