Activity participation and perceived health status in patients with severe mental illness: a prospective study
Open accessAbstract
Objective: To examine associations between severe mental illness (SMI), general health symptoms, mental wellbeing, and different activity levels in patients with SMI.Method: Consecutive patients with SMI referred for occupational therapy were prospectively included.Their hours of activities per day during hospital stay were recorded as <1 hour, 1-3 hours, and >3 hours in three categories: basic self-care activities, interest-based activities, and role-specific activities.Patients were free to join or decline any activities.Patients' somatic and mental health were measured at admission, discharge, and 1 month after discharge using the Brief Psychiatric Rating Scale (BPRS), Patient Health Questionnaire-15 (PHQ-15), Pittsburgh Sleep Quality Index (PSQI), Chinese version of Short Warwick Edinburgh Mental Wellbeing Scale (C-SWEMWBS), and Chinese version of General Activity Motivation Measure (GAMM).Results: 84 patients (35 men and 49 women) aged 16 to 63 years were assessed at the three timepoints.The mean length of hospital stay of current admission was 74.73 days.The most common diagnosis was schizophrenia (n=35), followed by depression (n=15), psychosis (n=14), bipolar affective disorder (n=10), others (n=8), and delusional disorder (n=2).The hours of activities per day was <1 hour in 32 (38.1%) patients, 1-3 hours in 34 (40%) patients, and >3 hours in 18 (21.2%)patients.Improvement in somatic and mental health was positively associated with hours of activities per day.Activities were associated with reduced psychiatric symptoms (measured by BPRS) at discharge (Z = 5.978, p < 0.01).Activities were associated with less somatic complaints (measured by PHQ-15) [χ 2 .=23.478, p < 0.01], better sleep quality (measured by PSQI) [χ 2 = 14.762, p < 0.01].The BPRS score for psychiatric symptoms at discharge was inversely associated with C-SWEMWBS score for mental wellbeing (r = -0.233,p = 0.033) and C-GAMM score for activity motivation (r = -0.258,p = 0.018).Basic self-care activities were a predictor for psychiatric symptoms (measured by BPRS) at discharge (adjusted R 2 = 0.091, F = 8.496, p = 0.005), whereas a combined group of badminton and Tai Chi was a predictor for general activity motivation (measured by GAMM) at 1 month after discharge (adjusted R 2 = 0.047, F = 4.697, p < 0.05), and soccer alone was a predictor for somatic health (measured by PHQ-15) at 1 month after discharge (adjusted R 2 = 0.06, F = 5.784, p < 0.05).Conclusion: Participating in activities of patients' own choice and interests is positively associated with patients' psychiatric and somatic health and subjective wellbeing.Outdoor soccer has added effect on patients' somatic health.The beneficial effects are maintained at 1 month after discharge.Daily participation of activity meaningful to patients can be a non-pharmacological treatment for patients with SMI to improve somatic and mental health.
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Similar results were found in recent published studies and a relationship was found between exercise interventions and healthy lifestyles acquisition.
“Similar results were found in recent published studies72–74 and additionally, was found a relationship between exercise interventions and healthy lifestyles acquisition74”
From Occupational therapy interventions for adults with severe mental illness: a scoping review (2021) · cites this paper as [72]
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- Authors
- Ng, S. S., Leung, T. K., Ng, P. P., Ng, R. K., & Wong, A. T.
- Affiliations
- Hospital Authority (HK)
- ORCID
- Ng, Serena SW
- Venue
- East Asian Archives of Psychiatry
- Publisher
- Hong Kong Academy of Medicine Press
- Published
- 2020-12-22
- Volume
- 30
- Issue
- 4
- Pages
- 95-100
- ISSN
- 2078-9947 (ISSN-L)
- OpenAlex
- W3113830407
- Cited by
- 9
- References
- 18
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 1
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- East Asian Archives of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Occupational Therapy › Occupational Therapy Practice and Research
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- severe mental illness, activities and participation, health perception, psychological well-being, activity motivation, occupational therapy, psychiatric hospitalization, schizophrenia, somatic symptoms, sleep quality, psychiatric symptoms, hospital discharge outcomes, self-care, community reintegration, psychosocial rehabilitation
- MeSH terms
- Adolescent, Adult, Mental Disorders, Female, Health Status, Hobbies, Humans, Length of Stay, Male, Mental Health, Middle Aged, Prospective Studies, Psychiatric Status Rating Scales, Self Care, Social Behavior, Young Adult
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