運動介入管理對體重過重精神分裂住院病人體重之影響

Effectiveness of Exercise Intervention for Overweight Patients with Schizophrenia

馮煥光(Huan-Kwang Ferng) ； 李嘉富(Jia-Fu Lee) ； 王果行(Guoo-Shyng W. Hsu) ； 高森永(Sen-Yeong Kao) ； 高百源(Pai-Yuan Kao) ； 陳中(Chung Chen)

《台灣精神醫學》 21卷4期 (2007/12) Pp. 282-290

https://doi.org/10.29478/TJP.200712.0006

摘要

Objective: One of the common side effects of antipsychotic medication is weight gain, with serious implications for a patient's health and well being. The purpose of this study is to evaluate the effectiveness of exercise for weight loss and improvement of hyperglycemia and/or hyperlipidemia in schizophrenic patients taking antipsychotic medications. Method: Fifty-one subjects with schizophrenia disorder (DSM-IV) who had been treated with antipsychotic drugs for at least 10 weeks with a 13MT＞24.9 kg/m^2 were recruited for this study. Subjects were assigned to a control group (26 out of 51) or an experimental group (25 out of 5l). Twelve weeks of exercise was given as intervention to the experimental group while the control group continued receiving only regular clinical care. Anthropometric measurements were taken. Body composition, blood biochemistry values and 24-hour dietary records were made. Results: There was no significant difference in calorie and macronutrient intake between the experimental and the control group. Compared with controls, weight loss (+1.72±3.0 vs.-0.86±2.8 kg, P＜0.05) and decreasing body mass index (+0.61+1.1 vs. -0.35±1.0, P＜0.05) were greater in the experimental group. However, exercise did not improve the subjects' fasting blood sugar and plasma lipid concentration. Conclusion: A major observation useful for patient education is that overweight schizophrenic patients (aged 40-65 years, body mass index (BMT) 25-35 kg m^2) with mild- to-moderate lipid abnormalities who eat about 2,000 kcal/day, without regular exercise may continue to gain weight at a rate of nearly I kg monthly. If exercise is to be recommended for individuals with schizophrenia, the optimal intensity and duration of exercise needs to be identified. Weight loss may be difficult, but it is not impossible for schizophrenic patients.

關鍵字

肥胖 ； 精神分裂症 ； 運動介入 ； 有氧運動

並列摘要

Objective: One of the common side effects of antipsychotic medication is weight gain, with serious implications for a patient's health and well being. The purpose of this study is to evaluate the effectiveness of exercise for weight loss and improvement of hyperglycemia and/or hyperlipidemia in schizophrenic patients taking antipsychotic medications. Method: Fifty-one subjects with schizophrenia disorder (DSM-IV) who had been treated with antipsychotic drugs for at least 10 weeks with a 13MT＞24.9 kg/m^2 were recruited for this study. Subjects were assigned to a control group (26 out of 51) or an experimental group (25 out of 5l). Twelve weeks of exercise was given as intervention to the experimental group while the control group continued receiving only regular clinical care. Anthropometric measurements were taken. Body composition, blood biochemistry values and 24-hour dietary records were made. Results: There was no significant difference in calorie and macronutrient intake between the experimental and the control group. Compared with controls, weight loss (+1.72±3.0 vs.-0.86±2.8 kg, P＜0.05) and decreasing body mass index (+0.61+1.1 vs. -0.35±1.0, P＜0.05) were greater in the experimental group. However, exercise did not improve the subjects' fasting blood sugar and plasma lipid concentration. Conclusion: A major observation useful for patient education is that overweight schizophrenic patients (aged 40-65 years, body mass index (BMT) 25-35 kg m^2) with mild- to-moderate lipid abnormalities who eat about 2,000 kcal/day, without regular exercise may continue to gain weight at a rate of nearly I kg monthly. If exercise is to be recommended for individuals with schizophrenia, the optimal intensity and duration of exercise needs to be identified. Weight loss may be difficult, but it is not impossible for schizophrenic patients.

並列關鍵字

obesity ； schizophrenia ； exercise intervention ； aerobic exercise

參考文獻

Allison DB,Fontaine KR,Heo M(1999).The distribution of body mass index among individuals with and without schizophrenia.J Clin Psychiatry.60,215-220.

Czobor P,Volavka J,Sheitman B(2002).Anti-psychotic-induced weight gain and therapeutic response: a differential association.J Clin Psychopharmacol.22,244-251.

Rippe JM,Crossley S,Ringer R(1998).Obesity as a chronic disease: Modern medical and lifestyle management.J Am Diet Assoc.98(suppl 2),9-15.

孔繁鐘、孔繁錦(1999)。精神疾病診斷準則手冊。台北市:合記圖書出版社。

Allison DB,Mentore JL,Heo M(1999).Antipsychotic-induced weight gain: a comprehensive research synthesis.Am J Psychiatry.156,1686-1696.