Abstract
Abstract
Background
The health of people with schizophrenia is poor, leading to shortened lifespans. Sedentary behavior has recently been identified as an independent health risk in the general population. Because people with schizophrenia lead even more sedentary lives, their health is at even greater risk, likely compounding their already unhealthy lifestyle. The prevalence and pattern of sedentary behavior in schizophrenia, however, has not been determined. This study used ecological momentary assessment (EMA) data for an innovative purpose, to estimate activity levels in people with schizophrenia.
Methods
Behavior and activity of 100 patients with schizophrenia were compared to healthy controls (n=71) using ecological momentary assessment (EMA). EMA provides real-time, real-world monitoring of behavior through the use of electronic devices that prompt participants to provide information. For this study, behavior was sampled seven times daily for 7 days, with the frequent sampling allowing for quantification of productive vs. unproductive and active vs. inactive behaviors; and three different movement/postural patterns (standing/moving, recumbent, sitting).
Results
Patients were at home and inactive most of the day most days. For 64% of the surveys, the patients reported being home for the entire last hour, with this rate higher for patients in assisted living. Healthy controls were much less likely to be at home (28%). When patients were at home, the most prominent activities during waking hours were combinations of watching TV resting and sitting (60% of samples). At home recreational activities, which are performed while seated, accounted for 15% of the samples. Activities at home that involved standing (20%) or moving (10%) were much less commonly performed. Out of home activities that involved, treatment, leisure, or vocational activities were reported in 20% of the out of home surveys. These activities themselves were generally not physically active. In contrast, the healthy controls were engaged in activities that involved standing or moving 60% of the time.
Discussion
Patients are inactive 60% of their time during the day while at home and are not particularly active when away from home. None of the predominant activities appeared to confer health benefits alone or in combination. This pattern poses a significant health risk and allows for targeted interventions. Even in a unique sample of healthy controls for are available to participate in an EMA study, levels of physical activity were considerably greater.
