Szortyka Michele Fonseca, Batista Cristiano Viviane, Belmonte-de-Abreu Paulo
Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil.
Schizophrenia Program of Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Front Psychiatry. 2021 Feb 9;12:536767. doi: 10.3389/fpsyt.2021.536767. eCollection 2021.
In contrast to several other severe illnesses marked by inflammation and autoimmunity that now have potent and efficient treatments and even cures, schizophrenia (SCZ) is a disease still associated with poor outcome, incapacity, and social burden. Even after decades of research on the brain and behavior, this illness is still associated with profound effects on both mental health and physical health, with recent studies showing that treatment is more efficient when associating drugs with psychological and physical treatments. Most of the studies measured the effects of physical intervention compared with usual care and demonstrated a positive effect as an add-on treatment. What remains unclear is the different effects of the same intervention in normal subjects in a sample of patients with the illness. The study aimed to evaluate the effects of physical intervention over motor functional capacity and mental health in patients with SCZ compared with healthy controls (HC). The outcomes were (a) functional capacity [by 6-min walk test (6MWT)], (b) body flexibility index (Wells' bench), (c) disease severity [by Brief Psychiatric Rating Scale (BPRS)], (d) quality of life [by 36-Item Short Form (SF-36) questionnaire], and (e) physical activity [Simple Physical Activity Questionnaire (SIMPAQ)]. The intervention was associated with significant decrease of body mass index (BMI), blood pressure, disease severity, and improvement in daily life activities. Unexpectedly, it was observed that schizophrenics, compared with matched HC, were at a lower level of performance in the beginning, remained below HC over the studied time despite similar physical intervention, and had different changes. The intervention had lower effects over physical capacity and better effects over quality of life and disease severity. The results confirm previous studies comparing patients receiving physical intervention but suggest that they may receive different types of intervention, suited for their different baseline fitness, motivation, and capacity to engage in physical effort over sustained time. Additionally, they point to extended time of intervention of multidisciplinary treatment (physical and psychological-cognitive techniques) to improve outcomes in SCZ.
与其他几种以炎症和自身免疫为特征的严重疾病不同，如今这些疾病已有强效且有效的治疗方法甚至治愈手段，而精神分裂症（SCZ）仍是一种与不良预后、功能丧失和社会负担相关的疾病。即便经过数十年对大脑与行为的研究，这种疾病仍对心理健康和身体健康有着深远影响，近期研究表明，将药物与心理和身体治疗相结合时治疗效果更佳。大多数研究测量了身体干预与常规护理相比的效果，并证明其作为附加治疗具有积极作用。尚不清楚的是，在患病样本中的正常受试者身上，相同干预会产生何种不同效果。该研究旨在评估与健康对照组（HC）相比，身体干预对SCZ患者运动功能能力和心理健康的影响。研究结果包括：（a）功能能力[通过6分钟步行试验（6MWT）]，（b）身体柔韧性指数（韦尔斯板凳试验），（c）疾病严重程度[通过简明精神病评定量表（BPRS）]，（d）生活质量[通过36项简短健康调查（SF - 36）问卷]，以及（e）身体活动[简单身体活动问卷（SIMPAQ）]。该干预与体重指数（BMI）、血压、疾病严重程度的显著降低以及日常生活活动的改善相关。出乎意料的是，研究发现，与匹配的HC相比，精神分裂症患者在开始时表现水平较低，尽管接受了相似的身体干预，但在研究期间仍低于HC，且有不同的变化。该干预对身体能力的影响较小，对生活质量和疾病严重程度的影响较好。研究结果证实了之前比较接受身体干预患者的研究，但表明他们可能接受了不同类型的干预，这些干预适合他们不同的基线健康状况、动机以及持续进行体力活动的能力。此外，研究结果还指出，多学科治疗（身体和心理 - 认知技术）的干预时间延长有助于改善SCZ的治疗效果。
