People with psychosis engage in low levels of physical activity, with men who have the serious mental disorder two times more likely to miss global activity targets compared to people without the illness, a study has found.

The results offer insights into the barriers that prevent people with psychosis from taking part in regular physical activity.

The research, led by King’s College London and the South London and Maudsley (SLaM) NHS Foundation Trust, studied more than 200,000 people in nearly 50 countries.

The World Health Organization (WHO) recommends that adults aged 18-64 should do at least 150 minutes of moderate-intensity physical activity throughout the week, including walking, cycling, household chores or sport. Physical inactivity is the fourth leading cause of avoidable death and is as harmful as smoking, according to the WHO.

People with psychosis die up to 15 years before the general population, largely due to cardiovascular disease.

The researchers sought to examine whether people with psychosis are meeting the WHO’s recommended levels of physical activity.

In their study, published in Schizophrenia Bulletin, the researchers collected data from the World Health Survey, which comprises more than 200,000 people aged 18-64 from nearly 50 low-and-middle-income countries. These individuals, who were living in their communities at the time of the study, were divided into three groups: people with a diagnosis of psychosis; those with psychotic symptoms but no diagnosis; and a control group (of people with no diagnosis of psychosis and no symptoms in the past 12 months).

The participants were interviewed to find out who had or had not met recommended levels of physical activity.

Overall, people with psychosis were 36 per cent more likely not to meet the recommended physical activity levels outlined by the WHO. When the researchers looked at men only, those with psychosis were over two times more likely not to meet the recommended levels compared to people in the control group.

When examining potential barriers, the researchers found that mobility difficulties, pain, depression and cognitive impairment explained the low levels of physical activity.

These findings will be used to guide a further King’s College London study called “Walk this Way”.

Dr Brendon Stubbs from King’s College London and the South London and Maudsley NHS Foundation Trust (SLaM), said: “Understanding and overcoming these barriers could be an important strategy to help people with psychosis be more active, and potentially to reduce their risk of cardiovascular disease.

“Our Walk this Way study is the first to specifically target the reduction of a sedentary lifestyle, and an increase in activity levels, in people with psychosis. We will investigate whether health coaching and providing people with pedometers can increase daily activity levels and hope that if successful, this programme will be offered more widely to people with psychosis.”

Dr Fiona Gaughran, also of King’s College London and SLaM, said: “People with psychosis have high levels of cardiovascular risk and die earlier as a result. Since physical activity is a key protective factor for cardiovascular disease, our finding that men with psychosis are particularly inactive means that they may benefit most from interventions to increase physical activity and reduce social isolation.

“It is unclear why men with psychosis showed such low levels of physical activity, although perhaps the earlier onset of illness typically seen in males means that lifestyle habits may have been altered over time by aspects of the illness or its management, such as negative symptoms, sedating medications or hospital admissions. Our data suggests that depression may also be important, which makes sense. Understanding these factors and what we might do about them is an important area for future research.”