Evaluation of Physical Activity, Physical Fitness, and Quality of Life in Patients With Schizophrenia
Condition: Schizophrenia
MeSH terms: Schizophrenia
Study type: Observational

Summary: 
      The aim of this study is to evaluate schizophrenic patients who benefit from community mental
      health center services in terms of physical activity, physical fitness, and quality of life.
    

Detailed description: 
      Mental health is defined (according to the World Health Organization) as a state of
      well-being in which a person can realize his/her abilities, coping with the normal stresses
      of life, and supporting society by working efficiently and productively. In other words,
      mental health is a dynamic internal balance that enables individuals to use their diversity
      of skills in harmony with the universal values of the society. For example, it is the
      flexibility and ability to cope with negative life experiences and social functioning and the
      harmonious connection between body and mind. To be more concrete, mental health includes
      different components of life, for example in terms of relationships, good relationships with
      friends and family, the ability to talk about feelings. Examples of leisure activities
      include taking up a hobby, exercising regularly, and routinely taking vacations. It is also
      important to maintain a lifestyle that consists of having a nutritious and regular diet, not
      smoking and using over-the-counter drugs, and achieving at least some goals in life.

      Mental disorders involve a wide variety of problems. Mental disorders are often characterized
      by a combination of abnormal thoughts, behaviors, emotions, and relationships with other
      people. Mental disorders include: depression, drug use disorders, mental disabilities,
      bipolar disorder and schizophrenia.

      Schizophrenia is a chronic mental disorder characterized by the appearance of both positive
      symptoms such as hallucinations and delusions and negative symptoms such as apathy and
      withdrawal, repetition of cognitive skills and disorganization. The number of schizophrenic
      patients in the world is approximately 20 million and this number will continue to increase
      every year. According to a systematic review of general population studies, the lifetime
      median prevalence of schizophrenia in Turkey was found to be 8.9 per 1000 people. In
      addition, schizophrenia patients have irregular self-esteem, inability to maintain social
      relationships, deterioration in cognitive skills, and sedentary behaviors in their daily
      lives. Sedentary behavior in patients with schizophrenia will increase the risks of
      cardiovascular and obstructive pulmonary disease, diabetes mellitus (especially type 2),
      cancer that can contribute greatly to death and disability. Therefore, it was found that
      patients with schizophrenia have a shorter life expectancy of 10-20 years compared to the
      general population.

      It has been found that people with schizophrenia are less physically active and less
      physically fit than the general population. Physical activity means any bodily movement
      produced by skeletal muscles that results in energy expenditure. Exercise is a subset of
      physical activity, which is planned, structured and repetitive bodily movements performed to
      increase and maintain one or more aspects of physical fitness. Physical fitness can be
      defined as a set of independent qualities associated with the ability to perform physical
      activities. Components such as cardiorespiratory fitness, muscle strength, muscular endurance
      and flexibility are more related to health, while components such as coordination and
      whole-body balance are more related to the performance of physical activities.

      There is an inverse relationship between sedentary behavior (related to time spent lying or
      sitting) and physical activity level in patients with schizophrenia. In addition, physical
      activity has a direct relationship with physical fitness and physical health in patients with
      schizophrenia. In addition, one study showed that poor physical activity level and poor
      physical fitness had a negative effect on the ability of schizophrenia participants to
      perform activities of daily living performance causes a decrease in the quality of life in
      these patients. According to the World Health Organization, quality of life is defined as
      individuals' perceptions of their position in life in the context of the value systems and
      culture in which they live and in relation to their goals, expectations, standards and
      concerns. Quality of life is a subjective, multidimensional term defined as a standard level
      for physical, emotional, material and social well-being.

      Community Mental Health Centers are State institutions that provide treatment and
      rehabilitation services to patients with certain mental health diseases outside the hospital
      and within the scope of State Hospitals. Community Mental Health Centers (CMHC) were opened
      in 2011 by the Ministry of Health in Turkey. Patients diagnosed with serious chronic mental
      disorders such as depression, drug use-related disorders, mental disabilities, bipolar
      disorder and especially schizophrenia are treated. The aim of these centers is to improve
      functional recovery, physical activity level and quality of life and integrate it into daily
      life, society and business life. It consists of a very comprehensive team of different
      professionals, such as physicians, psychologists, social workers, and nurses.

      Schizophrenic patients are treated in a community mental health center with a comprehensive
      treatment program. The content of the comprehensive rehabilitation program in community
      mental health centers includes: Psychosocial skills training / occupational treatments such
      as painting, music, and also these are done according to the patient's condition /
      psycho-education for patients and their families (information about the disease and
      treatment, methods of coping with symptoms are explained) training is provided on issues such
      as illness, crisis management of patients and their relatives), social skills training
      (patients who cannot participate in social life due to their illness are given training to
      gain the ability to reorganize human relations) and group treatment is provided for suitable
      patients.

      Evaluation of physical activity levels, physical fitness, and quality of life of patients
      with schizophrenia is essential to confirm the effectiveness of treatments and care
      activities at CMHCs and to plan new therapeutic and rehabilitative activities. In one study,
      they found that the level of physical activity - physical fitness has a positive effect on
      psychiatric services and can improve the physical health outcomes of people with
      schizophrenia. They also reveal improvement in psychological and social outcomes in these
      patients. Therefore, physical activity level and physical fitness are critical parameters of
      the biopsychosocial approach in recovery-oriented mental health services. In conclusion, our
      study aims to decide on physical activity, physical fitness and quality of life levels among
      a group of patients with schizophrenia treated at CMHC and to evaluate the relationship
      between these three important treatment parameters.

      The aim of this study is to evaluate schizophrenic patients who benefit from community mental
      health center services in terms of physical activity, physical fitness and quality of life.
      Therefore, given the importance of our study, our findings may contribute to the literature
      and improvement for mental health systems for people with psychotic disorders, especially
      schizophrenia. As a result of this study, an evaluation can be made in terms of physical
      activity, physical fitness and quality of life in schizophrenic patients who receive service
      from a community mental health center. According to this study, it will be possible to
      contribute to the effectiveness of treatments and care activities in CMHCs for patients with
      schizophrenia.
    

Intervention name(s): Diagnose
Intervention type(s): Diagnostic Test
Intervention description(s): First, the participants will be asked to fill out a structured questionnaire containing their sociodemographic characteristics. Then, the 2-minute walk test, the International physical activity questionnaire, the SF-36 short form, and the World health organization quality of life questionnaire will be applied respectively.
Observational model: Case-Only
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        It is planned to include 20 healthy individuals diagnosed with schizophrenia and 20 healthy
        individuals in the study.
      
Keywords: Schizophrenia; Physical Activity; Physical fitness; Quality of life