Rosenbaum Simon, Tiedemann Anne, Sherrington Catherine, Curtis Jackie, Ward Philip B
AEP, The George Institute for Global Health, Lv 13, 320 Kent St, Sydney, 2000, NSW, Australia
J Clin Psychiatry. 2014 Sep;75(9):964-74. doi: 10.4088/JCP.13r08765.
To determine effects of physical activity on depressive symptoms (primary objective), symptoms of schizophrenia, anthropometric measures, aerobic capacity, and quality of life (secondary objectives) in people with mental illness and explore between-study heterogeneity.
MEDLINE, Cochrane Controlled Trials Register, PsycINFO, CINAHL, Embase, and the Physiotherapy Evidence Database (PEDro) were searched from earliest record to 2013.
Randomized controlled trials of adults with a DSM-IV-TR, ICD-10, or clinician-confirmed diagnosis of a mental illness other than dysthymia or eating disorders were selected. Interventions included exercise programs, exercise counseling, lifestyle interventions, tai chi, or physical yoga. Study methodological quality and intervention compliance with American College of Sports Medicine (ACSM) guidelines were also assessed.
Two investigators extracted data. Data were pooled using random-effects meta-analysis. Meta-regression was used to examine sources of between-study heterogeneity.
Thirty-nine eligible trials were identified. The primary meta-analysis found a large effect of physical activity on depressive symptoms (n = 20; standardized mean difference (SMD) = 0.80). The effect size in trial interventions that met ACSM guidelines for aerobic exercise did not differ significantly from those that did not meet these guidelines. The effect for trials with higher methodological quality was smaller than that observed for trials with lower methodological quality (SMD = 0.39 vs 1.35); however, the difference was not statistically significant. A large effect was found for schizophrenia symptoms (SMD = 1.0), a small effect was found for anthropometry (SMD = 0.24), and moderate effects were found for aerobic capacity (SMD = 0.63) and quality of life (SMD = 0.64).
Physical activity reduced depressive symptoms in people with mental illness. Larger effects were seen in studies of poorer methodological quality. Physical activity reduced symptoms of schizophrenia and improved anthropometric measures, aerobic capacity, and quality of life among people with mental illness.
PROSPERO registration #CRD42012002012.
确定体育活动对精神疾病患者抑郁症状（主要目标）、精神分裂症症状、人体测量指标、有氧能力和生活质量（次要目标）的影响，并探讨研究间的异质性。
检索了MEDLINE、Cochrane对照试验注册库、PsycINFO、CINAHL、Embase和物理治疗证据数据库（PEDro），检索时间从最早记录至2013年。
选取了对患有精神疾病（除心境恶劣或饮食失调外）且经DSM-IV-TR、ICD-10或临床医生确诊的成年人进行的随机对照试验。干预措施包括运动项目、运动咨询、生活方式干预、太极拳或体式瑜伽。还评估了研究方法的质量以及干预措施是否符合美国运动医学学院（ACSM）的指南。
两名研究人员提取数据。采用随机效应荟萃分析对数据进行汇总。使用荟萃回归分析来研究研究间异质性的来源。
共确定了39项符合条件的试验。主要荟萃分析发现体育活动对抑郁症状有显著影响（n = 20；标准化均数差（SMD）= 0.80）。符合ACSM有氧运动指南的试验干预措施的效应大小与不符合这些指南的措施相比，差异无统计学意义。方法质量较高的试验的效应小于方法质量较低的试验（SMD = 0.39对1.35）；然而，差异无统计学意义。发现对精神分裂症症状有显著影响（SMD = 1.0），对人体测量指标有较小影响（SMD = 0.24），对有氧能力（SMD = 0.63）和生活质量（SMD = 0.64）有中等影响。
体育活动可减轻精神疾病患者的抑郁症状。在方法质量较差的研究中观察到的效应更大。体育活动可减轻精神疾病患者的精神分裂症症状，并改善其人体测量指标、有氧能力和生活质量。
PROSPERO注册号#CRD42012002012。
