Exploring the Relationship Between Movement Disorders and Physical Activity in Patients With Schizophrenia: An Actigraphy Study

Lydia E Pieters; Jeroen Deenik; Diederik E Tenback; Jasper van Oort; Peter N van Harten

doi:10.1093/schbul/sbab028

Exploring the Relationship Between Movement Disorders and Physical Activity in Patients With Schizophrenia: An Actigraphy Study

Schizophr Bull. 2021 Jul 8;47(4):906-914. doi: 10.1093/schbul/sbab028.

Authors

Lydia E Pieters^{1

2}, Jeroen Deenik^{1

2}, Diederik E Tenback³, Jasper van Oort^{4

5}, Peter N van Harten^{1

2}

Affiliations

¹ Research Department, Psychiatric Centre GGz Centraal, Innova, Amersfoort, The Netherlands.
² Faculty of Health Medicine and Life Sciences, Department of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
³ Centre for Transcultural Psychiatry Veldzicht, Balkbrug, The Netherlands.
⁴ Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands.
⁵ Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands.

Abstract

Low physical activity (PA) and sedentary behavior (SB) are major contributors to mental health burden and increased somatic comorbidity and mortality in people with schizophrenia and related psychoses. Movement disorders are highly prevalent in schizophrenia populations and are related to impaired functioning and poor clinical outcome. However, the relationship between movement disorders and PA and SB has remained largely unexplored. Therefore, we aimed to examine the relationship between movement disorders (akathisia, dyskinesia, dystonia, and parkinsonism) and PA and SB in 216 patients with schizophrenia and related psychoses. Actigraphy, the St. Hans Rating Scale for extrapyramidal syndromes, and psychopathological ratings (PANSS-r) were applied. Data were analyzed using multiple linear regression, adjusting for sex, age, negative symptoms, and defined daily dose of prescribed antipsychotics. Parkinsonism was significantly associated with decreased PA (β = -0.21, P < .01) and increased SB (β = 0.26, P < .001). For dystonia, only the relationship with SB was significant (β = 0.15, P < .05). Akathisia was associated with more PA (β = 0.14, P < .05) and less SB (β = -0.15, P < .05). For dyskinesia, the relationships were non-significant. In a prediction model, akathisia, dystonia, parkinsonism and age significantly predicted PA (F(5,209) = 16.6, P < .001, R2Adjusted = 0.27) and SB (F(4,210) = 13.4, P < .001, R2Adjusted = 0.19). These findings suggest that movement disorders, in particular parkinsonism, are associated with reduced PA and increased SB in patients with psychotic disorders. Future studies should take movement disorders into account when examining PA and SB, to establish the clinical value of movement disorders in activating people with psychotic disorders to improve their mental and somatic health.

Keywords: behavior; extrapyramidal symptoms; parkinsonism; psychosis; sedentary; somatic health.

MeSH terms

Actigraphy
Adult
Aged
Exercise*
Female
Humans
Male
Middle Aged
Movement Disorders / epidemiology*
Schizophrenia / epidemiology*
Schizophrenia / therapy*
Sedentary Behavior