Browsing by Author "Hallgren, Mats"

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Correlates of physical activity among community-dwelling individuals aged 65 years or older with anxiety in six low- and middle-income countries
(Cambridge University Press: International Psychogeriatrics, 2017-11-08) Vancampfort, Davy; Stubbs, Brendon; Hallgren, Mats; Veronese, Nicola; Mugisha, James; Probst, Michel; Koyanagi, Ai
Given the important health benefits of physical activity (PA) and the higher risk for physical inactivity in people with anxiety, and the high prevalence of anxiety and low PA among the elderly, there is a need for research to investigate what factors influence PA participation among anxious older individuals. We investigated PA correlates among community-dwelling adults aged ≥ 65 years with anxiety symptoms in six low- and middle-income countries. Methods: Cross-sectional data from the World Health Organization's Study on Global Ageing and Adult Health were analyzed. PA level was assessed by the Global Physical Activity Questionnaire. 980 participants with anxiety (mean age 73.3 years; 62.4% females) were grouped into those who do and do not (low PA) meet the 150 minutes of moderate-to-vigorous PA per week recommendation. Associations between PA and the correlates were examined using multivariable logistic regressions. Results: The prevalence of low PA was 44.9% (95% CI = 39.2–50.7%). Older age, male gender, less consumption of alcohol, mild cognitive impairment, pain, a wide range of somatic co-morbidities, slow gait, weak grip strength, poor self-rated health, and lower levels of social cohesion were identified as significant positive correlates of low PA. Conclusions: Our data illustrate that a number of sociodemographic and health factors are associated with PA levels among older people with symptoms of anxiety. The promotion of social cohesion may increase the efficacy of public health initiatives, while from a clinical perspective, somatic co-morbidities, cognitive impairment, pain, muscle strength, and slow gait need to be considered.
Correlates of physical activity among middle-aged and older adults with hazardous drinking habits in six low- and middle-income countries
(Kinetic: Aging and Physical Activity, 2017) Vancampfort, Davy; Stubbs, Brendon; Hallgren, Mats; Lundin, Andreas; Mugisha, James; Koyanagi, Ai
We investigated physical activity (PA) correlates among middle-aged and older adults (aged ≥50 years) with hazardous drinking patterns in six low- and middle-income countries. Cross-sectional data were analyzed from the World Health Organization’s Study on Global Ageing and Adult Health. Hazardous drinking was defined as consuming >7 (females) or >14 (males) standard drinks per week. Participants were dichotomized into low (i.e., not meeting 150 min of moderate PA/week) and moderate–high physically active groups. Associations between PA and a range of correlates were examined using multivariable logistic regressions. The prevalence of low PA in 1,835 hazardous drinkers (60.5 ± 13.1 years; 87.9% males) was 16.2% (95% confidence interval [13.9%, 18.9%]). Older age, living in an urban setting, being unemployed, depression, underweight, obesity, asthma, visual impairment, poor self-rated health, and higher levels of disability were identified as significant PA correlates. The current data provide important guidance for future interventions to assist older hazardous drinkers to engage in regular PA.
The efficacy of meditation-based mind-body interventions for mental disorders: a meta-review of 17 meta-analyses of randomized controlled trials
(Elsevier: Journal of Psychiatric Research., 2021-02) Vancampfort, Davy; Stubbs, Brendon; Van Damme, Tine; Smith, Lee; Hallgren, Mats; Schuch, Felipe; Deenik, Jeroen; Rosenbaum, Simon; Ashdown-Franks, Garcia; Mugisha, James; Firth, Joseph
There is increasing interest in the potential efficacy of meditation-based mind-body interventions (MBIs) within mental health care. We conducted a systematic metareview of the published randomized control trial (RCT) evidence. MEDLINE/PubMed, PsycARTICLES and EMBASE were searched from inception to 06/2020 examining MBIs (mindfulness, qigong, tai chi, yoga) as add-on or monotherapy versus no treatment, minimal treatment and passive and active control conditions in people with a mental disorder. The quality of the methods of the included meta-analyses using A Measurement Tool to Assess Systematic Reviews (AMSTAR) and the methodological quality of the RCTs using AMSTAR-Plus. Sixteen (94%) of 17 meta-analyses had good overall methodological quality. The content validity of the included RCTs was considered good in 9 (53%) meta-analyses. In meta-analyses with good methodological quality (AMSTAR 8≤) and content validity (AMSTAR+ 4≤), large effect sizes (0.80 or higher) were observed for mindfulness in schizophrenia and in ADHD, a moderate (0.50 ≤ 0.80) effect size for mindfulness in PTSD and a small (0.20 < 0.50) effect size for yoga in schizophrenia No serious adverse events were reported (n RCTs = 43, n in the MBI arms = 1774), while the attrition rates were comparable with the rates in passive and active control conditions. Our meta-review demonstrates that mindfulness and to a lesser extent yoga may serve as an efficacious supplement to pharmacotherapy, and psychotherapy and can be complementary in healthy lifestyle interventions for people with mental disorders. Meta-analytic evidence of high methodological quality and content validity of included trials is currently lacking for qigong and tai chi.
Motives for physical activity in the adoption and maintenance of physical activity in men with alcohol use disorders
(Elsevier: Psychiatry Research, 2018-03) Vancampfort, Davy; Van Damme, Tine; Probst, Michel; Vandael, Hannelore; Hallgren, Mats; Mutamba, Byamah Brian; Nabanoba, Justine; Basangwa, David; Mugisha, James
Within the self-determination theory and the trans-theoretical model (stages of change) frameworks, we investigated motives for physical activity adoption and maintenance in men with alcohol use disorder (AUD). Fifty Ugandan patients completed the Behavioral Regulation in Exercise Questionnaire-3 (BREQ-3) to assess exercise motives, the Patient-centred Assessment and Counselling for Exercise (PACE) to determine stage of change and the Alcohol Use Disorders Identification Test. The relationship between motives for physical activity and stage of change was investigated using ANOVA with post-hoc Scheffe tests. Multivariate analyses found significantly higher levels of introjected, identified and integrated motivation in the action and maintenance stage versus the pre-action stage. There were no differences in intrinsic motivation between the stages of change. Our results suggest that in order to adopt and maintain an active lifestyle the most important source of motivation comes from the benefits that may be obtained rather than from the inherent pleasure or challenge associated with it. The study provides a platform for future research to investigate the importance of autonomous motivation within physical activity interventions for people with AUD.
Physical activity and anxiety: a perspective from the World Health Survey
(Elsevier: Journal of Affective Disorders ., 2017-01-15) Stubbs, Brendon; Koyanagi, Ai; Hallgren, Mats; Firth, Joseph; Richards, Justin; Schuch, Felipe; Rosenbaum, Simon; Mugisha, James; Veronese, Nicola; Lahti, Jouni; Vancampfort, Davy
Despite the known benefits of physical activity (PA) among people with anxiety, little is known about PA levels in people with anxiety at the population level. This study explored the global prevalence of anxiety and its association with PA. Methods Cross-sectional, community-based data from the World Health Survey was analyzed. Prevalence of anxiety was estimated for 237,964 individuals (47 countries). PA was categorized as low, moderate, and high based on the International Physical Activity Questionnaire (short form). The association between PA and anxiety was assessed by multivariable logistic regression. Results The overall global prevalence of anxiety was 11.4% (47 countries). Across 38 countries with available data on PA, 62.5%, 20.2%, and 17.3% of the sample engaged in high, moderate, and low levels of PA respectively. The prevalence of low physical activity in those with and without anxiety was 22.9% vs. 16.6% (p<0.001) (38 countries, n=184,920). In the pooled model adjusted for socio-demographics, depression, and country, individuals engaging in low PA (vs. high PA) had 1.32 (95% CI=1.17–1.47) times higher odds for anxiety than those with high PA. Female sex, older age, lower education and wealth, and depression were also associated with low PA. At the individual country level, there was a significant positive association between low PA and anxiety in 17 of the 38 countries. Conclusion Low PA levels are associated with increased prevalence of anxiety. There is a need for longitudinal research to establish the directionality of the relationships observed
Physical activity and suicidal ideation: a systematic review and meta-analysis
(Elsevier: Journal of Affective Disorders, 2018-01-01) Vancampfort, Davy; Hallgren, Mats; Firth, Joseph; Rosenbaum, Simon; Schuch, Felipe B.; Mugisha, James; Probst, Michel; Van Damme, Tine; Carvalho, André F.; Stubbs, Brendon
A potential approach to suicide prevention that has not been closely examined, but which holds promise in terms of widespread dissemination without major side-effects, is physical activity (PA). This systematic review and meta-analysis set out to: (a) explore associations between PA and suicidal ideation (SI) levels, and (b) investigate the effect of PA interventions on SI. Methods Major electronic databases were searched from inception up to 05/2017 to identify quantitative studies reporting an association between PA and SI. A quantitative correlates synthesis and random effects meta-analysis were conducted. Results Fourteen of 21 studies in adults (67%) (n = 130,737), 7/14 (50%) in adolescents (n = 539,170) and 2/3 (67%) in older adults (n = 50,745) found a significant negative association between PA- and SI-levels. Pooled adjusted meta-analysis of 14 effect sizes over eight studies and 80,856 people found that those who were “active” versus those who were “inactive” were less likely to have SI (OR = 0.87, 95%CI = 0.76–0.98). Additionally, meeting PA guidelines conferred a significant protective effect against SI (OR = 0.91, 95%CI = 0.51–0.99, P = 0.03; N studies = 3, n people = 122,395), while not meeting guidelines was associated with increased SI (OR = 1.16, 95%CI = 1.09–1.24, P < 0.001; N = 4, n = 78,860). Data from the intervention studies (N = 3, n = 121) was mixed and limited. Limitations Our findings are based mainly on cross-sectional studies, while the majority of studies did not include a rigorous physical activity assessment. Conclusions The current study suggests that higher PA levels are associated with lower SI. However, the associations observed need to be confirmed in prospective observational studies and controlled trials.
Physical activity correlates among 24,230 people with depression across 46 low- and middle-income countries
(Elsevier: Journal of Affective Disorders, 2017-10-15) Vancampfort, Davy; Stubbs, Brendon; Firth, Joseph; Hallgren, Mats; Schuch, Felipe; Lahti, Jouni; Rosenbaum, Simon; Ward, Philip B.; Mugisha, James; Carvalho, André F.; Koyanagi, Ai
There is a paucity of nationally representative data available on the correlates of physical activity (PA) among people with depression, especially in low- and middle-income countries (LMICs). Thus, we investigated PA correlates among community-dwelling adults with depression in this setting. Methods World Health Survey data included 24,230 adults (43.1 ± 16.1 years; 36.1% male) with ICD-10 diagnoses of depression including brief depressive episode and subsyndromal depression aged ≥ 18 years from 46 LMICs. PA was assessed by the International Physical Activity Questionnaire. Participants were dichotomised into low and moderate-to-high physically active groups. Associations between PA and a range of sociodemographic, health behaviour and mental and physical health variables were examined using multivariable logistic regressions. Results 34.8% of participants with depression were physically inactive. In the multivariate analyses, inactivity was associated with male sex, older age, not being married/cohabiting, high socio-economic status, unemployment, living in an urban setting, less vegetable consumption, and poor sleep/ low energy. In addition, mobility difficulties and some somatic co-morbidity were associated with not complying with the 150 min per week moderate-to-vigorous PA recommendations. Conclusions The current data provide guidance for future population level interventions across LMICs to help people with depression engage in regular PA.
Physical activity participation is associated with higher quality of life scores in men with alcohol use disorders: a study from Uganda
(African Health Sciences., 2020-10-07) Vancampfort, Davy; Hallgren, Mats; Mutamba, Byamah Brian; Van Damme, Tine; Probst, Michel; van Winkel, Ruud; Myin-Germeys, Inez; De Hert, Marc; Mugisha, James
There is a growing recognition of the importance of encouraging people with alcohol use disorders (AUD) to become more active as an achievable strategy to reduce the disability-associated burden. Objective: We investigated whether physical activity and sedentary behaviour in men with AUD contribute to their quality of life (QoL). Methods: Fifty male Ugandan inpatients with AUD (33.0±10.7 years) completed the World Health Organization Quality of Life Assessment brief version, Simple Physical Activity Questionnaire and the Alcohol Use Disorders Identification Test while waist circumference, body mass index and blood pressure were assessed. Linear multiple regression analysis explored the total variance in QoL explained by all predictor variables. Results: SIMPAQ walking and SIMPAQ exercise explained 46% of the variability in physical QoL, 45% of the variability in psychological QoL, and 40% of the variability in environmental QoL. The SIMPAQ walking score predicted 37% of the variability in social QoL. Conclusion: The current findings suggest that higher levels of walking and exercising are associated with a better QoL. Our study therefore provides a platform for future research to investigate the role of physical activity on QoL levels in people with AUD, also in low resourced settings in low-income countries such as Uganda.
The prevalence of diabetes mellitus type 2 in people with alcohol use disorders: a systematic review and large scale meta-analysis
(Elsevier: Psychiatry Research, 2016-12-30) Vancampfort, Davy; Mugisha, James; Hallgren, Mats; De Hert, Marc; Probst, Michel; Monsieur, Dirk; Stubbs, Brendon
Type 2 Diabetes Mellitus (T2DM) is highly predictive of cardiovascular diseases and is associated with worse quality of life and increased healthcare utilisation. The current meta-analysis aimed to (i) describe the pooled prevalence of T2DM in people with alcohol use disorders (AUDs), (ii) investigate the impact of demographic, clinical and treatment factors, and (iii) compare T2DM prevalences in AUDs versus the general population. The trim and fill adjusted pooled T2DM prevalence among 3998 people with AUDs (age range 34.8-51.1 years; 76.6% male) (N studies=7) was 12.4% (95%CI=11.8–13.9%). Higher T2DM prevalences were observed in studies with a higher mean age and a higher percentage of male participants, and in studies with self- or physician reported T2DM assessment. A trend for higher T2DM prevalences was found in inpatient settings, in studies assessing T2DM with the gold-standard oral glucose tolerance test compared with fasting glucose only, and with studies including patients with a higher percentage of physical co-morbidity. Although healthy control data are lacking, the pooled prevalence is similar to that observed in people with severe mental illness who are considered a high-risk group. Routine screening and multidisciplinary management of T2DM in people with AUDs is needed.
Sedentary behavior and anxiety-induced sleep disturbance among 181,093 adolescents from 67 countries: a global perspective
(Elsevier: Sleep Medicine, 2019-06) Vancampfort, Davy; Van Damme, Tine; Stubbs, Brendon; Smith, Lee; Firth, Joseph; Hallgren, Mats; Mugisha, James; Koyanagi, Ai
Sleep problems are burdensome in adolescents. Understanding modifiable environmental risk factors is essential. There is evidence that physical activity is protective against sleep problems in adolescents. However, the association between sedentary behavior (SB) and anxiety-induced sleep disturbance has not been investigated. Methods Using cross-sectional data from the Global school-based Student Health Survey, we explored the association between SB and anxiety-induced sleep disturbance in 181,093 adolescents [mean (standard deviation, SD) age 13.7 (1.0) years; 48.4% girls] from 67 countries, controlling for confounders (including physical activity). Adolescents reported anxiety-induced sleep disturbance during the past 12 months, and SB, which was a composite variable assessing time spent sitting and watching television, playing computer games, talking with friends during a typical day excluding the hours spent sitting at school and doing homework. Multivariable logistic regression analysis was conducted and a countrywide meta-analysis undertaken. Results Overall, 7.8% of adolescents had anxiety-induced sleep disturbance. The prevalence of SB was: <1 h/day 39.9%; 1–2 h/day 33.8%; 3–4 h/day 15.4%; 5–8 h/day 7.4%; and >8 h/day 3.6%. Compared to <1 h/day of SB, >8 h/day was associated with a 2.27 [95% confidence interval (CI) = 1.98–2.62] times higher odds for anxiety-induced sleep disturbance. The association was similar among both sexes. The pooled odds ratio for anxiety-induced sleep disturbance when being sedentary ≥3 h/day was 1.42 (95% CI = 1.36–1.48) with only a small degree of between-country heterogeneity (I2 = 41.4%). Conclusions Future longitudinal data are required to confirm/refute the findings to inform public interventions which aim to reduce anxiety and sleep disturbance in adolescents.
Sedentary behavior and physical activity levels in people with schizophrenia, bipolar disorder and major depressive disorder: a global systematic review and meta-analysis
(World Psychiatry:Official Journal of the World Psychiatric Association(WPA)., 2017-10) Vancampfort, Davy; Firth, Joseph; Schuch, Felipe B.; Rosenbaum, Simon; Mugisha, James; Hallgren, Mats; Probst, Michel; Ward, Philip B.; Gaughran, Fiona; De Hert, Marc; Carvalho, André F.; Stubbs, Brendon
People with severe mental illness (schizophrenia, bipolar disorder or major depressive disorder) die up to 15 years prematurely due to chronic somatic comorbidities. Sedentary behavior and low physical activity are independent yet modifiable risk factors for cardiovascular disease and premature mortality in these people. A comprehensive meta-analysis exploring these risk factors is lacking in this vulnerable population. We conducted a meta-analysis investigating sedentary behavior and physical activity levels and their correlates in people with severe mental illness. Major electronic databases were searched from inception up to April 2017 for articles measuring sedentary behavior and/or physical activity with a self-report questionnaire or an objective measure (e.g., accelerometer). Random effects meta-analyses and meta-regression analyses were conducted. Sixty-nine studies were included (N=35,682; 39.5% male; mean age 43.0 years). People with severe mental illness spent on average 476.0 min per day (95% CI: 407.3-545.4) being sedentary during waking hours, and were significantly more sedentary than age- and gender-matched healthy controls (p=0.003). Their mean amount of moderate or vigorous physical activity was 38.4 min per day (95% CI: 32.0-44.8), being significantly lower than that of healthy controls (p=0.002 for moderate activity, p<0.001 for vigorous activity). People with severe mental illness were significantly less likely than matched healthy controls to meet physical activity guidelines (odds ratio = 1.5; 95% CI: 1.1-2.0, p<0.001, I2=95.8). Lower physical activity levels and non-compliance with physical activity guidelines were associated with male gender, being single, unemployment, fewer years of education, higher body mass index, longer illness duration, antidepressant and antipsychotic medication use, lower cardiorespiratory fitness and a diagnosis of schizophrenia. People with bipolar disorder were the most physically active, yet spent most time being sedentary. Geographical differences were detected, and inpatients were more active than outpatients and those living in the community. Given the established health benefits of physical activity and its low levels in people with severe mental illness, future interventions specifically targeting the prevention of physical inactivity and sedentary behavior are warranted in this population.
Test-retest reliability, concurrent validity and correlates of the two-minute walk test in outpatients with alcohol use disorder
(Elsevier, 2021-02) Vancampfort, Davy; Kimbowa, Samuel; Basangwa, David; Hallgren, Mats; Damme, TineVan; Rosenbaum, Simon; Mugisha, James
We investigated the test-retest reliability of the 2-min walk test (2MWT) and its concurrent validity with the 6-min walk test (6MWT) in Ugandan outpatients with alcohol use disorder (AUD). We also explored practice effects, and assessed the minimal detectable change (MDC) and correlations with the 2MWT. Fifty outpatients [7 women; median age = 32.0 years] performed the 2MWT twice, the 6MWT once, and completed the Simple Physical Activity Questionnaire, Brief Symptoms Inventory-18 (BSI-18), and Alcohol Use Disorders Identification Test. The median (interquartile) 2MWT score on the first and second test were 162.0 (49.0) meters and 161.0 (58.0) meters, respectively, without significant difference between the two trials (p = 0.20). The intraclass correlation between the two 2MWTs was 0.96 (95% confidence interval = 0.94–0.98). The Spearman Rho correlation between the second 2MWT and the 6MWT was 0.91 (p < 0.001). The MDC for the 2MWT was 18 m. There was no evidence of a practice effect. Variance in BSI-18 depression and the presence of leg pain following the 2MWT explained 18.7% of 2MWT score variance. The 2MWT is a reliable and valid fitness test, which can be conducted without any special equipment or substantial time demands in outpatients with AUD.