Læknablaðið - 01.11.2015, Blaðsíða 24
524 LÆKNAblaðið 2015/101
Heimildir
1. Mcgrath J, Saha S, Chant D, Welham J. Schizophrenia: a
concise overview of incidence, prevalence, and morta-
lity. Epidemiol Rev 2008; 30: 67-76.
2. World Health Organization. The ICD-10 classification of
mental and behavioural disorders: clinical descriptions
and diagnostic guidelines. (2. útgáfa). Genf 2007.
3. Hausmann A, Fleischhacker WW. Differential diagnosis
of depressed mood in patients with schizophrenia: a
diagnostic algorithm based on a review. Acta Psychiatr
Scand 2002; 106: 83-96.
4. Nordentoft M, Wahlbeck K, Hallgren J, Westman J, Osby
U, Alinaghizadeh H et al. Excess mortality, causes of death
and life expectancy in 270,770 patients with recent onset of
mental disorders in Denmark, Finland and Sweden. PloS
One 2013; 8: e55176.
5. Roick C, Fritz-Wieacker A, Matschinger H, Heider D,
Schindler J, Riedel-Heller S, et al. Health habits of patients
with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 2007;
42: 268-76.
6. Sveinsson Ó, Þorleifsson K, Aspelund T, Kolbeinsson H.
Rannsókn á áhættuþáttum hjarta- og æðasjúkdóma hjá
geðklofasjúklingum á geðsviði Landspítala. Læknablaðið
2012; 98: 399-402.
7. McIntyre RS, McCann SM, Kennedy SH. Antipsychotic
metabolic effects: weight gain, diabetes mellitus, and lipid
abnormalities. Can J Psychiat 2001; 46: 273-81.
8. Daumit GL, Dickerson FB, Wang PN, Dalcin A, Jerome GJ,
Anderso CAM et al. A behavioral weight-loss intervention
in persons with serious mental illness. N Engl J Med 2013;
368: 1594-602.
9. Warburton D, Charlesworth S, Ivey A, Nettlefold L, Bredin
S. A systematic review of the evidence for Canada's physi-
cal activity guidelines for adults. IJBNPA 2010; 7: 1 -220.
10. Gorczynski P, Faulkner G. Exercise therapy for schizop-
hrenia. Schizophr Bull 2010; 36: 665-6.
11. Pelham T, Campagna P, Ritvo P, Birnie W.The effects of
exercise therapy on clients in a psychiatric rehabilitation
program. Psychosoc Rehabil J 1993; 16: 75-84.
12. Tkachuk GA, Martin GL. Exercise therapy for patients
with psychiatric disorders: research and clinical implica-
tions. Prof Psychol Res Pr 1999; 30: 275-82.
13. Asmundson GJG, Fetzner M., DeBoer LB, Powers MB,
Otto MW, Smits JAJ. Let´s get physical: a contemporary
review of the anxiolytic effects of exercise for anxiety and
its disorders. Depress Anxiety; 30: 362-73.
14. Faulkner G, Gorczynski P, Arbour-Nicitopoulos K.
Exercise as an adjunct treatment for schizophenia.
Routledge handbook of physical activity and mental
health. Ekkekakis, Panteleimon 2013a; 541.
15. Kay SR, Fiszbein A, Opler LA. The positive and negative
syndrome scale (PANSS) for schizophrenia. Schizophr
Bull 1987; 13: 261-76.
16. Lovibond PF. The structure of negative emotional states:
comparison of the depression anxiety stress scales (DASS)
with the Beck sepression and anxiety inventories. Behav
Res Ther 1995; 33: 335-43.
17. Evans C, Connell J, Barkham M, Margison F, McGrath G,
Mellor-Clark J et al. Towards a standardised brief outcome
measure: psychometric properties and utility of the
CORE—OM. Br J Psychiatry 2002; 180: 51-60.
18. Flanagan J. A research approach to improving our quality
of life. Am J Commun Psychol 1978; 33: 138-47.
19. Rosenberg M. Society and the adolescent self-image.
Princeton University Press, Princeton NJ 1965.
20. Beck ATW, Lester D, Trexler L. The measurement of
pessimism: The hopelessness scale. J Consult Clin 1974;
42: 861-5.
21. Halldórsdóttir S. Vancouver-skólinn í fyrirbærafræði. Í
Sigríður Halldórsdóttir og Kristján Kristjánsson, ritstj.
Handbók í aðferðafræði og rannsóknum í heilbrigðis-
vísindum. Háskólinn á Akureyri, Akureyri 2003: 249-66.
22. Shapiro SS, Wilk MB. An analysis of variance tests for
normality (complete samples). Biometrica 1965; 52: 591-
611.
23. Lakens D. Calculating and reporting effect sizes to facili-
tate cumulative science: a practical primer for t-tests and
ANOVAs. Front Psychol 2013; 4: 863.
24. Beebe L, Tian L, Goodwin A, Allen S, Kuldau J. Effects
of exercise on mental and physical health parameters of
persons with schizophrenia. Issues Ment Health Nurs
2005; 26: 661-76.
25. Chamove AS. Positive short-term effects of activity on
behaviour in chronic schizophrenic patients. Brot J Clin
Psychol 1986; 25: 125-33
26. Pelham T, Campagna P. Benefits of exercise in psychiatric
rehabilitation of persons with schizophrenia. Can J Reh
1991; 4: 159-68.
27. Ussher M, Doshi R, Sampuran A, West R. Cardiovascular
risk factors in patients with schizophrenia receiving
continuous medical care. Community Ment Health J 2011;
47: 688-93.
28. De Hert M, Detraux J, Van Winkel R, Yu W Correll
CU. Metabolic and cardiovascular adverse effects asso-
ciated with antipsychotic drugs. Nat Rev Endocrino 2011;
8: 114-26.
29. Daley AJ. Exercise therapy and mental health in clinical
populations: Is exercise therapy a worthwhile interven-
tion? Adv Psychiatr Treat 2002; 8: 262-70.
30. Faulkner G, Duncan M, Hahn M, Remington G, Cohn T.
Behavioural interventions for reducing weight gain in
schizophrenia. Cochrane Library 2013b; 24: 1.
ENgLISH SUMMArY
introduction: due to an unhealthy lifestyle, individuals with schizop-
hrenia are at higher risk of morbidity compared to the general popula-
tion. Studies have shown that physical activity can have positive effects
on physical and mental health in these patients. The aim of the study
was to evaluate the effects of a physical activity intervention on symp-
toms of schizophrenia, as well as on a number of physical and mental
health variables. The aim was also to gain more understanding of the
participants´ experience of the intervention with interviews.
Material and methods: Seventeen individuals between the ages of
21-31, diagnosed with schizophrenia participated in the study. They
exercised under professional supervision for a minimum of two sessions
per week for 20 weeks and attended weekly lectures on a healthy lif-
estyle. The participants answered standardized questionnaires (PANSS,
dASS, Rosenberg, CoRE-oM, BHS, QoLS), and physical measure-
ments (weight, height, body mass index, resting blood pressure, waist
circumference and resting heart rate) were taken before and after the
intervention. Six participants were interviewed after the intervention and
asked about their experience.
Results: Negative and general psychiatric symptoms, depression,
anxiety and stress scores decreased significantly whereas well-being,
quality of life and physical activity increased (p<0.05). Apart from resting
heart rate that decreased (p<0.05), physical measurements remained
unchanged at the end of the intervention.
Conclusion: The participants´ physical activity increased, their mental
well-being improved, and they did not gain weight during the interven-
tion period. Regular exercise under supervision and education about
a healthy lifestyle are a beneficial adjunct to the primary treatment of
people with schizophrenia.
The effects of physical activity intervention on symptoms in schizophrenia,
mental well-being and body composition in young adults
kristjana Sturludóttir1,2, Sunna Gestsdóttir2, Rafn Haraldur Rafnsson1, Erlingur jóhannsson2
1Division of Psychiatry, Landspitali University Hospital2, Research Centre for Sport and Health Sciences, School of Education, University of Iceland
key words: schizophrenia, physical activity, positive symptoms, negative symptoms, mental well-being, intervention.
Correspondence: Erlingur Jóhannsson, erljo@hi.is
R A N N S Ó K N
gegn
heilablóðfalli/
segareki
Forvörn gegn heilablóðfalli / segareki hjá sjúklingum með gáttatif sem ekki tengist
lokusjúkdómum (NVAF) ásamt einum eða fleiri áhættuþáttum.
Aðeins Eliquis® tengir
saman þessa kosti
Veldu Eliquis®, eina Xa hemilinn sem sýnt hefur
verið fram á að veiti áhrifaríkari vörn gegn
heilablóðfalli/segareki með marktækt minni
tíðni á meiriháttar blæðingum samanborið við
warfarin2.
Eliquis® (apixaban), sem ætlað er til inntöku, er beinn hemill á storkuþátt Xa og hefur eftirfarandi
ábendingar:
• Forvörn gegn bláæðasegareki (VTE) hjá fullorðnum sjúklingum sem hafa gengist undir valfrjáls
mjaðmarliðskipti eða hnéliðskipti.
• Forvörn gegn heilablóðfalli og segareki í slagæð hjá fullorðnum sjúklingum með gáttatif sem
ekki tengist hjartalokusjúkdómum (non-valvular atrial fibrillation, NVAF) ásamt einum eða fleiri
áhættuþáttum, svo sem sögu um heilablóðfall eða tímabundna blóðþurrð í heila (transient ischaemic
attack, TIA), aldur ≥75 ára, háþrýstingi, sykursýki eða hjartabilun með einkennum (NYHA flokkur ≥II)1.
• Meðferð við segamyndun í djúplægum bláæðum (DVT) og lungnasegareki (PE) og forvörn gegn
endurtekinni segamyndun í djúplægum bláæðum og lungnasegareki hjá fullorðnum.
Þetta lyf er undir sérstöku eftirliti til að nýjar upplýsingar um öryggi lyfsins komist fljótt og örugglega til skila.
Heilbrigðisstarfsmenn eru hvattir til að tilkynna allar aukaverkanir sem grunur er um að tengist lyfinu.
Sjá frekari upplýsingar um lyfið á www. lyfjastofnun.is
Heimildir: 1. Samantekt á eiginleikum lyfs fyrir Eliquis. 2. Granger CB et al. Apixaban versus warfarin in patients with atrial fibrillation.
N Engl J Med 2011; 365: 981–992.2.
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PF151001
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við warfarin2samanborið
við warfarin2
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