Risk of Lifestyle Diseases for Patients With Schizophrenia

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Improving physical activity levels and eating habits could help patients with schizophrenia.

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A Polish study seeking to understand the potential association between lifestyle choices and schizophrenia observed a significant relationship between reported habits and severity of schizophrenia symptoms. According to researchers, patients with schizophrenia who eat poorly, have insufficient physical activity, and use nicotine are at increased risk for lifestyle diseases, such as hypertension, obesity, and type 2 diabetes.¹

From 2011 to 2016, the study enrolled 106 participants with schizophrenia, 42 male and 64 female, aged 18 to 69 years. Many of these patients were recruited from inpatient and outpatient psychiatric facilities and wards at the Department of Psychiatry of the Pomeranian Medical University in Szczecin (Poland). Patients were evaluated using the Positive and Negative Syndrome Scale (PANSS), and completed a survey that gathered additional information, like their illness duration, selected eating habits, sweet beverage consumption, nicotine use, and physical activity in the last 3 months.

Increased physical activity was correlated with a reduced total PANSS score, improved negative and general symptomatology, and improvement of the lipid profile and blood glucose levels. Participants’ physical activity was gauged using a 3-point scale: 1 for low physical activity (sedentary), 2 for moderate activity (physical for daily routines), and 3 for intense activity (physical activity at least 3 times per week for more than 30 minutes). The study did not seek to cause any lifestyle-changing interventions, and patients did not receive lifestyle education at any time during the study’s duration. However, patients were allowed to view their laboratory test results and were free to consult a general practitioner or psychiatrist.

Significant adverse effects of smoking on metabolic parameters were observed, particularly on the lipid profile values; however, there is also evidence that smokers had significantly lower PANSS scores within the negative symptoms. This may be related to the relationship between smoking and the use of antipsychotics.

Researchers also noted an interesting development; while lifestyle education was not offered, many patients changed their behavior after completing the questionnaires. Positive change was noted in the number of cigarettes smoked per day, consumed coffee and sodas, and especially intake of sugar and sweets. Male participants especially were observed to consume significantly higher amounts of sweets and sweet beverages than their female counterparts, but many cut back on sweets and sodas after their follow-up.

There are clear benefits to providing educational interventions on physical activity and proper eating habits to patients with schizophrenia, especially since, “physical activity and exercise are now recognized as fundamental tools for reducing the impact of chronic diseases…”² Both mental and physical outcomes could be improved for these patients.

References

1. Kalinowska S, Trześniowska-Drukała B, Kloda K, Safranow K, et al. The association between lifestyle choices and schizophrenia symptoms. J Clin Med. 2021;10(1):165.

2. Belvederi Murri M, Ekkekakis P. Can exercise decrease mortality risk in patients with depression? Psychiatric Times. 2020;37(11).