Study Protocol for a Pilot High Intensity Interval Training Intervention in Inpatient Mental Health Settings: A Two-Part Study Using a Randomised Controlled Trial and Naturalistic Study Design (preprint)

Background: Severe mental illnesses (SMI), including schizophrenia spectrum disorder, bipolar disorder and major depressive disorder are associated with physical health comorbidities and premature mortality. Physical activity and structured exercise have a beneficial impact on cardiometabolic risk and ameliorate mental health symptomology and cognition. This protocol describes a feasibility study for a high intensity interval training (HIIT) intervention amongst inpatients with SMI, to improve their physical and mental health.                                                         Methods: The feasibility study follows a two-part design owing to Covid-19 related adaptations to project design: a) A non-blinded randomized controlled trial (RCT) of 12 weeks of bicycle-based HIIT, delivered twice weekly in a face-to-face, one-to-one setting, compared to treatment as usual (TAU). b) A naturalistic study of inpatient HIIT; eligible participants will be invited to two sessions of HIIT per week, delivered by the research team remotely or in person. Additionally, participants may use the bike to conduct self-directed sessions of their chosen length and intensity. We will measure feasibility and acceptability of the HIIT intervention as primary outcomes, alongside secondary and tertiary outcomes evaluating the physical, mental and cognitive effects of HIIT. The study aims to recruit 40 patients to the RCT and 6-8 patients to the naturalistic design.                                                                                     Discussion: Exercise is a modifiable lifestyle barrier that can reverse cardiometabolic disease risk. If HIIT is found to be feasible and acceptable in inpatients with SMI there would be scope for large scale work to evaluate the clinical, cost and implementation effectiveness of HIIT in inpatient mental health settings.   Trial registration: ClinicalTrials.gov, registration no: NCT03959735, registered 22/05/2019, https://clinicaltrials.gov/ct2/show/NCT03959735

Depression is Associated with Moderate-Intensity Physical Activity Among College Students During the COVID-19 Pandemic: Differs by Activity Level, Gender and Gender Role.

PURPOSE: The novel coronavirus disease (COVID-19) pandemic and associated restrictive measures have implications for depressive symptoms (henceforth depression) of young people and risk may be associated with their reduced physical activity (PA) level. Therefore, we aimed to examine the association between depressive symptoms and PA among college students with different gender and gender role (masculinity traits and femininity traits) during the COVID-19 pandemic. PARTICIPANTS AND METHODS: Cross-sectional study included 628 healthy college students from nineteen different locations. The Center for Epidemiological Studies Depression Scales (CES-D), the International Physical Activity Questionnaire - Short Form (IPAQ-SF), and the 50-item Chinese Sex-Role Inventory (CSRI-50) were used to measure depressive symptoms, PA continuous (weekly metabolic equivalent minutes, MET-minutes/week) and categorical indicators (activity level category) and gender role, respectively. The statistical analyses were used in partial correlation analysis, t-test, one-way ANOVA, moderation model tests, and linear regression model tests. RESULTS: Total of 34.72% participants had clinically relevant depression (16, CES-D scale). Total of 58.6% participants were classified as a "low" activity level for spending less time on PA. Depression significantly negatively correlated with MET-minutes/week in moderate-intensity PA but not vigorous and walking scores. Of note, the depression-PA association was only moderated by the "low" activity level group in terms of categorical scores across gender groups. Participants with higher masculinity traits were less likely to have depression among all participants. Moreover, more recovered cases and fewer deaths could also predict the lower depression risk in the "high" activity level group. CONCLUSION: Moderate-intensity PA is beneficial for reducing depression risk among college students at a low activity level. College students with fewer masculinity traits (regardless of gender) are highly vulnerable to depression during the outbreak of COVID-19. Effective control of the COVID-19 pandemic seems critical to alleviating the burden of mental disorders of the public including depression.

Psychometric Evaluation of The Fear of COVID-19 Scale Among Chinese Population (preprint)

Background. Fear is a negative emotional reaction to or persistent worry over an imminent public health event like COVID-19. The COVID-Fear Scale was developed in many countries, but not in China. The current study aims to examined the psychometric properties of Chinese version of the Fear of COVID-19 Scale.Methods. Translation into Chinese and back-translation into English were conducted firstly. Item analysis and exploratory factor analysis in Sample 1, followed by validity tests in Sample 2). Likely, test-rest reliability was conducted in Sample 3.Results. A bifactor structure of Chinese version of FCV-19S with a general fear factor and two orthogonal group factors with fear thoughts and physical response was confirmed. Besides, it has good internal consistency reliability (α=.92), composite reliability (CR=.92) and validity correlation validity.Conclusion. The results of the present study confirmed that the Chinese version of FCV-19S has good psychometric properties in the Chinese communities.