EPA guidance on physical activity as a treatment for severe mental illness: a meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental Health (IOPTMH)

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art_STUBBS_EPA_guidance_on_physical_activity_as_a_treatment_2018.PDF (836.98 KB)
Citações na Scopus
369
Tipo de produção
article
Data de publicação
2018
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER
Autores
STUBBS, Brendon
VANCAMPFORT, Davy
HALLGREN, Mats
FIRTH, Joseph
VERONESE, Nicola
SOLMI, Marco
BRAND, Serge
CORDES, Joachim
MALCHOW, Berend
GERBER, Markus
Citação
EUROPEAN PSYCHIATRY, v.54, p.124-144, 2018
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Physical activity (PA) may be therapeutic for people with severe mental illness (SMI) who generally have low PA and experience numerous life style-related medical complications. We conducted a meta-review of PA interventions and their impact on health outcomes for people with SMI, including schizophrenia-spectrum disorders, major depressive disorder (MDD) and bipolar disorder. We searched major electronic databases until January 2018 for systematic reviews with/without meta-analysis that investigated PA for any SMI. We rated the quality of studies with the AMSTAR tool, grading the quality of evidence, and identifying gaps, future research needs and clinical practice recommendations. For MDD, consistent evidence indicated that PA can improve depressive symptoms versus control conditions, with effects comparable to those of antidepressants and psychotherapy. PA can also improve cardiorespiratory fitness and quality of life in people with MDD, although the impact on physical health outcomes was limited. There were no differences in adverse events versus control conditions. For MDD, larger effect sizes were seen when PA was delivered at moderate-vigorous intensity and supervised by an exercise specialist. For schizophrenia-spectrum disorders, evidence indicates that aerobic PA can reduce psychiatric symptoms, improves cognition and various subdomains, cardiorespiratory fitness, whilst evidence for the impact on anthropometric measures was inconsistent. There was a paucity of studies investigating PA in bipolar disorder, precluding any definitive recommendations. No cost effectiveness analyses in any SMI condition were identified. We make multiple recommendations to fill existing research gaps and increase the use of PA in routine clinical care aimed at improving psychiatric and medical outcomes.
Palavras-chave
Physical activity, Sedentary behaviour, Exercise, Psychosis, Schizophrenia, Severe mental illness, Bipolar disorders, Major depressive disorders
URI
https://observatorio.fm.usp.br/handle/OPI/29718
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Artigos e Materiais de Revistas Científicas - LIM/27