THE ROLE OF PHYSICAL ACTIVITY IN MANAGEMENT OF BODY WEIGHT IN PSYCHOTIC SUBJECTS

Abstract

Psychotic subjects live an unhealthy lifestyle that tends to reinforce the metabolic syndrome (1). It is known, indeed, that antipsychotic treatments stimulate appetite (2) and induce weight gain (3). Several therapeutic approaches including psycho-educational behavioral interventions and exercise training programs have been elaborated in order to manage antipsychotic-induced weight gain (4,5). Wirshing et al. (2006) elaborated a specific project based on oral presentations in order to educate psychotic subjects about lifestyle changes they can adopt to reduce weight gain. They showed that patients with mental illness are able to benefit from educational presentations about nutrition and a healthy lifestyle (4). Moreover, the prospective naturalistic study of Poulin et al. (2007) investigated the efficiency of a controlled physical activity program and a nutritional counseling in psychotic patients. They found that a weight control program including unstandardized exercise could effectively manage body weight and metabolic syndrome in subjects receiving atypical antipsychotic treatments (5). The aim of this study was to investigate the effects of soccer practice on the self reported health quality of life (SRHQL), sports performance (SP) and body weight (BW) control in subjects with a diagnosis of schizophrenia. Twenty-three male subjects were recruited in the Psychiatric Departments of Local Health of Palermo (Sicily, Italy) and randomized into either a control group (CG) and the trained one (TG). All patients participated in the local project “Calciapensieri”. Two subjects of TG were excluded from study because did not attend 80% of training period; instead 3 patients of CG were not subjected to post-test. For these reasons, eighteen overweight male subjects, of which 10 trained psychotics (age: 36.00±5.00 yrs.; weight: 77.44±13.60 kg; height: 164.44±7.00 cm; BMI: 28.55±4.06) and 8 no-trained psychotics (age: 35.00±4.00 yrs.; weight: 76.71±09.75 kg; height: 163.42±4.99 cm; BMI: 28.65±2.62), were considered in this study. TG was trained for 12 weeks by two soccer training sessions/week. CG did not perform any physical activity during experimental period. Body weight (BW), BMI, SRHQL and SP were evaluated before and after experimental period. SRHQL was assessed using SF-12 questionnaire measuring physical (PCS-12) and mental (MCS-12) component summary scores. After the training period, TG showed a relevant decrease by 4.6% in body weight (BW) and body mass index (BMI) compared to baseline. On the contrary, CG showed an increased BW and BMI by 1.8% from baseline to post test. Moreover, at 12 weeks we found that control patients increased significantly their BW than trained ones (∆= 5.4%; p<0.05). After the training period, comparing TG’s SF-12-scores from baseline to post-test, we found an improvement by 10.5% and 10.8% in PCS and MCS respectively. In addition, TG’s SF improved significantly (p<0.05) from baseline to post-test compared to CG (6). Weight gain associated with abdominal obesity and metabolic syndrome are the main collateral effects associated with modern second-generation antipsychotics treatments (7). We showed that regular physical activity could reduce antipsychotic medication-related weight gain and improve SRHQL and SP in psychotic subjects. However, there are only a few studies that evaluate the effects of exercise training on physical fitness of psychotic subjects. We suggest that it is need to speculate multifaceted interventions aimed at combining traditional pharmacologic treatments and alternative behavioural methods such as physical activity (6). References 1. Kopp M. [Physical activity in persons with severe mental illness: research-based clinical recommendations]. Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater. 2009;23(3):151–6. 2. Robinson RG, McHugh PR