HPER professors study mentally ill

While reality television shows attempt to give viewers a fly-on-the-wall "insider" view of the daily lives of their casts, what appears on the screen isn't complete 24-hour footage. Instead, viewers just see an overview cut to provide a condensed synopsis of the activities of the cast. Either way, it's a challenge to make an accurate assessment of what a person - or a group of people's - everyday life is like. Luckily, two researchers in the School of Health, Physical Education and Recreation are up to the challenge - and their original data tracking methods are the first of their kind.\nBryan McCormick of Recreation and Park Administration and Georgia Frey of Kinesiology have partnered in a quest to discover the day-to-day activities of people with severe and persistent mental illnesses (a condition abbreviated "SPMI," for short). SPMI patients include people diagnosed with one or more of schizophrenia or a psychotic disorder, a major depressive or bipolar disorder or some type of anxiety disorder.\nMcCormick and Frey both say that health behavioral research in this area is scant.\n"Treatments are often looked at, but health behaviors have really not been addressed at all for this group," McCormick said.\nTo combat this, Frey and McComick designed a week-long program for SPMI adults to follow that would provide a sampling of moments from their everyday lives, combined with a measurement of their activity rate. From this data, the two have constructed a picture of the way this population lives.\nThe seven-day program is simple, but unlike reality TV, no cameras are involved.\nInstead, it relies on compliance. Participants are prompted by random beeps from a watch seven times a day to write down what they are doing, their mood, who they are with and other aspects of their daily activities. This record, coupled with a strap-on motion sensor called a uniaxial accelerometer that records their activity level, provided the scientists with comparative data groupings that acted as checks for one another, enhancing their reliability. The actions and moods in the patient's notebook were compared to the activity level recorded by the accelerometers, enabling the researchers to make connections between mood states and activity levels.\nThe quality of the results recorded through this two-fold method are impressive when compared to older methods often characterized just by a patient's recall or standardized wellness tests - and McCormick and Frey's results are markedly more in depth.\n"Accelerometers are used ubiquitously in physical research ... and interestingly, in sleep studies for restlessness, but they haven't been used to look at everyday life," Frey said. "They're a nice, objective measurement."\n"As far as we know, no one's done this before," McCormick added.\nThe researchers found the SPMI participants quite inactive, with an average of counts per minute recorded by the accelerators significantly lower than comparative groups who were active, sedentary or even mentally challenged. \nThe activity rates of SPMI participants were highly significant to McCormick and Frey because more active people generally report higher mood states. Additionally, the amount of time SPMI participants spent alone was found to be comparable to an average working age adult, and higher than the average elderly adult.\nFrey and McCormick focused on a U.S. group and a Serbian group for an international comparison- and they found that the U.S. population is more effected. \n"Its kind of counter-intuitive, but rates of disability are higher in developed countries," McCormick said. "Schizophrenics also fare better in developed countries."\nMany more SPMI patients in the United States are able to function in society as a result of the abundance of medication available here. In Serbia, McCormick says, medications are fewer, and the mentally handicapped wards of some institutions are almost unimaginable by U.S. standards. \nOther differences noticed by the researchers in the two groups were lifestyle differences and who SPMI participants were close to. In Serbia, McCormick says, people tend to live a more public life than in the United States, and Serbians also tend to be with family members more often. U.S. patients usually list friends as people they are with often, which is significant to McCormick and Frey because most of the friends listed also carry some mild disorder. This may imply, as McCormick believes, that overall Serbian SPMI patients receive better support than U.S. patients on a daily basis. \nMcCormick and Frey plan to extend the data they have gathered to focus on a complete measure of health, especially focusing on heart disease. Their eventual hope is that better methods can be devised to improve the quality of SPMI patients lives.\nIn the meantime, McCormick especially feels many questions about the day-to-day lives of SPMI patients are still unanswered.\n"These people's lives are less stimulating than people in nursing homes - but they're not bored," McCormick said. "Have they adapted somehow? There's a whole host of things I think we could study in everyday life."\n-- Contact health and science editor Kelly Phillips at kephilli@indiana.edu.