Fitness Reference Values to Identify Health Risks in Severe Mental Disorders: A Multicenter Cross-Sectional Study from the PsychiActive Project

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Abstract
Background : One factor that could reduce the burden associated with severe mental disorders is to improve the detection of people at health risk to prioritize the application of therapeutic interventions. Having specific risk values for robust health variables that can be measured through easy-to-use, inexpensive, feasible and reliable tools would make it possible to overcome the usual lack of resources in mental health services. Aims : To provide reference values for levels of physical fitness (a more powerful predictor of disease, disability and mortality than smoking, hypertension, hypercholesterolaemia and diabetes) evaluated through low-resource tools in people with severe mental disorders. Method : In total, 305 people (83 women) with severe mental disorders aged between 20 and 82 years were evaluated on a set of components of physical fitness (aerobic fitness, strength, flexibility, agility and balance) using the Senior Fitness Test battery. Results : Reference values were provided by quartiles according to sex and age (20–39 years, 40–59 years, > 60 years). Women had significant lower performance than men in the aerobic fitness test (p <0.001; Cohen’s standardized effect size [d]: -0.83, 95 % confidence interval [CI]: -0.54, -1.12) and men had significant lower performance in the lower limb flexibility test (p <0.001; d: -0.55, CI: -0.83, -0.26). Performance in all tests was lower as age increased (standardized regression coefficients [β] ranged from -0.10 to -0.40). Conclusions : This study provides the first reference values for physical fitness components specific to adults with severe mental disorders, helping identify individuals at potential health risk and prioritize therapeutic interventions. The main contribution was to provide the first reference values of a set of physical fitness components specific for adults with severe mental disorders.

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