Abstract
Problematic lifestyle behaviors and high rates of physical illness are well documented in people with schizophrenia, contributing to premature mortality. Yet, there is a notable absence of research examining general lifestyle and health issues in participants at risk for psychosis. This form of research may help identify concerns that exist during prodromal periods related to future outcomes. Accordingly, the current study examined lifestyle and health in a nonclinical sample of 530 young adults with varying levels of schizotypy. Increasing symptom severity was associated with greater somatic symptoms and poorer sleep quality across positive, negative, and disorganized domains. Elevated negative and disorganized symptoms were associated with significantly reduced health-related quality of life, while evidence for reduced engagement in health behaviors was largely limited to those with elevated negative schizotypy. No relationships emerged between symptom presentation/severity and body mass index or substance use, although zero-order correlations suggested an association between disorganized schizotypy and nicotine use. The pattern of relationships in the current study was consistent with findings from the ultra-high risk and clinical literature suggesting that lifestyle and health concerns may exist on a continuum with psychosis. Future research should seek to clarify if these patterns are associated with long-term physical or mental health outcomes.
Highlights
Individuals diagnosed with schizophrenia tend to have higher rates of obesity, physical illness, and premature mortality when compared to the general public [1,2,3,4,5]
There is accumulating evidence suggesting that a number of physical health issues [16,17] and lifestyle concerns [18,19,20,21,22] exist prior to the development of clinically significant symptoms or prolonged treatments
Information relating to lifestyle and physical health is inconsistently collected in those at-risk for psychosis contributing to considerable gaps in our collective knowledge [23]
Summary
Individuals diagnosed with schizophrenia tend to have higher rates of obesity, physical illness, and premature mortality when compared to the general public [1,2,3,4,5]. Functional disruptions caused by symptoms and/or the side effects of antipsychotic medications may contribute to the deterioration of physical health These issues are compounded by lifestyle behaviors including unhealthy patterns of eating, low levels of physical activity, and high rates of smoking [10,11,12,13,14,15]. The existing literature examining sleep disturbance and risk for psychosis is relatively circumscribed, focusing on issues of sleep and clinical symptoms without integration of other lifestyle/health indicators These findings suggest that health-related concerns may exist prior to diagnosis/treatment of psychosis and may be relevant to understanding prospective mental and physical health outcomes. Based on the associated literature, we anticipated that higher levels of schizotypy would be associated with poorer health behaviors (e.g., reduced activity, increased smoking and substance use, poorer sleep quality) and indications of poor physical health (physical symptoms; health-related quality of life). Evidence for differential health and lifestyle patterns could have potential implications for existing risk-assessment protocols, etiological models of psychosis, as well as the consideration of preventative care strategies for those at-risk
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