People living with a severe mental illness like schizophrenia, schizoaffective disorder, or bipolar disorder may struggle to get enough physical activity, a new study suggests. Those diagnosed with psychosis die up to 15 years earlier than the general population, but more exercise could help prevent early death. However, there are often significant barriers to helping those with psychosis become more physically active.
The study, conducted by King's College London and the South London and Maudsley (SLaM) NHS Foundation Trust, used a random sampling of more than 200,000 people from 46 different countries. The findings indicated that those with a diagnosis of psychosis were 36 percent more likely to get less than 150 minutes of moderate physical activity per week (the minimum amount of exercise recommended by the World Health Organization for adults aged 18 to 64) than those not diagnosed with psychosis. The study also found that men with psychosis were twice as likely to not get enough exercise than the control population.
Dr. Fiona Gaughran, an author of the study, tells Broadly that there are many potential explanations for why people with psychosis may not meet the minimum recommended exercise amounts.
"We all find it difficult to exercise," she says. "If you have this illness, you have not just what we call 'positive incidents,' such as hallucination, but there are also negative symptoms, which can include a lack of motivation to get up and get out."
"Cognitive problems are also part of the spectrum," says Gaughran. "This interferes with the ability to plan and to execute plans. Depression can be very common as well."
Gaughran explains that treatment for psychosis can interfere with a person's ability to set up a routine as well, which makes developing an exercise habit difficult. "If you have to seek health care on an intermittent basis, that's another challenge." Also, though doctors try to reduce the burden of side effects as much as possible, medication can make patients feel sleepy.
"It's logical that the illness itself will make a person less likely to be motivated to exercise. You might want to, but you just don't get around to it."
Gaughran notes that despite these challenges, it's important for people with psychosis to get physical activity. She points out that other research has shown that exercise not only helps with the physical health of those with psychosis, but one study even showed aerobic exercise improves cognitive functioning in people with schizophrenia. Another showed physical activity could be a treatment for depression.
"Physical activity is good for both body and mind," says Gaughran. "It helps overall, and though it's not going to be the only answer, it's something we recommend for everyone."
Those with psychosis can face real challenges when it comes to getting a healthy amount of physical activity, though, and doctors are working to develop intervention methods to help patients surmount these difficulties. King's College is conducting one such study itself called "Walk This Way," which will aim to understand the barriers people with psychosis face when it comes to exercise, as well as how to overcome them.
"People with psychosis should be able to access any health care," says Gaughran. "But also exercise facilities and programs that help promote healthy lifestyles."