Browsing by Author "Winkel, Ruudvan"

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Adherence to physical activity recommendations and physical and mental health risk in people with severe mental illness in Uganda
(Elsevier: Psychiatry Research, 2018-02) Vancampfort, Davy; Probst, Michel; Basangwa, David; De Hert, Marc; Myin-Germeys, Inez; Winkel, Ruudvan; Ward, Philip B.; Rosenbaum, Simon; Mugisha, James
This study investigated cardio-metabolic risk factors among patients with severe mental illness who do or do not meet the recommendations of 150 min per week of physical activity. A secondary aim was to assess whether those that do meet the recommendations report lower levels of mental health symptoms. 107 (60♀) Ugandan in- and outpatients (mean age=34.4 ± 9.7 years) with severe mental illness (depression=7, bipolar disorder=55, schizophrenia=45) completed the Physical Activity Vital Sign (PAVS) method and Brief Symptoms Inventory −18. Participants were also screened for abdominal obesity (waist circumference>90 cm), overweight (body mass index≥25) and hypertension (systolic pressure≥140 mmHg and/or diastolic pressure≥90 mmHg).48.6% (n = 52) of patients met the physical activity recommendations as assessed by the PAVS method. 41.1% (n = 44) were overweight, 40.2% (n = 43) had abdominal obesity and 23.4% (n = 25) had hypertension. Those who did not meet the physical activity recommendations were significantly older, had a higher BSI-18 somatisation score, and had a higher risk of overweight [relative risk (RR) = 2.88, 95% confidence interval (CI) = 1.59–4.99], abdominal obesity (RR = 1.82, 95%CI = 1.13–2.93), and hypertension (RR = 2.16, 95%CI = 0.99–4.73). The PAVS is a feasible method of assessing physical activity among patients with severe mental illness in a low resource setting. The PAVS may have clinical utility for physical and mental health risk stratification.
Health care professionals’ perspectives on physical activity within the Ugandan mental health care system
(Elsevier: Mental Health and Physical Activity, 2019-03) Mugisha, James; De Hert, Marc; Knizek, Birthe Loa; Kwiringira, Japheth; Kinyanda, Eugene; Byansi, William; Winkel, Ruudvan; Myin-Germeys, Inez; Stubbs, Brendon; Vancampfort, Davy
Mental health care systems in Africa are faced with a high burden of mental disorders. There is need to explore evidence-based, scalable interventions to compliment the “traditional” health care system. Physical activity (PA) can augment the effectiveness of existing programs. However, little is known about the perspectives of health care professionals on PA. Understanding this is key to implementation. Methods This was a qualitative exploratory study based on 13 key informant interviews among experienced health care professionals working at Butabika National Referral and Teaching Hospital, Uganda. Data was analyzed through content thematic analysis. Results Participants reported PA benefits were: improved individual competences and engagement, social reintegration and reduced family and community burden. Self-stigma, lack of community support, lack of infrastructure and equipment, lack of monitoring capacity, human resource challenges and a focus solely on pharmacotherapy were among the most reported barriers to application of PA in management of mental health problems. Conclusion Despite the high level of understanding of PA among health care professionals, PA promotion largely depends on implementation of strategies to deal with community and health systems barriers. Although patients need to be empowered to deal with their individual barriers, greater support and action is needed by policy makers. Public health programs should support PA through community engagement and social re-integration programs. The government should promote a holistic mental health care perspective and provide adequate infrastructural and human resources to support PA in the existing primary and mental health care systems.
Interest, competence, appearance, fitness and social relatedness as motives for physical activity in Ugandan outpatients with psychosis
(Elsevier: Mental Health and Physical Activity, 2017-10) Vancampfort, Davy; De Hert, Marc; Probst, Michel; Firth, Joseph; Myin-Germeys, Inez; Winkel, Ruudvan; Naisiga, Annetie; Basangwa, David; Mugisha, James
Motivating people with psychosis to meet recommended physical activity levels is a public health priority. It remains unclear whether physical activity motives differ between male and female patients, those with and without cardio-metabolic risks, those who exercise alone versus in group and in aerobic exercise versus resistance training. The aim of this study was to explore differences in PA motives related to several patient characteristics in Ugandan outpatients with psychosis. Methods 48 patients (24♀; 33.3 ± 9.6 years) completed the Motives for Physical Activity Measure – Revised (MPAM-R), Patient-centred Assessment and Counselling for Exercise questionnaire, the Brief Symptoms Inventory - 18 (BSI -18), were asked for their physical activity participation in the last 7 days and screened for abdominal obesity, overweight, hypertension, smoking, medication use and the presence of chronic conditions. Results A multivariate analysis of variance demonstrated main effects for stages of physical activity behavior change (Wilks λ = 0.40, F = 2.98, P = 0.043) and gender (Wilks λ = 0.45, F = 3.45, P = 0.031). There were no interaction effects between stage of change and gender (Wilks λ = 0.35, F = 1.89, P = 0.089). Men scored higher on appearance (P = 0.046) and interest/enjoyment (P = 0.042). Higher (P < 0.05) MPAM-R were observed in action and maintenance behaviour stages versus pre-action stages but there were no differences between the action and maintenance stage. There were no significant correlates between MPAM-R and BSI-18 scores. Conclusions Extrinsic (fitness, appearance, social benefits) and intrinsic (interest, competence) motives are equally important in adopting and maintaining physical activity in people with psychosis. Socio-cultural role patterns should be considered, also in Western settings (e.g., in refugees).