Abstract
BackgroundPhysical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness.MethodsThe five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Patients with a DSM or ICD mental illness diagnoses were recruited and completed the SIMPAQ on two occasions, one week apart. Participants wore an Actigraph accelerometer and completed brief cognitive and clinical assessments.ResultsEvidence of SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1010 participants. The SIMPAQ had good test-retest reliability. Correlations for moderate-vigorous physical activity was comparable to studies conducted in general population samples. Evidence of validity for the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had stronger evidence of validity. This alternative method is recommended for use in future studies employing the SIMPAQ.ConclusionsThe SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals.
Highlights
Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness
In order to ensure the accurate assessment of physical activity across people with mental illness, we developed a self-report, physical activity measurement tool, designed to be administered via interview
In a large diverse sample of psychiatric patients, ascertained across a variety of treatment settings and including a range of psychiatric diagnoses, with substantial representation from low- and middle- income countries, we found that the Simple Physical Activity Questionnaire (SIMPAQ) was a reliable tool for assessing physical activity and sedentary behaviour
Summary
Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. People with mental disorders experience high rates of comorbid chronic physical diseases including diabetes, obesity, and cardiovascular disease, contributing to an increased mortality risk, regardless of psychiatric diagnosis [1, 2]. A 2019 Lancet Psychiatry Commission on protecting the physical health of people with mental illness recommended that physical activity be incorporated as part of routine psychiatric care regardless of diagnosis and across all treatment settings [7]. In addition to the established physical health benefits, physical activity can have both preventive and treatment effects on psychiatric symptomatology for people experiencing a range of mental disorders, including depression [8,9,10], anxiety disorders [11] and psychosis [12]. Despite numerous calls for physical activity to be recognised as an integral component of routine psychiatric care [16], including recognition in the recent WHO guidelines [17], access to programs and integration within mental health services remains ad-hoc in many jurisdictions, with limited funding or resources available for implementation in routine clinical care [18]
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