Koepl Katharina Leah, Wambsganz Antonia, Roell Lukas, Schwaiger Rebecca, Fischer Tim, Falkai Peter, Hasan Alkomiet, Schmitt Andrea, Maurus Isabel
Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Muenchen, Bayern, Germany
Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Muenchen, Bayern, Germany.
BMJ Open. 2025 Jun 8;15(6):e092862. doi: 10.1136/bmjopen-2024-092862.
Regular exercise significantly benefits mental health, yet its therapeutic potential in psychiatric care remains underutilised. Understanding the factors influencing physical activity in individuals with mental illness is crucial to realising its full therapeutic potential. Our study seeks to explore motivational and socio-demographic determinants affecting exercise habits in individuals with mental illness and compare them to those without mental illness.
Distribution of the link to a cross-sectional online survey at psychiatric clinics, practices, university events and sports clubs, via self-help group email lists and on social media.
An online survey using validated questionnaires supplemented with self-developed items was conducted. Statistical analysis encompassed unpaired t-tests and χ tests to compare individuals with and without mental illness, as well as multiple linear regression to investigate the relationship between childhood exercise experience, psychometrics and current physical activity behaviour in individuals with mental illness.
1564 individuals (66.5% female) including 417 diagnosed with any kind of mental illness.
In comparison with mentally healthy participants, individuals diagnosed with mental illness displayed notably lower activity levels (eg, engaging in regular physical activity 55.6% vs 69.3%, x2(1, n=1458) = 26.03, p<0.001), autonomous motivation (sport- und bewegungsbezogene Selbstkonkordanzskala Index: M=3.62, SD=3.07 vs M=4.62, SD=2.74, t(594.58)=5.4, p=0.009), self-efficacy expectancies (Allgemeine Selbstwirksamkeit Kurzskala: M=3.65, SD=0.81 vs M=4.10, SD=0.59, t(505.39)=9.76, p<0.001), and resilience (Brief Resilience Scale: M=2.81, SD=0.83 vs M=3.46, SD=0.70, t(555.52)=13.28, p<0.001), and a greater external locus of control (Internale-Externale-Kontrollüberzugung Scale: M=2.53, SD=0.89 vs M=2.13, SD=0.76, t(565.43)=-7.78, p<0.001). Throughout childhood and adolescence, they reported less activity (66.9% vs 78.0%, x2(1, n=1549) = 18.22, p<0.001) and lower grades in physical education (M=2.1, SD=0.8 vs M=1.8, SD=0.8, U=1 888 071.00, Z=-6.19, p<0.001). Individuals with mental illness favoured a structured sports programme led by professionals. Factors like self-concordance (ß=0.29, p<0.001), intrinsic motivation (ß=0.22, p=0.02), and self-efficacy expectations (ß=0.35, p<0.001) were strong predictors of current physical activity levels (eg, measured as training sessions per week) in this group.
There is a dire need for professionally supervised, small group exercise programmes for people with mental illness incorporating cognitive-behavioural elements, to better address their individual needs and to positively influence previously mentioned psychometric determinants. Furthermore, the importance of sport and physical activity in childhood, and especially in adolescence, was reaffirmed, underlining the paramount importance of youth sport programmes in long-term health promotion from a public health perspective.
规律运动对心理健康有显著益处，但其在精神科护理中的治疗潜力仍未得到充分利用。了解影响精神疾病患者身体活动的因素对于充分发挥其治疗潜力至关重要。我们的研究旨在探索影响精神疾病患者运动习惯的动机和社会人口学决定因素，并将其与无精神疾病的个体进行比较。
通过自助团体电子邮件列表和社交媒体，在精神科诊所、医疗机构、大学活动和体育俱乐部分发横断面在线调查链接。
使用经过验证的问卷并补充自行编制的项目进行在线调查。统计分析包括非配对t检验和χ检验，以比较有精神疾病和无精神疾病的个体，以及多元线性回归，以研究童年运动经历、心理测量指标与精神疾病患者当前身体活动行为之间的关系。
1564名个体（66.5%为女性），其中417名被诊断患有任何类型的精神疾病。
与心理健康的参与者相比，被诊断患有精神疾病的个体活动水平显著较低（例如，经常进行体育活动的比例为55.6%对69.3%，χ2(1, n = 1458) = 26.03，p < 0.001），自主动机（与运动相关的自我一致性量表指数：M = 3.62，SD = 3.07对M = 4.62，SD = 2.74，t(594.58) = 5.4，p = 0.009），自我效能期望（一般自我效能简表：M = 3.65，SD = 0.81对M = 4.10，SD = 0.59，t(505.39) = 9.76，p < 0.001），以及心理韧性（简易心理韧性量表：M = 2.81，SD = 0.83对M = 3.46，SD = 0.70，t(555.52) = 13.28，p < 0.001），且外部控制点更强（内外控制倾向量表：M = 2.53，SD = 0.89对M = 2.13，SD = 0.76，t(565.43) = -7.78，p < 0.001）。在整个童年和青少年时期，他们报告的活动较少（66.9%对78.0%，χ2(1, n = 1549) = 18.22，p < 0.001），体育成绩较低（M = 2.1，SD = 0.8对M = 1.8，SD = 0.8，U = 1 888 071.00，Z = -6.19，p < 0.001）。患有精神疾病的个体更喜欢由专业人员主导的结构化体育项目。自我一致性（β = 0.29，p < 0.001）、内在动机（β = 0.22，p = 0.02）和自我效能期望（β = 0.35，p < 0.001）等因素是该组当前身体活动水平（如每周训练次数）的强预测因素。
迫切需要为精神疾病患者提供专业监督的、包含认知行为元素的小组运动项目，以更好地满足他们的个体需求，并对上述心理测量指标产生积极影响。此外，重申了运动和体育活动在童年尤其是青少年时期的重要性，从公共卫生角度强调了青少年体育项目在长期健康促进中的至关重要性。
