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

10.29478/TJP.200712.0006

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)

肥胖 ； 精神分裂症 ； 運動介入 ； 有氧運動 ； obesity ； schizophrenia ； exercise intervention ； aerobic exercise

台灣精神醫學

21卷4期（2007 / 12 / 01）

282 - 290

繁體中文

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.

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.

1. 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.
2. Allison DB,Mentore JL,Heo M(1999).Antipsychotic-induced weight gain: a comprehensive research synthesis.Am J Psychiatry,156,1686-1696.
3. Centorrino F,Wurtzman JJ,Duca KK(2002).Comprehensive weight loss program for overweight subjects treated with atypical antipsychotics.Poster presented at 155th American Psychiatric Association Annual Meeting,Philadelphia. PA:
4. Czobor P,Volavka J,Sheitman B(2002).Anti-psychotic-induced weight gain and therapeutic response: a differential association.J Clin Psychopharmacol,22,244-251.
5. Knox JM(1980).A study of weight reducing diets im psychiatric inpatients.Br J Psychiatry,136,287-289.
6. 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.
7. Rotatori AF,Fox R,Wicks A(1980).Weight loss with psychiatric residents in a behavioral self-control program.Psychol Rep,46,483-486.
8. Sletten IW,Ognjanov V,Menendez S(1967).Weight reduction with chlorphenetermine and phenmetrazine in obese psychiatric patients during chlorpromazine therapy.Curr Ther Res Clin Exp,9,570-575.
9. 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。
10. 吳至行、梁忠君、張銘峰(2001)。何謂減肥成功。基層醫學，16，61-66。

1. Yang, Yen Kuang,Tsai, Hsin Chun,Lu, Ru-Band,Chi, Mei Hung,Chen, Po See,Chang, Wei Hung(2014).Effects of Short-term Exercise Intervention on Metabolic Features and Bone Mineral Density in Patients with Serious Mental Illnesses.台灣精神醫學,28(2),121-127.
2. 蔡芸芳、吳玉茹、吳文正、王鐘賢(2016)。體感式電玩介入對慢性思覺失調症病人健康體適能之成效。護理雜誌，63(1)，49-58。
3. 藍章杰、藍旻暉、鄭學慧、蔡玉霞、程以勝、涂慧慈、林琴玲、史麗珠(2009)。健康體適能活動在都會原住民部落的成效。運動休閒餐旅研究，4(2)，122-138。
4. 林麗鳳、李幸容(2011)。衛生教育介入對日間留院精神病患體重管理之成效探討。醫護科技期刊，13(3)，155-168。
5. 蕭世朗、禚昌麟、黃鈞鈴、張明昆、留淑婷、林嘉倩(2010)。中低強度運動對服用第二代抗精神藥物Clozapine的肥胖精神分裂症病患之影響。醫護科技期刊，12(1)，35-46。