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Lookup NU author(s): Dr Mary Tacchi, Emeritus Professor Jan Scott
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© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons LtdBackground: Clinical staging models describe where an individual exists on a continuum from asymptomatic at-risk states (Stage 0) through to established late-stage disease (Stage 4). We applied this framework to systematically assess evidence for any associations between objectively assessed cardiorespiratory fitness (CRF) and stage of psychosis. Method: Nine electronic databases were searched for relevant publications from inception until October 31, 2019. Pooled effect sizes (Hedges’ g and 95% confidence intervals (95% CI)) were estimated for differences in CRF for studies that reported mean oxygen uptake (max, peak, or predicted VO2 in ml/kg/min). Results: Thirty-eight studies were eligible. Findings indicated that suboptimal CRF can be present at Stages 0 and 1. Meta-analyses of 22 studies demonstrated that CRF was significantly reduced in individuals classified between Stages 1 and 4 compared with matched or general population controls (g = −0.93; 95% CI −1.14, −0.71). Mean VO2 was decreased by 28% in Stage 4 compared with Stage 1 (34.1 vs. 24.66 ml/kg/min); the largest effect size for CRF reduction was reported between Stages 2 and 3 (g = −1.16; 95% CI −1.31, −1.03). Conclusions: Although not identifying direct causal links between clinical stage and CRF, using this framework may enhance understanding of co-associations between mental and physical health markers across the entire spectrum of psychosis. Limitations include lack of research on CRF in Stages 0 and 1 alongside problems determining stage in some studies. However, impaired CRF is reported in emerging psychosis, supporting calls that early intervention programmes should address both mental and physical wellbeing.
Author(s): Heggelund J, Vancampfort D, Tacchi MJ, Morken G, Scott J
Publication type: Review
Publication status: Published
Journal: Acta Psychiatrica Scandinavica
Year: 2019
Volume: 141
Issue: 3
Pages: 190-205
Print publication date: 24/02/2020
Online publication date: 23/10/2019
Acceptance date: 21/10/2019
ISSN (print): 0001-690X
ISSN (electronic): 1600-0447
Publisher: Blackwell Publishing Ltd
URL: https://doi.org/10.1111/acps.13119
DOI: 10.1111/acps.13119
PubMed id: 31646608
