Risicofactoren voor inactiviteit bij patiënten met ernstige psychiatrische aandoeningen in de langdurige zorg

BACKGROUND: Inactivity is a major problem in long-stay patients with severe mental illness. Very little research has been done into the variables that can predict and explain this inactivity. AIM: To find associations between inactivity and the variables (psychiatric, pharmacological, lifestyle and comorbidity) of patients with severe mental health illness. METHODS: A cross-sectional study was performed at 'Zon en Schild', a centre for mental health care in Amersfoort in the Netherlands. The study included too long-stay psychiatric patients hospitalized throughout the period February 2011 till July 2011. All of these patients were being treated with antipsychotics and were long-term inpatients at a psychiatric clinic. At the out-patient clinic of 'Zon en Schild' they were screened for inactivity via a subscale of the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30). Data were collected and analysed by means of a validated questionnaire, physical examination and patient records. Simple and multiple regression analyses were performed in order to find associated factors associated with inactivity. RESULTS: We found that 31.3% of the variance predicted by the multiple regression analysis model for inactivity was associated with the variables parkinsonism, negative Symptoms, metabolic syndrome, diabetes, body-mass index (BMI), first-generation antipsychotics and combination of first- and second-generation antipsychotics. Age (β=0.235, P=0.04) and a combination therapy involving traditional and atypical antipsychotics (β=0.317, p=0.04) were significantly associated with inactivity. CONCLUSION: Age and the combination of first- and second-generation antipsychotics were associated with inactivity. Cross-sectional studies do not demonstrate any causal links, but can generate a hypothesis. One possible hypothesis for the surprising link between inactivity and the combination of traditional and atypical antipsychotics is that the combination of antipsychotics promotes and fosters inactivity.