Richardson Caroline R, Faulkner Guy, McDevitt Judith, Skrinar Gary S, Hutchinson Dori S, Piette John D
Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Psychiatr Serv. 2005 Mar;56(3):324-31. doi: 10.1176/appi.ps.56.3.324.
This article reviews evidence supporting the need for interventions to promote physical activity among persons with serious mental illness. Principles of designing effective physical activity interventions are discussed along with ways to adapt such interventions for this population. Individuals with serious mental illness are at high risk of chronic diseases associated with sedentary behavior, including diabetes and cardiovascular disease. The effects of lifestyle modification on chronic disease outcomes are large and consistent across multiple studies. Evidence for the psychological benefits for clinical populations comes from two meta-analyses of outcomes of depressed patients that showed that effects of exercise were similar to those of psychotherapeutic interventions. Exercise can also alleviate secondary symptoms such as low self-esteem and social withdrawal. Although structured group programs can be effective for persons with serious mental illness, especially walking programs, lifestyle changes that focus on accumulation of moderate-intensity activity throughout the day may be most appropriate. Research suggests that exercise is well accepted by people with serious mental illness and is often considered one of the most valued components of treatment. Adherence to physical activity interventions appears comparable to that in the general population. Mental health service providers can provide effective, evidence-based physical activity interventions for individuals with serious mental illness.
本文综述了支持采取干预措施以促进严重精神疾病患者身体活动的证据。文中讨论了设计有效身体活动干预措施的原则以及针对该人群调整此类干预措施的方法。严重精神疾病患者患与久坐行为相关的慢性病（包括糖尿病和心血管疾病）的风险很高。生活方式改变对慢性病结局的影响在多项研究中都很大且一致。临床人群心理益处的证据来自两项对抑郁症患者结局的荟萃分析，结果表明运动的效果与心理治疗干预措施相似。运动还可以缓解诸如自卑和社交退缩等继发症状。虽然结构化的团体项目对严重精神疾病患者可能有效，尤其是步行项目，但关注全天中等强度活动积累的生活方式改变可能最为合适。研究表明，运动很受严重精神疾病患者的欢迎，并且常被认为是治疗中最有价值的组成部分之一。对身体活动干预措施的依从性似乎与普通人群相当。心理健康服务提供者可以为严重精神疾病患者提供有效、基于证据的身体活动干预措施。
