Sedentary Behavior and Quality of Life in People with Psychotic Disorders from a Low Income Country: A Study from Uganda

  • Davy VancampfortEmail author
  • Michel Probst
  • Simon Rosenbaum
  • Philip B. Ward
  • Tine Van Damme
  • James Mugisha
Original Paper


The current study examined the impact of sedentary behaviour (SB) on quality of life (QoL) in people with psychotic disorders. Thirty-six Ugandan women (mean age = 33.9 ± 8.0 years) and 23 men (37.4 ± 11.8 years) with a DSM 5 diagnosis of psychosis completed the World Health Organization Quality of Life—Brief version and Simple Physical Activity Questionnaire (SIMPAQ). Medication use, physical co-morbidities, weight, height, blood pressure and smoking habits were recorded. Multiple regression analyses were undertaken. Variability in SIMPAQ sedentary and walking scores explained 56% of the variability in psychological QoL, while variability in SIMPAQ walking explained 46% of the variability in physical QoL. Health care professionals should not only consider increasing physical activity but also reducing SB to improve QoL in their patients.


Physical activity Exercise Sedentary Psychosis Quality of life 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed Consent

All participants gave their informed written consent. In case participants were not able to read or write, fingerprints were taken and a related witness signed the informed consent document.

Research Involving Human Participants and/or Animals

The study procedure was approved by the Scientific and Ethical Committee of Mengo Hospital, Kampala, Uganda and the Butabika Hospital Research Committee, Kampala, Uganda. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Supplementary material

10597_2018_353_MOESM1_ESM.docx (23 kb)
Supplementary material 1 (DOCX 23 KB)


  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). Washington, DC: American Psychiatric Association.Google Scholar
  2. Cart, L. R. S. M. (2012). Letter to the editor: Standardized use of the terms “sedentary” and “sedentary behaviours”. Applied Physiology Nutrition and Metabolism, 37(3), 540.Google Scholar
  3. Chou, C.-Y., Ma, M.-C., & Yang, T.-T. (2014). Determinants of subjective health-related quality of life (HRQoL) for patients with schizophrenia. Schizophrenia Research, 154(1), 83–88.PubMedGoogle Scholar
  4. Correll, C., Detraux, J., De Lepeleire, J., & De Hert, M. (2015). Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. World Psychiatry, 14(2), 119–136.PubMedPubMedCentralGoogle Scholar
  5. Correll, C. U., Solmi, M., Veronese, N., Bortolato, B., Rosson, S., Santonastaso, P., et al. (2017). Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: A large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry, 16(2), 163–180.PubMedPubMedCentralGoogle Scholar
  6. Dauwan, M., Begemann, M. J., Heringa, S. M., & Sommer, I. E. (2016). Exercise improves clinical symptoms, quality of life, global functioning, and depression in schizophrenia: A systematic review and meta-analysis. Schizophrenia Bulletin, 42(3), 588–599.PubMedGoogle Scholar
  7. Edwards, M. K., & Loprinzi, P. D. (2016). Effects of a sedentary behavior–inducing randomized controlled intervention on depression and mood profile in active young adults. Paper presented at the Mayo Clinic proceedings.Google Scholar
  8. Edwards, M. K., & Loprinzi, P. D. (2017). Experimentally increasing sedentary behavior results in decreased life satisfaction. Health Promotion Perspectives, 7(2), 88.PubMedPubMedCentralGoogle Scholar
  9. Gardner, D. M., Murphy, A. L., O’Donnell, H., Centorrino, F., & Baldessarini, R. J. (2010). International consensus study of antipsychotic dosing. American Journal of Psychiatry, 167, 686–693.PubMedGoogle Scholar
  10. Hjorthøj, C., Stürup, A. E., McGrath, J. J., & Nordentoft, M. (2017). Years of potential life lost and life expectancy in schizophrenia: A systematic review and meta-analysis. The Lancet Psychiatry, 4, 295–301.PubMedGoogle Scholar
  11. Lozano, R., Naghavi, M., Foreman, K., Lim, S., Shibuya, K., Aboyans, V., et al. (2012). Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 380(9859), 2095–2128.Google Scholar
  12. Mugisha, J., Abdulmalik, J., Hanlon, C., Petersen, I., Lund, C., Upadhaya, N., et al. (2017a). Health systems context (s) for integrating mental health into primary health care in six Emerald countries: A situation analysis. International Journal of Mental Health Systems, 11, 7.PubMedPubMedCentralGoogle Scholar
  13. Mugisha, J., Hert, M. D., Stubbs, B., Basangwa, D., & Vancampfort, D. (2017b). Physical health policies and metabolic screening in mental health care systems of sub-Saharan African countries: A systematic review. International Journal of Mental Health Systems. 11. 31PubMedPubMedCentralGoogle Scholar
  14. Mugisha, J., Hjelmeland, H., Kinyanda, E., & Knizek, B. L. (2011). Distancing: A traditional mechanism of dealing with suicide among the Baganda, Uganda. Transcultural Psychiatry, 48(5), 624–642.PubMedGoogle Scholar
  15. Rosenbaum, S., Tiedemann, A., Sherrington, C., Curtis, J., & Ward, P. B. (2014). Physical activity interventions for people with mental illness: A systematic review and meta-analysis. Journal of Clinical Psychiatry, 75(9), 964–974.PubMedGoogle Scholar
  16. Rosenbaum, S., & Ward, P. B. (2016). The simple physical activity questionnaire. The Lancet Psychiatry, 3(1), 1.Google Scholar
  17. Saarni, S. I., Viertiö, S., Perälä, J., Koskinen, S., Lönnqvist, J., & Suvisaari, J. (2010). Quality of life of people with schizophrenia, bipolar disorder and other psychotic disorders. The British Journal of Psychiatry, 197(5), 386–394.PubMedGoogle Scholar
  18. Sallis, J. F., Bull, F., Guthold, R., Heath, G. W., Inoue, S., Kelly, P., et al. (2016). Progress in physical activity over the Olympic quadrennium. The Lancet, 388(10051), 1325–1336.Google Scholar
  19. Skevington, S. M., Lotfy, M., & O’Connell, K. A. (2004). The World Health Organization’s WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. A report from the WHOQOL group. Quality of Life Research, 13(2), 299–310.PubMedGoogle Scholar
  20. Soundy, A., Roskell, C., Stubbs, B., & Vancampfort, D. (2014). Selection, use and psychometric properties of physical activity measures to assess individuals with severe mental illness: A narrative synthesis. Archives of Psychiatric Nursing, 28(2), 135–151.PubMedGoogle Scholar
  21. Soundy, A., Wampers, M., Probst, M., De Hert, M., Stubbs, B., & Vancampfort, D. (2013). Physical activity and sedentary behaviour in outpatients with schizophrenia: A systematic review and meta-analysis. International Journal of Therapy and Rehabilitation, 20(12), 588–596.Google Scholar
  22. Stubbs, B., Firth, J., Berry, A., Schuch, F. B., Rosenbaum, S., Gaughran, F., et al. (2016a). How much physical activity do people with schizophrenia engage in? A systematic review, comparative meta-analysis and meta-regression. Schizophrenia Research, 176, 431–440.PubMedGoogle Scholar
  23. Stubbs, B., Gardner-Sood, P., Smith, S., Ismail, K., Greenwood, K., Farmer, R., et al. (2015). Sedentary behaviour is associated with elevated C-reactive protein levels in people with psychosis. Schizophrenia Research, 168(1), 461–464.PubMedGoogle Scholar
  24. Stubbs, B., Koyanagi, A., Veronese, N., Vancampfort, D., Solmi, M., Gaughran, F., et al. (2016b). Physical multimorbidity and psychosis: Comprehensive cross sectional analysis including 242,952 people across 48 low-and middle-income countries. BMC Medicine, 14(1), 189.PubMedPubMedCentralGoogle Scholar
  25. Stubbs, B., Williams, J., Gaughran, F., & Craig, T. (2016c). How sedentary are people with psychosis? A systematic review and meta-analysis. Schizophrenia Research, 171(1–3), 103–910.PubMedGoogle Scholar
  26. Vancampfort, D., Correll, C. U., Galling, B., Probst, M., De Hert, M., Ward, P. B., et al. (2016). Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: A systematic review and large scale meta-analysis. World Psychiatry, 15(2), 166–174.PubMedPubMedCentralGoogle Scholar
  27. Vancampfort, D., Firth, D., Schuch, F., Rosenbaum, S., Mugisha, J., Hallgren, M., et al. (2017a). 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, 16(3), 308–315.PubMedPubMedCentralGoogle Scholar
  28. Vancampfort, D., Guelinckx, H., Probst, M., Stubbs, B., Rosenbaum, S., Ward, P. B., et al. (2015a). Health-related quality of life and aerobic fitness in people with schizophrenia. International Journal of Mental Health Nursing, 24(5), 394–402.PubMedGoogle Scholar
  29. Vancampfort, D., Probst, M., Scheewe, T., Maurissen, K., Sweers, K., Knapen, J., et al. (2011). Lack of physical activity during leisure time contributes to an impaired health related quality of life in patients with schizophrenia. Schizophrenia Research, 129(2), 122–127.PubMedGoogle Scholar
  30. Vancampfort, D., Stubbs, B., De Hert, M., du Plessis, C., Gbiri, C. A. O., Kibet, J., et al. (2017b). A systematic review of physical activity policy recommendations and interventions for people with mental health problems in sub-Saharan African countries. Pan African Medical Journal. 26(104).Google Scholar
  31. Vancampfort, D., Stubbs, B., Mitchell, A. J., De Hert, M., Wampers, M., Ward, P. B., et al. (2015b). Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: A systematic review and meta-analysis. World Psychiatry, 14(3), 339–347.PubMedPubMedCentralGoogle Scholar
  32. Vancampfort, D., Stubbs, B., Ward, P., Teasdale, S., & Rosenbaum, S. (2015c). Integrating physical activity as medicine in the care of people with severe mental illness. Australian and New Zealand Journal of Psychiatry, 49(8), 681–682.PubMedGoogle Scholar
  33. Vancampfort, D., Stubbs, B., Ward, P. B., Teasdale, S., & Rosenbaum, S. (2015d). Why moving more should be promoted for severe mental illness. The Lancet Psychiatry, 2(4), 295.PubMedGoogle Scholar
  34. Vancampfort, D., Wampers, M., Mitchell, A., Correll, C., Herdt, A., Probst, M., et al. (2013). A meta-analysis of cardio-metabolic abnormalities in drug naive, first-episode and multi-episode patients with schizophrenia versus general population controls. World Psychiatry, 12(3), 240–250.PubMedPubMedCentralGoogle Scholar
  35. Vanhees, L., Lefevre, J., Philippaerts, R., Martens, M., Huygens, W., Troosters, T., et al. (2005). How to assess physical activity? How to assess physical fitness? European Journal of Cardiovascular Prevention & Rehabilitation, 12(2), 102–114.Google Scholar
  36. Whiteford, H. A., Degenhardt, L., Rehm, J., Baxter, A. J., Ferrari, A. J., Erskine, H. E., et al. (2013). Global burden of disease attributable to mental and substance use disorders: Findings from the Global Burden of Disease Study 2010. The Lancet, 382(9904), 1575–1586.Google Scholar
  37. World Health Organization. (1993). The ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. Geneva: World Health Organization.Google Scholar
  38. World Health Organization. (2011). Mental health atlas 2011. Geneva: World Health Organization.Google Scholar
  39. Zipursky, R. B., Menezes, N. M., & Streiner, D. L. (2014). Risk of symptom recurrence with medication discontinuation in first-episode psychosis: A systematic review. Schizophrenia Research, 152(2), 408–414.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Rehabilitation SciencesKU LeuvenLeuvenBelgium
  2. 2.University Psychiatric CentreKU LeuvenKortenbergBelgium
  3. 3.School of PsychiatryUNSWSydneyAustralia
  4. 4.The Black Dog InstituteRandwickAustralia
  5. 5.Schizophrenia Research UnitIngham Institute of Applied Medical ResearchLiverpoolAustralia
  6. 6.Kyambogo UniversityKampalaUganda
  7. 7.Butabika National Referral and Mental Health HospitalKampalaUganda

Personalised recommendations