Studies on PA in schizophrenia: What did we learn? What is effective?

2016 ◽  
Vol 33 (S1) ◽  
pp. S41-S41
Author(s):  
G. de Girolamo ◽  
V. Bulgari
Keyword(s):  
Negative Symptoms ◽  
Psychiatric Symptoms ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Well Being ◽  
Cardiovascular Fitness ◽  
Small Sample ◽  
Attrition Rate ◽  
Intention To Treat

Schizophrenia is frequently associated with abnormal physical activity (PA) per se (e.g., hypokinesia, motor retardation, etc.) or related to antipsychotic medications (e.g., extrapyramidal symptoms including bradykinesia, tremor, etc.). Daily amounts of PA for subjects diagnosed with schizophrenia tend to decrease over the illness course and contribute to metabolic and cognitive disturbances. PA intervention for schizophrenia patients may result in increased well-being, improved cognitive functioning, fewer negative symptoms and increased self-efficacy, leading to improved management of psychosocial life domains. However, PA trials conducted among people suffering from schizophrenia show several methodological limits: small sample sizes, lack of randomized patients’ allocation, heterogeneity of interventions and inappropriate outcome measures.Firth et al. (2015) have recently conducted a systematic review and meta-analysis of 11 trials on structured PA in schizophrenia (n = 659, median age of 33 years). The conclusions of this recent review are the following:– aerobic exercise (for instance exercise bike) of moderate-to-vigorous intensity done at least 90 minutes per week is effective in improving cardiovascular fitness; studies (n = 7) using VO2max as an assessment of fitness have reported clinically significant increases in VO2max, “defined as sufficient to reduce cardiovascular disease risk by 15% and mortality by 20%”;– several low-dose aerobic interventions did not shown any effect;– there was a “strong effect of exercise on total psychiatric symptoms” (both positive and negative symptoms were reduced);– total attrition rate was 32%. Group exercise showed a much lower attrition rate than solitary exercise;– caregivers’ supervision increased compliance as compared to unsupervised intervention;– in the only study that compared per-protocol and intention-to-treat analysis, a significant improvement in fitness, psychiatric symptoms and overall functioning only occurred in participants who attended > 50% of exercise sessions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The effects of vitamin and mineral supplementation on symptoms of schizophrenia: a systematic review and meta-analysis

2017 ◽  
Vol 47 (9) ◽  
pp. 1515-1527 ◽  
Author(s):  
J. Firth ◽  
B. Stubbs ◽  
J. Sarris ◽  
S. Rosenbaum ◽  
S. Teasdale ◽  
...  
Keyword(s):  
Systematic Review ◽  
Negative Symptoms ◽  
Psychiatric Symptoms ◽  
Meta Analysis ◽  
Preliminary Evidence ◽  
Outcome Data ◽  
Vitamin B ◽  
Mineral Supplements ◽  
Intention To Treat ◽  
The Impact

BackgroundWhen used as an adjunctive with antipsychotics, certain vitamins and minerals may be effective for improving symptomatic outcomes of schizophrenia, by restoring nutritional deficits, reducing oxidative stress, or modulating neurological pathways.MethodWe conducted a systematic review of all randomized controlled trials (RCTs) reporting effects of vitamin and/or mineral supplements on psychiatric symptoms in people with schizophrenia. Random-effects meta-analyses were used to calculate the standardized mean difference between nutrient and placebo treatments.ResultsAn electronic database search in July 2016 identified 18 eligible RCTs, with outcome data for 832 patients. Pooled effects showed that vitamin B supplementation (including B6, B8 and B12) reduced psychiatric symptoms significantly more than control conditions [g= 0.508, 95% confidence interval (CI) 0.01–1.01,p= 0.047,I2= 72.3%]. Similar effects were observed among vitamin B RCTs which used intention-to-treat analyses (g= 0.734, 95% CI 0.00–1.49,p= 0.051). However, no effects of B vitamins were observed in individual domains of positive and negative symptoms (bothp> 0.1). Meta-regression analyses showed that shorter illness duration was associated with greater vitamin B effectiveness (p= 0.001). There were no overall effects from antioxidant vitamins, inositol or dietary minerals on psychiatric symptoms.ConclusionsThere is preliminary evidence that certain vitamin and mineral supplements may reduce psychiatric symptoms in some people with schizophrenia. Further research is needed to examine how the benefits of supplementation relate to nutrient deficits and the impact upon underlying neurobiological pathways, in order to establish optimal nutrient formulations for improving clinical outcomes in this population. Future studies should also explore the effects of combining beneficial nutrients within multi-nutrient formulas.

Abstract P087: Association of Psychological Well-Being With Cardiac Repolarization

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Amit J Shah ◽  
Robert Carney ◽  
Elsayed Z Soliman ◽  
Viola Vaccarino
Keyword(s):  
Psychological Health ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Well Being ◽  
Left Ventricular ◽  
Morbidity And Mortality ◽  
Psychological Well Being ◽  
Psychological Wellness ◽  
Increased Risk ◽  
The Mean

Background: Abnormal frontal T-axis is an independent predictor of mortality, and may be influenced by increased sympathetic tone and cardiovascular disease risk factors. Factors related to poor psychological health, such as depression, are associated with increased risk of CVD morbidity, although the mechanisms are not clear. We tested the hypothesis that: 1) reduced psychological wellness is associated with abnormal T-axis and 2) this association may help to explain the excess risk of CVD morbidity and mortality related to poor psychological health. Methods: We studied 4485 community-based adults aged 25–65 years without a history of CVD from NHANES I (1971–75) who were monitored for CVD hospitalization and death until 1993. Those with ECG evidence of previous MI, left ventricular hypertrophy, and major ventricular conduction defects (QRS interval ≥ 120 ms) were excluded. Frontal T-axis was obtained through 12-lead ECG, and a deviation of ≥ 30° from normal (45°) was considered abnormal. Psychological well-being was measured with the General Well-Being Scale (GWB). Results: The mean ± SD age was 43.1 ± 11.5 years and 55% were women. The mean ± SD GWB score was 80.5 ± 17.3, the median frontal T-axis was 51°, and 13% had an abnormal T-axis. In cross-sectional analysis adjusting for age, sex, and race, a 1-SD decrease in GWB was associated with an OR of 1.12 for abnormal T-axis (p=0.01). This effect was unchanged after adjusting for systolic blood pressure, smoking, diabetes, total cholesterol, and BMI. Abnormal T-axis was associated with CVD hospitalization/death (adjusted HR 1.29, p=0.01), as was GWB (adjusted HR 1.104 per 1-SD decrease, p=0.01). When both factors were included in the model, the HR of GWB decreased by 8% to 1.096 (p=0.02). Conclusion: Abnormal frontal T-axis is modestly but significantly associated with reduced psychological wellness. Although this association may help understand neurocardiac relationships, it does not substantially explain morbidity and mortality associated with reduced psychological wellness.

Abstract P375: Vascular Age Versus Calendar Age as Surrogate for Atherosclerotic Burden and Cardiovascular Disease Risk

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Sanne A Peters ◽  
Karlijn A Groenewegen ◽  
Hester M den Ruijter ◽  
Michiel L Bots
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Intima Media Thickness ◽  
Chronological Age ◽  
Specific Reference ◽  
Communication Tool ◽  
Vascular Age

Background Vascular age is the chronological age of an individual adjusted by their level of atherosclerosis. Vascular age can be used as understandable communication tool towards patients. It has been proposed that carotid intima-media thickness (CIMT) could be used to estimate the vascular age in individuals. The issue on how to best estimate vascular age remains an unanswered question and was evaluated in this study. Methods Data were used from the USE-IMT study collaboration, a global individual patient data meta-analysis including 14 population-based cohorts contributing data for 45 828 individuals. We used two methods to define vascular age. First, vascular age was the age at which a participant’s CIMT value would be at the 50th percentile of the age-and sex specific reference values of the healthy USE-IMT subpopulation (VA50). Second, vascular age was the age at which the estimated cardiovascular risk equals the risk of the observed CIMT value (VArisk). Results Mean (+/- standard deviation [SD]) chronological age, VA50, and VArisk were 58 (9), 63 (19), and 59 (7) years, respectively. VArisk was 0.24 yrs higher in women and 1.5 yrs higher in men than chronological age whereas VA50 was 4.4 yrs higher in women and 5.8 yrs higher in men than chronological age. After adjustment for traditional cardiovascular risk factors, a SD increase in VA50 and VArisk was associated with a 15% (95% confidence interval [CI]: 1.12; 1.19) and 22% (95% CI: 1.17; 1.28) higher risk of cardiovascular disease. For comparison, a SD increase in mean common CIMT increased the risk of cardiovascular disease with 15% (95% CI: 1.12; 1.19). Conclusion We presented two distinct measures a vascular age: VA50, and VArisk. VA50 is a straightforward translation of CIMT and is a measure of the age at which the average person would be expected to have a certain CIMT. In contrast, VArisk incorporates information about expected cardiovascular risk and is the chronological age of a person that conveys the same risk as the CIMT. VA50 and VArisk might provide a convenient transformation of CIMT to a scale that is more easily understood by patients and clinicians.

scholarly journals Meta-analysis of cardiovascular disease risk markers in women with polycystic ovary syndrome

2011 ◽  
Vol 17 (6) ◽  
pp. 741-760 ◽  
Author(s):  
Konstantinos A. Toulis ◽  
Dimitrios G. Goulis ◽  
Gesthimani Mintziori ◽  
Evangelia Kintiraki ◽  
Evangelos Eukarpidis ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Polycystic Ovary Syndrome ◽  
Disease Risk ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Risk Markers ◽  
Ovary Syndrome

scholarly journals Treatment for lymphoma and late cardiovascular disease risk: A systematic review and meta‐analysis

2019 ◽  
Vol 2 (10) ◽  
Author(s):  
Chelsea R. Stone ◽  
Alexis T. Mickle ◽  
Devon J. Boyne ◽  
Aliya Mohamed ◽  
Doreen M. Rabi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk

scholarly journals Cardiovascular disease risk factors in chronic kidney disease: A systematic review and meta-analysis

PLoS ONE ◽  
2018 ◽  
Vol 13 (3) ◽  
pp. e0192895 ◽  
Author(s):  
Rupert W. Major ◽  
Mark R. I. Cheng ◽  
Robert A. Grant ◽  
Saran Shantikumar ◽  
Gang Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Cardiovascular Disease Risk Factors

The significance of DOHaD for Small Island Developing States

2018 ◽  
Vol 9 (5) ◽  
pp. 487-491 ◽  
Author(s):  
S. Tu’akoi ◽  
M. H. Vickers ◽  
K. Tairea ◽  
Y. Y. M. Aung ◽  
N. Tamarua-Herman ◽  
...  
Keyword(s):  
Early Life ◽  
Disease Risk ◽  
Communicable Disease ◽  
Adult Population ◽  
Well Being ◽  
Small Sample ◽  
Small Island ◽  
Sample Sizes ◽  
Small Island Developing States ◽  
The Impact

AbstractSmall Island Developing States (SIDS) are island nations that experience specific social, economic and environmental vulnerabilities associated with small populations, isolation and limited resources. Globally, SIDS exhibit exceptionally high rates of non-communicable disease (NCD) risk and incidence. Despite this, there is a lack of context-specific research within SIDS focused on life course approaches to NCD prevention, particularly the impact of the early-life environment on later disease risk as defined by the Developmental Origins of Health and Disease (DOHaD) framework. Given that globalization has contributed to significant nutritional transitions in these populations, the DOHaD paradigm is highly relevant. SIDS in the Pacific region have the highest rates of NCD risk and incidence globally. Transitions from traditional foods grown locally to reliance on importation of Western-style processed foods high in fat and sugar are common. The Cook Islands is one Pacific SIDS that reports this transition, alongside rising overweight/obesity rates, currently 91%/72%, in the adult population. However, research on early-life NCD prevention within this context, as in many low- and middle-income countries, is scarce. Although traditional research emphasizes the need for large sample sizes, this is rarely possible in the smaller SIDS. In these vulnerable, high priority countries, consideration should be given to utilizing ‘small’ sample sizes that encompass a high proportion of the total population. This may enable contextually relevant research, crucial to inform NCD prevention strategies that can contribute to improving health and well-being for these at-risk communities.

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