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精神分裂症患者运动干预的系统评价与荟萃分析

A systematic review and meta-analysis of exercise interventions in schizophrenia patients.

作者信息

Firth J, Cotter J, Elliott R, French P, Yung A R

机构信息

Institute of Brain, Behaviour and Mental Health, University of Manchester,UK.

Psychosis Research Unit, Greater Manchester West NHS Mental Health Trust,UK.

出版信息

Psychol Med. 2015 May;45(7):1343-61. doi: 10.1017/S0033291714003110. Epub 2015 Feb 4.

Abstract

BACKGROUND

The typically poor outcomes of schizophrenia could be improved through interventions that reduce cardiometabolic risk, negative symptoms and cognitive deficits; aspects of the illness which often go untreated. The present review and meta-analysis aimed to establish the effectiveness of exercise for improving both physical and mental health outcomes in schizophrenia patients.

METHOD

We conducted a systematic literature search to identify all studies that examined the physical or mental effects of exercise interventions in non-affective psychotic disorders. Of 1581 references, 20 eligible studies were identified. Data on study design, sample characteristics, outcomes and feasibility were extracted from all studies and systematically reviewed. Meta-analyses were also conducted on the physical and mental health outcomes of randomized controlled trials.

RESULTS

Exercise interventions had no significant effect on body mass index, but can improve physical fitness and other cardiometabolic risk factors. Psychiatric symptoms were significantly reduced by interventions using around 90 min of moderate-to-vigorous exercise per week (standardized mean difference: 0.72, 95% confidence interval -1.14 to -0.29). This amount of exercise was also reported to significantly improve functioning, co-morbid disorders and neurocognition.

CONCLUSIONS

Interventions that implement a sufficient dose of exercise, in supervised or group settings, can be feasible and effective interventions for schizophrenia.

摘要

背景

精神分裂症通常较差的预后可通过降低心脏代谢风险、减轻阴性症状和改善认知缺陷的干预措施得到改善;而疾病的这些方面往往未得到治疗。本综述和荟萃分析旨在确定运动对改善精神分裂症患者身心健康结局的有效性。

方法

我们进行了系统的文献检索,以识别所有研究非情感性精神障碍运动干预的身体或心理影响的研究。在1581篇参考文献中,确定了20项符合条件的研究。从所有研究中提取关于研究设计、样本特征、结局和可行性的数据,并进行系统综述。还对随机对照试验的身心健康结局进行了荟萃分析。

结果

运动干预对体重指数没有显著影响,但可以改善身体素质和其他心脏代谢风险因素。每周进行约90分钟的中度至剧烈运动的干预措施可显著减轻精神症状(标准化平均差:0.72,95%置信区间-1.14至-0.29)。据报道,这个运动量还能显著改善功能、共病和神经认知。

结论

在有监督的或团体环境中实施足够剂量运动的干预措施,对于精神分裂症患者可能是可行且有效的干预方法。

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