How much physical activity do people with schizophrenia engage in? A systematic review, comparative meta-analysis and meta-regression
Open accessAbstract
Objective Physical activity (PA) improves health outcomes in people with schizophrenia. It is unclear how much PA people with schizophrenia undertake and what influences PA participation. We conducted a meta-analysis to investigate PA levels and predictors in people with schizophrenia.Method Major databases were searched from inception till 02/2016 for articles measuring PA (self-report questionnaire (SRQ) or objective measure (e.g. accelerometer)) in people with schizophrenia, including first episode psychosis (FEP). A random effects meta-analysis and meta-regression analysis were conducted.Results 35 studies representing 3453 individuals with schizophrenia (40.0years; 64.0% male) were included. Engagement in light PA was 80.44min (95% CI 68.32-92.52, n=2658), 47.1min moderate-vigorous PA (95% CI 31.5-62.8, n=559) and 1.05min (95% CI 0.48-1.62, n=2533) vigorous PA per day. People with schizophrenia engaged in significantly less moderate (hedges g=-0.45, 95% CI -0.79 to -0.1, p=0.01) and vigorous PA (g=-0.4, 95% CI -0.60 to -0.18) versus controls. Higher light to moderate, but lower vigorous PA levels were observed in outpatients and in studies utilizing objective measures versus SRQ. 56.6% (95% CI 45.8-66.8, studies=12) met the recommended 150min of moderate physical activity per week. Depressive symptoms and older age were associated with less vigorous PA in meta-regression analyses.Conclusions Our data confirm that people with schizophrenia engage in significantly less moderate and vigorous PA versus controls. Interventions aiming to increase PA, regardless of intensity are indicated for people with schizophrenia, while specifically increasing moderate-vigorous PA should be a priority given the established health benefits.
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People with major depressive disorder, bipolar disorder and schizophrenia have been found to be more sedentary than controls.
“although people with major depressive disorder, bipolar disorder and schizophrenia have been found to be more sedentary and less physically active than controls 21-24”
From Sedentary behavior and physical activity levels in people with schizophrenia, bipolar disorder and major depressive disorder: a global systematic review and meta-analysis (2017) · cites this paper as [24]
The indexed copy appears to be a paper on peer-support interventions, not the cited schizophrenia activity review: it lists the cited review in its References (p. 17). Searches for sedentary behaviour and comparisons with controls found no passage establishing the claim for major depressive disorder, bipolar disorder, or schizophrenia. (LLM, conf=0.78)
Experimental — accuracy not yet measuredPeople with major depressive disorder, bipolar disorder and schizophrenia have been found to be less physically active than controls.
“although people with major depressive disorder, bipolar disorder and schizophrenia have been found to be more sedentary and less physically active than controls 21-24”
From Sedentary behavior and physical activity levels in people with schizophrenia, bipolar disorder and major depressive disorder: a global systematic review and meta-analysis (2017) · cites this paper as [24]
The Introduction (p. 4) discusses physical health and activity interventions in serious mental illness, but does not compare activity levels with controls. Searches for lower physical activity and greater sedentary time found no such comparison for major depressive disorder, bipolar disorder, or schizophrenia in our copy. The copy lists the cited paper in its References (p. 17), but that listing does not establish the claim. (LLM, conf=0.73)
Experimental — accuracy not yet measuredSchizophrenia patients tend to be more sedentary than healthy controls.
“Given the fact that schizophrenia patients tended to be more sedentary than healthy controls [186]”
From Comparative Effectiveness of Multiple Exercise Interventions in the Treatment of Mental Health Disorders: A Systematic Review and Network Meta-Analysis (2022) · cites this paper as [186]
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Self-citationSchuch, F., Vancampfort, D., Firth, J., Rosenbaum, S., Ward, P., Reichert, T., Bagatini, N. C., Bgeginski, R., & Stubbs, B. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.10.050 · Cited by 663 · see citing works
Self-citationFirth, J., Rosenbaum, S., Stubbs, B., Gorczynski, P., Yung, A. R., & Vancampfort, D. (2016) · Psychological Medicine · doi:10.1017/s0033291716001732 · Cited by 577 · see citing works
Self-citationCardiovascular disease in patients with severe mental illness
Nielsen, R. E., Banner, J., & Jensen, S. E. (2021) · Nature Reviews Cardiology · doi:10.1038/s41569-020-00463-7 · Cited by 389 · see citing works
Pillinger, T., Osimo, E. F., Brugger, S., Mondelli, V., McCutcheon, R. A., & Howes, O. D. (2019) · Schizophrenia Bulletin · doi:10.1093/schbul/sby160 · Cited by 190 · see citing works
Quality of life in schizophrenia: a meta-analysis of comparative studies.
Dong, M., Lu, L., Zhang, L., Zhang, Y.-S., Ng, C. H., Ungvari, G. S., Li, G., Meng, X., Wang, G., & Xiang, Y.-T. (2019) · Psychiatric Quarterly · doi:10.1007/s11126-019-09633-4 · Cited by 142 · see citing works
Stubbs, B., Vancampfort, D., Firth, J., Schuch, F. B., Hallgren, M., Smith, L., Gardner, B., Kahl, K. G., Veronese, N., Solmi, M., et al. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.12.104 · Cited by 138 · see citing works
Stubbs, B., Koyanagi, A., Schuch, F. B., Firth, J., Rosenbaum, S., Veronese, N., Solmi, M., Mugisha, J., & Vancampfort, D. (2016) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12654 · Cited by 128 · see citing works
Self-citationThe pro‐cognitive mechanisms of physical exercise in people with schizophrenia
Firth, J., Cotter, J., Carney, R., & Yung, A. R. (2017) · British Journal of Pharmacology · doi:10.1111/bph.13772 · Cited by 79 · see citing works
Self-citationYu, Q., Wong, K.-K., Lei, O.-K., Nie, J., Shi, Q., Zou, L., & Kong, Z. (2022) · Sports Medicine - Open · doi:10.1186/s40798-022-00529-5 · Cited by 80 · see citing works
Brokmeier, L. L., Firth, J., Vancampfort, D., Smith, L., Deenik, J., Rosenbaum, S., Stubbs, B., & Schuch, F. B. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2019.112675 · Cited by 56 · see citing works
Self-citationConn, A., Bourke, N., James, C., & Haracz, K. (2019) · Australian Occupational Therapy Journal · doi:10.1111/1440-1630.12575 · Cited by 21 · see citing works
Schulze, T., Hahn, E., Hahne, I., Bergmann, N., Fuchs, L. M., Mähler, F., Zierhut, M. M., Ta, T. M. T., Pijnenborg, G. H. M., & Böge, K. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.715670 · Cited by 17 · see citing works
- Authors
- Stubbs, B., Firth, J., Berry, A., Schuch, F. B., Rosenbaum, S., Gaughran, F., Veronesse, N., Williams, J., Craig, T., Yung, A. R., & Vancampfort, D.
- Affiliations
- National Health Service (GB)
- University of Manchester (GB)
- Universidade Federal do Rio Grande do Sul (BR)
- UNSW Sydney (AU)
- King's College London (GB)
- University of Padua (IT)
- KU Leuven (BE)
- Corresponding author
- Stubbs, Brendon
- ORCID
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2016-10
- Volume
- 176
- Issue
- 2-3
- Pages
- 431-440
- ISSN
- 0920-9964 (ISSN-L)
- OpenAlex
- W2410943997
- Cited by
- 379
- References
- 73
- Citations by year
- 2026: 13 · 2025: 30 · 2024: 32 · 2023: 46 · 2022: 23 · 2021: 36 · 2020: 41 · 2019: 39 · 2018: 59 · 2017: 51 · 2016: 9
- FWCI
- 6.12
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- cc-by-nc-nd
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by-nc-nd)
- Lirias (submittedVersion, other-oa)
- Research Explorer (The University of Manchester) (submittedVersion, other-oa)
- Funders
- Medical Research Council (1789937)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Life-span and Life-course Studies › Sports and Physical Education Studies
- Keywords
- physical activity, schizophrenia
- MeSH terms
- Humans, Regression Analysis, Schizophrenia, Exercise
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