title: 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.
abstract: Physical activity (PA) can help reduce cardiovascular disease and premature mortality in people with psychosis. However, there is a paucity of representative data on PA in people with psychosis, especially from low- and middle-income countries (LMICs). Moreover, data on subclinical psychosis and PA is absent. This study explored whether complying with PA recommendations of 150 minutes of moderate-vigorous PA per week is related to: (1) psychotic symptoms without a psychosis diagnosis (subclinical psychosis); and (2) clinical psychosis (psychosis diagnosis). A total of 204 186 participants aged 18-64 years from 46 LMICs recruited via the World Health Survey were subdivided into those with (1) no psychosis diagnosis and no psychotic symptoms in the past 12 months (controls); (2) subclinical psychosis; and (3) psychosis diagnosis. People with a psychosis diagnosis had significantly higher odds for low PA in the overall sample (OR = 1.36; 95% CI = 1.04-1.78; P = .024) and among males (OR = 2.29; 95% CI = 1.57-3.34; P < .0001) but not females (OR = 0.93; 95% CI = 0.67-1.30; P = .6712). No difference was found among those with subclinical psychosis vs controls. Mediation analyses demonstrated that mobility difficulties explained the largest amount of low PA among males (18.5%) followed by self-care difficulties (16.3%), depression (16.1%), cognition (11.8%), pain and discomfort (11.4%), interpersonal activities (8.6%), sleep and energy (7.2%), and vision (3.0%). The results from the largest dataset on PA and psychosis and first in LMICs, found that psychosis diagnosis (especially among males) but not subclinical psychosis, is associated with physical inactivity. Population level interventions seeking to increase PA among people with psychosis may help improve health outcomes.
authors: Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.|Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors: Brendon
authors: B
authors: Stubbs
authors: Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.|Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
authors: Ai
authors: A
authors: Koyanagi
authors: Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.|Programa de Pós Graduação em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors: Felipe
authors: F
authors: Schuch
authors: Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK.
authors: Joseph
authors: J
authors: Firth
authors: Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Sydney, Australia.
authors: Simon
authors: S
authors: Rosenbaum
authors: Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK.
authors: Fiona
authors: F
authors: Gaughran
authors: Kyambogo University, Kampala, Uganda.|Butabika National Referral and Mental Health Hospital, Kampala, Uganda.
authors: James
authors: J
authors: Mugisha
authors: Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.|KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium.
authors: Davy
authors: D
authors: Vancampfort
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003906:Developing Countries / Q000706:statistics & numerical data*; D015444:Exercise; D005260:Female; D014943:Global Health / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000453:epidemiology*; D012737:Sex Factors; D055815:Young Adult
keywords: activity; exercise; physical activity; physical health; psychosis; psychotic like experiences; schizophrenia