Research Department, Psychiatric Centre GGz Centraal, Innova, Amersfoort, The Netherlands.
Faculty of Health Medicine and Life Sciences, Department of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
Schizophr Bull. 2021 Jul 8;47(4):906-914. doi: 10.1093/schbul/sbab028.
Low physical activity (PA) and sedentary behavior (SB) are major contributors to mental health burden and increased somatic comorbidity and mortality in people with schizophrenia and related psychoses. Movement disorders are highly prevalent in schizophrenia populations and are related to impaired functioning and poor clinical outcome. However, the relationship between movement disorders and PA and SB has remained largely unexplored. Therefore, we aimed to examine the relationship between movement disorders (akathisia, dyskinesia, dystonia, and parkinsonism) and PA and SB in 216 patients with schizophrenia and related psychoses. Actigraphy, the St. Hans Rating Scale for extrapyramidal syndromes, and psychopathological ratings (PANSS-r) were applied. Data were analyzed using multiple linear regression, adjusting for sex, age, negative symptoms, and defined daily dose of prescribed antipsychotics. Parkinsonism was significantly associated with decreased PA (β = -0.21, P < .01) and increased SB (β = 0.26, P < .001). For dystonia, only the relationship with SB was significant (β = 0.15, P < .05). Akathisia was associated with more PA (β = 0.14, P < .05) and less SB (β = -0.15, P < .05). For dyskinesia, the relationships were non-significant. In a prediction model, akathisia, dystonia, parkinsonism and age significantly predicted PA (F(5,209) = 16.6, P < .001, R2Adjusted = 0.27) and SB (F(4,210) = 13.4, P < .001, R2Adjusted = 0.19). These findings suggest that movement disorders, in particular parkinsonism, are associated with reduced PA and increased SB in patients with psychotic disorders. Future studies should take movement disorders into account when examining PA and SB, to establish the clinical value of movement disorders in activating people with psychotic disorders to improve their mental and somatic health.
低身体活动（PA）和久坐行为（SB）是导致精神健康负担增加以及精神分裂症和相关精神病患者躯体合并症和死亡率增加的主要因素。运动障碍在精神分裂症人群中非常普遍，与功能受损和临床预后不良有关。然而，运动障碍与 PA 和 SB 之间的关系在很大程度上仍未得到探索。因此，我们旨在研究 216 例精神分裂症和相关精神病患者的运动障碍（静坐不能、运动障碍、肌张力障碍和帕金森病）与 PA 和 SB 之间的关系。应用活动记录仪、圣汉斯锥体外系综合征评定量表和精神病理学评定量表（PANSS-r）进行评估。使用多元线性回归分析数据，调整性别、年龄、阴性症状和规定的抗精神病药物日剂量。帕金森病与 PA 减少（β=-0.21，P<.01）和 SB 增加（β=0.26，P<.001）显著相关。对于肌张力障碍，仅与 SB 的关系具有显著性（β=0.15，P<.05）。静坐不能与更多的 PA（β=0.14，P<.05）和更少的 SB（β=-0.15，P<.05）相关。对于运动障碍，这些关系无统计学意义。在预测模型中，静坐不能、肌张力障碍、帕金森病和年龄显著预测 PA（F（5,209）=16.6，P<.001，R2Adjusted=0.27）和 SB（F（4,210）=13.4，P<.001，R2Adjusted=0.19）。这些发现表明，运动障碍，特别是帕金森病，与精神障碍患者的 PA 减少和 SB 增加有关。未来的研究应在检查 PA 和 SB 时考虑运动障碍，以确定运动障碍在激活精神障碍患者以改善其精神和身体健康方面的临床价值。
