Browsing by Author "Smith, Lee"

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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.
Leisure-time sedentary behavior and suicide attempt among 126,392 adolescents in 43 countries
(Elsevier: Journal of Affective Disorders, 2019-05-01) Vancampfort, Davy; Stubbs, Brendon; Mugisha, James; Firth, Joseph; Van Damme, Tine; Smith, Lee; Koyanagi, Ai
Adolescent suicide is a major global mental health problem. Exploring variables associated with suicide attempts is important for the development of targeted interventions. The aim of the current study was to explore associations between leisure-time sedentary behavior and suicide attempts. Methods Data from the Global School-based Student Health Survey were analyzed. Data on past 12-month suicide attempts and self-reported leisure-time sedentary time were collected. Multivariable logistic regression and meta-analysis were conducted to assess the associations. Results Among 126,392 students from 43 countries (mean age 13.8 ± 0.96 years; 48.9% female), 10.6% had attempted suicide. The prevalence of suicide attempts increased with increasing sedentary leisure-time per day (from 9% at <1 h/day to 16.8% at >8 h/day). Compared to those engaging in <1 h/day sedentary during leisure-time, there was a dose-dependent increase in odds ratios (ORs) for suicide attempts, with the OR for >8 h/day being 1.45 (95% confidence interval=1.19–1.77). Limitations The study is cross-sectional, therefore the directionality of the relationships cannot be deduced. Conclusions Our data suggest that leisure-time sedentary behavior is associated with increased odds for suicide attempt in adolescence. Future longitudinal data are required to confirm/refute the findings to inform public prevention campaigns.
Motives for physical activity in the adoption and maintenance of physical activity in middle-aged and old age outpatients with a mental disorder: a cross-sectional study from a low-income country
(Elsevier: Psychiatry Research, 2019-12) Vancampfort, Davy; Basangwa, David; Nabanoba, Justine; Smith, Lee; Mugisha, James
Within the trans-theoretical model (stages of change) and self-determination theory frameworks, we investigated motives for physical activity adoption and maintenance in middle-aged and old age people with a mental disorder from a low-income setting. Ninety Ugandan outpatients completed the Behavioral Regulation in Exercise Questionnaire-3 (BREQ-3) to assess exercise motives and the Patient-centred Assessment and Counselling for Exercise (PACE) to determine stage of change. The relationship between motives for physical activity and stage of change was investigated using MANOVA with post-hoc Scheffe tests. Higher amotivation levels were observed in the pre-action compared with action and maintenance stages, while except for external regulation, all regulation scores were significantly lower in the pre-action compared with action and maintenance stages. There were no significant differences in levels of motivational types between the action and maintenance stage. The study provides a platform for future research to investigate relationships between motivational factors and physical and mental health outcomes within physical activity interventions for middle-aged and old age people with a mental disorder.
Pain and severe sleep disturbance in the general population: primary data and meta-analysis from 240,820 people across 45 low- and middle-income countries
(Elsevier: General Hospital Psychiatry, 2018-08) Stubbs, Brendon; Vancampfort, Davy; Thompson, Trevor; Veronese, Nicola; Carvalho, Andre F.; Solmi, Marco; Mugisha, James; Schofield, Patricia; Prina, A.Matthew; Smith, Lee; Koyanagi, Ai
Pain and sleep disturbances are widespread, and are an important cause of a reduced quality of life. Despite this, there is a paucity of multinational population data assessing the association between pain and sleep problems, particularly among low- and middle-income countries (LMICs). Therefore, we investigated the relationship between pain and severe sleep disturbance across 45 LMICs. Method Community-based data on 240,820 people recruited via the World Health Survey were analyzed. Multivariable logistic regression analyses adjusted for multiple confounders were performed to quantify the association between pain and severe sleep problems in the last 30 days. A mediation analysis was conducted to explore potential mediators of the relationship between pain and severe sleep disturbance. Results The prevalence of mild, moderate, severe, and extreme levels of pain was 26.0%, 16.2%, 9.1%, and 2.2% respectively, whilst 7.8% of adults had severe sleep problems. Compared to those with no pain, the odds ratio (OR, 95% CI) for severe sleep problems was 3.65 (3.24–4.11), 9.35 (8.19–10.67) and 16.84 (13.91–20.39) for those with moderate, severe and extreme pain levels respectively. A country wide meta-analysis adjusted for age and sex demonstrated a significant increased OR across all 45 countries. Anxiety, depression and stress sensitivity explained 12.9%, 3.6%, and 5.2%, respectively, of the relationship between pain and severe sleep disturbances. Conclusion Pain and sleep problems are highly co-morbid across LMICs. Future research is required to better understand this relationship. Moreover, future interventions are required to prevent and manage the pain and sleep disturbance comorbidity.
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.
Test-retest reliability, concurrent validity and correlates of the two-minute walk test in outpatients with psychosis
(Elsevier: Psychiatry Research., 2019-12) Vancampfort, Davy; Kimbowa, Samuel; Basangwa, David; Smith, Lee; Stubbs, Brendon; Damme, TineVan; De Hert, Marc; Mugish, James
The aim of this study was to investigate the test-retest reliability of the 2-minute walk test (2MWT) and the concurrent validity with the 6-minute walk test (6MWT) in outpatients with psychosis. We also explored whether there was a practice effect, determined minimal detectable changes (MDC) and assessed which factors are associated with the 2MWT performance. Fifty outpatients [22 women; 33.5 (14.3) years] performed the 2MWT twice and the 6MWT once and completed the Simple Physical Activity Questionnaire (SIMPAQ) and Brief Symptoms Inventory -18. The median (interquartile) 2MWT score on the first and second test were 128.0 (44.0) meters and 128.0 (31.5) meters, without significant difference between the two trials. The intraclass coefficient was 0.94 (95% confidence interval=0.91–0.97). The significant Spearman Rho correlation between the second 2MWT and the 6MWT was 0.69. The MDC was 22 m for men and 21 m for women. There was no evidence for a practice effect. Variability in SIMPAQ sedentary, exercise, incidental physical activity and leg pain following the test explained 54.6% of the variance in 2MWT score. The current study demonstrates that the 2MWT is a reliable, valid and clinically feasible tool for assessing and evaluating the functional exercise capacity in outpatients with psychosis.