中低強度運動對服用Clozapine之肥胖精神分裂症病患身體組成、血脂肪、精神症狀與憂鬱程度的影響

Abstract

Metabolic syndrome is a serious side effect of many atypical antipsychotic medications, yet successful strategies for significant weight loss are lacking. The purpose of this study was to assess the effects of exercise intervention on body composition, blood lipid profile, psychotic symptoms and depression status in schizophrenia with clozapine-therapy. Thirty-three schizophrenia patients with clozapine-therapy over 3 months in Yuli-hospital were included (Body Mass Index＞24 Kg/㎡, age＜60 yrs). They are divided into exercise and control group. Twenty-eight patients (14 in control and 14 in exercise group) finished the program. The exercise program is stepper training 30-60 minutes per section, 3 sections a week, total 12 weeks. Pre-test data reveal that male patient had better satisfaction on body figure than female; the prevalence of metabolic syndrome and depression disorder are higher than common population. After exercise intervention, exercise group had significant improvement on BMI, hip circumference, waist circumference or the items of sleeping behavior change and loss of sexual interesting in the Beck Depression Inventory-Second Edition. Compared with control group, the exercise group shows improvement on body weight, BMI, waist circumference, body fat, depression and suspiciousness in Brief Psychiatric Rating Scale. However the blood biochemical laboratory data did not had significant difference after training. The exercise duration reveals negative moderate correlation with Waist-Hip-Ratio change and positive moderate correlation with high density lipoprotein change. There is positive moderate correlation between the change of snacks times per day and low density lipoprotein change. According the result, we conclude that: The 12-week exercise training program contributes to the improvement of body composition, psychotic symptoms, and severity of depression. The amount and duration of exercise, diet amount reveal moderate correlation with body composition and some items of blood biochemical value. But the exercise intervention reveals no significant effect on blood biochemical value. For further study, we suggest increasing the sample’s diversity, random grouping, and excluding the patient with diabetes mellitus or hyperlipidemia history to lower the study bios. Additionally, we also suggest prolonging the exercise duration and follow-up period for more definitive result.