运动改善精神分裂症的临床症状、生活质量、整体功能及抑郁：一项系统评价与荟萃分析
Exercise Improves Clinical Symptoms, Quality of Life, Global Functioning, and Depression in Schizophrenia: A Systematic Review and Meta-analysis.
作者信息
Dauwan Meenakshi, Begemann Marieke J H, Heringa Sophie M, Sommer Iris E
机构信息
Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Neurophysiology and MEG Center, Neuroscience Campus, VU University Medical Center, Amsterdam, The Netherlands
Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands;
出版信息
Schizophr Bull. 2016 May;42(3):588-99. doi: 10.1093/schbul/sbv164. Epub 2015 Nov 7.
BACKGROUND
Physical exercise may be valuable for patients with schizophrenia spectrum disorders as it may have beneficial effect on clinical symptoms, quality of life and cognition.
METHODS
A systematic search was performed using PubMed (Medline), Embase, PsychInfo, and Cochrane Database of Systematic Reviews. Controlled and uncontrolled studies investigating the effect of any type of physical exercise interventions in schizophrenia spectrum disorders were included. Outcome measures were clinical symptoms, quality of life, global functioning, depression or cognition. Meta-analyses were performed using Comprehensive Meta-Analysis software. A random effects model was used to compute overall weighted effect sizes in Hedges' g.
RESULTS
Twenty-nine studies were included, examining 1109 patients. Exercise was superior to control conditions in improving total symptom severity (k = 14, n = 719: Hedges' g = .39, P < .001), positive (k = 15, n = 715: Hedges' g = .32, P < .01), negative (k = 18, n = 854: Hedges' g = .49, P < .001), and general (k = 10, n = 475: Hedges' g = .27, P < .05) symptoms, quality of life (k = 11, n = 770: Hedges' g = .55, P < .001), global functioning (k = 5, n = 342: Hedges' g = .32, P < .01), and depressive symptoms (k = 7, n = 337: Hedges' g = .71, P < .001). Yoga, specifically, improved the cognitive subdomain long-term memory (k = 2, n = 184: Hedges' g = .32, P < .05), while exercise in general or in any other form had no effect on cognition.
CONCLUSION
Physical exercise is a robust add-on treatment for improving clinical symptoms, quality of life, global functioning, and depressive symptoms in patients with schizophrenia. The effect on cognition is not demonstrated, but may be present for yoga.
背景
体育锻炼对精神分裂症谱系障碍患者可能具有重要价值，因为它可能对临床症状、生活质量和认知产生有益影响。
方法
使用PubMed（Medline）、Embase、PsychInfo和Cochrane系统评价数据库进行系统检索。纳入了研究任何类型体育锻炼干预对精神分裂症谱系障碍影响的对照和非对照研究。结局指标为临床症状、生活质量、整体功能、抑郁或认知。使用Comprehensive Meta-Analysis软件进行荟萃分析。采用随机效应模型计算Hedges' g的总体加权效应量。
结果
纳入29项研究，共1109例患者。在改善总症状严重程度（k = 14，n = 719：Hedges' g = 0.39，P < 0.001）、阳性症状（k = 15，n = 715：Hedges' g = 0.32，P < 0.01）、阴性症状（k = 18，n = 854：Hedges' g = 0.49，P < 0.001）和一般症状（k = 10，n = 475：Hedges' g = 0.27，P < 0.05）、生活质量（k = 11，n = 770：Hedges' g = 0.55，P < 0.001）、整体功能（k = 5，n = 342：Hedges' g = 0.32，P < 0.01）和抑郁症状（k = 7，n = 337：Hedges' g = 0.71，P < 0.001）方面，锻炼优于对照。具体而言，瑜伽改善了认知子领域的长期记忆（k = 2，n = 184：Hedges' g = 0.32，P < 0.05），而一般锻炼或任何其他形式的锻炼对认知无影响。
结论
体育锻炼是改善精神分裂症患者临床症状、生活质量、整体功能和抑郁症状的有效辅助治疗方法。对认知的影响未得到证实，但瑜伽可能有此作用。
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