“Sit less, Move more”: Impact on the depression symptoms of adults with severe mental illness.

Background: Twenty-five percent of the population worldwide will experience a severe mental illness (SMI) during their lifetime. Replacing daily sedentary behaviour (SB) with physical activity (PA) can be fundamental to promote the well-being, mental health, and quality of life of adults with SMI. However, effective interventions aiming to reduce SB in adults with SMI are scarce.

Purpose: To assess the impact of a “sit less, move more” intervention on the depression symptoms, SB, and PA of adults with SMI as part of their rehabilitation.

Methods: Randomized Clinical Trial. Adults with SMI (39.8 years) were allocated to a control (n=29; 74,2% males, usual care) or intervention group (n=31; 48.3% males; Sit less, Move more). The intervention (n=16 weeks) organized “groups of friends” to meet up for regular city walks combined with social activities and individual home-based exercises. The Hamilton Depression Rating Scale (HAM-D) assessed depressive symptoms. ActivPALs™ assessed daily total sitting time, sitting time spent on bouts of different lengths, total time spent in light and moderate-to vigorous PA (MVPA). Mann-Whitney U Tests assessed group differences between baseline and at 3-months follow-up.

Results: 29 adults with SMI (93%) completed the intervention (75% adherence to the “sit less, move more” activities). Compared to the control group, scores for depressive symptoms were reduced from 13 to 6.5 (p = 0.003) from baseline to follow up, while time spent in MVPA (+11.3 min/day; 95% CI 3.7 – 18.9; size effect 0.64) and sedentary time spent in short bouts (<20') were significantly increased (+40.9 min/day; 95% CI 19.5 – 72.3; effect size 0.78).

Conclusions: Reducing SB throughout the day can reduce the severity of depressive symptoms of adults with SMI.

Practical implications: Mental Health Care Centres would benefit from adding “sit less, move more” interventions in their rehabilitation services.

Funding: AGAUR 2015 DI 024.