Of the 151 patients invited, 120 patients agreed to be interviewed. Of these a majority were male (70 patients, or 58%), smokers (70 patients, or 58%), single (92 patients, or 77%), unemployed (98 patients, or 82%), and receiving inpatient treatment (80 patients, or 67%). A total of 82 patients (68%) were Caucasian, 27 (23%) were black, six (5%) were Asian, and five (4%) were in another racial or ethnic group. The mean±SD age was 42.6±16.1 years. Sixteen patients (13%) had recently entered the treatment service and a diagnosis had not yet been made. Of 104 participants with a diagnosis, the largest percentage had a primary diagnosis of schizophrenia (36 patients, or 35%), followed by depression (20 patients, or 19%), bipolar disorder (18 patients, or 17%), schizoaffective disorder (nine patients, or 9%), personality disorder (eight patients, or 8%), and psychosis (five patients, or 5%). The remaining eight patients were diagnosed as having either mania (two patients, or 2%), alcoholism (one patient, or 1%), anorexia (one patient, or 1%), generalized anxiety disorder (two patients, or 2%), monosymptomatic delusional disorder (one patient, or 1%), or acute confusional state (one patient, or 1%). Recommended physical activity levels—at least 30 minutes of at least moderate intensity at least five days a week (10)—were achieved by 24 participants (20%). Details of other assessments are given in Table 1.
The most popular activity was walking, followed by structured exercise at a facility. The sample was evenly split between preferring individual exercise or group exercise, and more than a third expressed no preference. Almost half agreed or strongly agreed that they would exercise more at home rather than at a gym. A majority agreed or strongly agreed that they would exercise more if they talked with an instructor or were advised to do so by their doctor. The most frequently reported reasons for not exercising were fatigue, illness, and bad weather.
A vast majority of respondents reported that they believed in the benefits of exercise for both physical and mental health and that they enjoyed exercise, but they had little confidence in being able to exercise when feeling sad or stressed and received little, if any, support for exercise from family and friends. Around half reported a high level of motivation to exercise more regularly.
The findings for exercise levels (number of days with 30 minutes of activity) and for the key psychological variables of motivation to exercise, self-efficacy, and social support were assessed for differences according to gender, age, smoking status, treatment setting, diagnosis, employment status, and marital status. When regression analysis was performed, we found no significant differences in reports of exercise levels, motivation, or social support according to these characteristics. However, self-efficacy for exercise was significantly lower among women compared with men, among patients with depression compared with those with other disorders, and among outpatients compared with inpatients. When a forced-entry regression analysis was performed, several factors remained associated with self-efficacy: gender (β=.43, p=.042), outpatient versus inpatient (β=.57, p=.011), and diagnosis (β=.76, p=.011).