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  1. Article ; Online: Framework for understanding movement and physical activity in patients diagnosed with psychosis.

    Diamond, Rowan / Waite, Felicity / Boylan, Anne-Marie / Hicks, Alice / Kabir, Thomas / Freeman, Daniel

    BMJ mental health

    2024  Volume 27, Issue 1

    Abstract: Background: Patients diagnosed with psychosis often spend less time than others engaged in exercise and more time sitting down, which likely contributes to poorer physical and mental health.: Objective: The aim of this study was to develop a ... ...

    Abstract Background: Patients diagnosed with psychosis often spend less time than others engaged in exercise and more time sitting down, which likely contributes to poorer physical and mental health.
    Objective: The aim of this study was to develop a comprehensive framework from the perspective of patients, carers, and staff for understanding what promotes movement and physical activity.
    Methods: A critical realist approach was taken to design the study. Interviews (n=23) and focus groups (n=12) were conducted with (1) outpatients aged 16 years or older diagnosed with psychosis, and under the care of a mental health team, (2) carers and (3) mental health staff working in the community. Purposive sampling was used to maximise variation in participant characteristics. Data were analysed using reflexive thematic analysis.
    Findings: 19 patients (9 women and 10 men, mean age=45·0 (SD=12·2) years, 15 White British, 2 Black African, 1 Pakistani and 1 other ethnic group), 14 carers (11 women and 3 men, mean age=59·9 (SD=12·7) years, 13 White British and 1 Asian) and 18 staff (14 women and 4 men, mean age=38·7 (SD=12·3) years, 15 White British, 1 White other, 1 Asian Bangladeshi and 1 other Asian) participated in the study. Five factors were found to promote movement and physical activity. Patients must be able to find a purpose to moving which is meaningful to them (Factor 1: Purpose). Patients need to have an expectation of the positive consequences of movement and physical activity, which can be influenced by others' expectations (Factor 2: Predictions). A patient's current physical (eg, pain) and emotional state (eg, distress about voices) needs to be addressed to allow movement and physical activity (Factor 3: Present state). Movement and physical activity can also be encouraged by the availability of effective and tailored support, provided by engaged and supported people (Factor 4: Provision). Finally, through the identification and interruption of vicious cycles (eg, between inactivity and mood states) more positive cycles can be put in place (Factor 5: Process).
    Conclusions and clinical implications: The 5 P (Purpose, Predictions, Present state, Provision and Process Physical Activity Framework) for understanding movement and physical activity for people diagnosed with psychosis has the potential to inform future research and guide interventions. A checklist is provided for clinicians to help foster change in activity levels.
    MeSH term(s) Adult ; Female ; Humans ; Male ; Middle Aged ; Ethnicity ; Exercise ; Mental Health ; Psychotic Disorders/diagnosis ; Aged
    Language English
    Publishing date 2024-02-01
    Publishing country England
    Document type Journal Article
    ISSN 2755-9734
    ISSN (online) 2755-9734
    DOI 10.1136/bmjment-2023-300878
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Coronavirus disease 2019: achieving good mental health during social isolation.

    Diamond, Rowan / Willan, John

    The British journal of psychiatry : the journal of mental science

    2020  Volume 217, Issue 2, Page(s) 408–409

    Abstract: The coronavirus disease 2019 pandemic has led to unprecedented disruption to the normal way of life for people around the globe. Social distancing, self-isolation or shielding have been strongly advised or mandated in most countries. We suggest evidence- ... ...

    Abstract The coronavirus disease 2019 pandemic has led to unprecedented disruption to the normal way of life for people around the globe. Social distancing, self-isolation or shielding have been strongly advised or mandated in most countries. We suggest evidence-based ways that people can maintain or even strengthen their mental health during this crisis.
    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections/psychology ; Humans ; Mental Health ; Pandemics ; Pneumonia, Viral/psychology ; Quarantine/psychology ; SARS-CoV-2 ; Social Isolation/psychology
    Keywords covid19
    Language English
    Publishing date 2020-05-04
    Publishing country England
    Document type Editorial
    ZDB-ID 218103-4
    ISSN 1472-1465 ; 0007-1250
    ISSN (online) 1472-1465
    ISSN 0007-1250
    DOI 10.1192/bjp.2020.91
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Standing up for health - improving mental wellbeing during COVID-19 isolation by reducing sedentary behaviour.

    Diamond, Rowan / Byrd, Erin

    Journal of affective disorders

    2020  Volume 277, Page(s) 232–234

    Abstract: The global COVID-19 outbreak and its management are disrupting ways of life and increasing the risk of poor mental and physical health for many. The restrictions on movement have made some forms of physical activity harder to achieve and increased the ... ...

    Abstract The global COVID-19 outbreak and its management are disrupting ways of life and increasing the risk of poor mental and physical health for many. The restrictions on movement have made some forms of physical activity harder to achieve and increased the chances of more sedentary behaviour. Independent of exercise taken, sedentary behaviour can have a negative impact upon mental health, especially by lowering mood. We suggest evidence-based ways of reducing sedentary behaviour with commentary on how they may be adapted for life at home. These include: ways to use external cues, moving more frequently, maximising movement whilst waiting, reallocating time, workstation alternatives, restructuring the physical environment and recruiting help from others. At a time in which our mental and physical health needs are more critical than ever, the relationship between sedentary behaviour and low mood is of particular importance. The current situation represents a good opportunity for us all to change habits to implement a less sedentary lifestyle, for now and the future. This can start with changes we can make at home during lockdown.
    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Cues ; Depression/psychology ; Environment Design ; Exercise/psychology ; Humans ; Mental Health ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2 ; Sedentary Behavior
    Keywords covid19
    Language English
    Publishing date 2020-08-12
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 135449-8
    ISSN 1573-2517 ; 0165-0327
    ISSN (online) 1573-2517
    ISSN 0165-0327
    DOI 10.1016/j.jad.2020.07.137
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Physical activity in a pandemic: A new treatment target for psychological therapy.

    Diamond, Rowan / Waite, Felicity

    Psychology and psychotherapy

    2020  Volume 94, Issue 2, Page(s) 357–364

    Abstract: The COVID-19 pandemic and its management are placing significant new strains on people's well-being, particularly those with pre-existing mental health conditions. Physical activity has been shown to improve mental as well as physical health. Increasing ... ...

    Abstract The COVID-19 pandemic and its management are placing significant new strains on people's well-being, particularly those with pre-existing mental health conditions. Physical activity has been shown to improve mental as well as physical health. Increasing activity levels should be prioritized as a treatment target, especially when the barriers to exercise are greater than ever. Promoting physical activity has not traditionally been the remit of psychologists. Yet psychological theory and therapeutic techniques can be readily applied to address physical inactivity. We present theoretical perspectives and therapy techniques relating to (1) beliefs about physical activity, (2) motivation to be physically active, and (3) the sense of reward achieved through being physically active. We outline strategies to initiate and maintain physical activity during the COVID-19 pandemic, thereby benefitting mental and physical health. COVID-19 is demanding rapid and substantial change across the whole health care system. Psychological therapists can respond creatively by addressing physical activity, a treatable clinical target which delivers both mental and physical health benefits. PRACTITIONER POINTS: Physical activity is essential for our mental and physical health. Yet COVID-19 presents novel barriers to physical activity. Psychological theory and techniques to address beliefs, motivation, and reward can be applied to increase physical activity during COVID-19. Physical activity is an important clinical target to sustain and improve mental health, especially in the current pandemic.
    MeSH term(s) COVID-19 ; Exercise ; Health Education ; Health Knowledge, Attitudes, Practice ; Humans ; Psychotherapy
    Keywords covid19
    Language English
    Publishing date 2020-06-25
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2063873-5
    ISSN 2044-8341 ; 1476-0835
    ISSN (online) 2044-8341
    ISSN 1476-0835
    DOI 10.1111/papt.12294
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Standing up for health – improving mental wellbeing during COVID-19 isolation by reducing sedentary behaviour

    Diamond, Rowan / Byrd, Erin

    Journal of Affective Disorders

    2020  Volume 277, Page(s) 232–234

    Keywords Clinical Psychology ; Psychiatry and Mental health ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 135449-8
    ISSN 1573-2517 ; 0165-0327
    ISSN (online) 1573-2517
    ISSN 0165-0327
    DOI 10.1016/j.jad.2020.07.137
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article: Coronavirus disease 2019: achieving good mental health during social isolation

    Diamond, Rowan / Willan, John

    Br J Psychiatry

    Abstract: The coronavirus disease 2019 pandemic has led to unprecedented disruption to the normal way of life for people around the globe. Social distancing, self-isolation or shielding have been strongly advised or mandated in most countries. We suggest evidence- ... ...

    Abstract The coronavirus disease 2019 pandemic has led to unprecedented disruption to the normal way of life for people around the globe. Social distancing, self-isolation or shielding have been strongly advised or mandated in most countries. We suggest evidence-based ways that people can maintain or even strengthen their mental health during this crisis.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #154519
    Database COVID19

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  7. Article ; Online: Body image concerns in patients with persecutory delusions.

    Waite, Felicity / Diamond, Rowan / Collett, Nicola / Bold, Emily / Chadwick, Eleanor / Freeman, Daniel

    Psychological medicine

    2022  Volume 53, Issue 9, Page(s) 4121–4129

    Abstract: Background: Persecutory fears build on feelings of vulnerability that arise from negative views of the self. Body image concerns have the potential to be a powerful driver of feelings of vulnerability. Body image concerns are likely raised in patients ... ...

    Abstract Background: Persecutory fears build on feelings of vulnerability that arise from negative views of the self. Body image concerns have the potential to be a powerful driver of feelings of vulnerability. Body image concerns are likely raised in patients with psychosis given the frequent weight gain. We examined for the first-time body esteem - the self-evaluation of appearance - in relation to symptom and psychological correlates in patients with current persecutory delusions.
    Methods: One-hundred and fifteen patients with persecutory delusions in the context of non-affective psychosis completed assessments of body image, self-esteem, body mass index (BMI), psychiatric symptoms and well-being. Body esteem was also assessed in 200 individuals from the general population.
    Results: Levels of body esteem were much lower in patients with psychosis than non-clinical controls (
    Conclusions: Patients with current persecutory delusions have low body esteem. Body image concerns are associated with poorer physical and mental health, including more severe psychotic experiences. Improving body image for patients with psychosis is a plausible target of intervention, with the potential to result in a wide range of benefits.
    MeSH term(s) Male ; Humans ; Female ; Delusions/diagnosis ; Body Image ; Quality of Life ; Psychotic Disorders/psychology ; Paranoid Disorders/psychology
    Language English
    Publishing date 2022-04-07
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 217420-0
    ISSN 1469-8978 ; 0033-2917
    ISSN (online) 1469-8978
    ISSN 0033-2917
    DOI 10.1017/S0033291722000800
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Standing up for health - improving mental wellbeing during COVID-19 isolation by reducing sedentary behaviour

    Diamond, Rowan / Byrd, Erin

    J Affect Disord

    Abstract: The global COVID-19 outbreak and its management are disrupting ways of life and increasing the risk of poor mental and physical health for many. The restrictions on movement have made some forms of physical activity harder to achieve and increased the ... ...

    Abstract The global COVID-19 outbreak and its management are disrupting ways of life and increasing the risk of poor mental and physical health for many. The restrictions on movement have made some forms of physical activity harder to achieve and increased the chances of more sedentary behaviour. Independent of exercise taken, sedentary behaviour can have a negative impact upon mental health, especially by lowering mood. We suggest evidence-based ways of reducing sedentary behaviour with commentary on how they may be adapted for life at home. These include: ways to use external cues, moving more frequently, maximising movement whilst waiting, reallocating time, workstation alternatives, restructuring the physical environment and recruiting help from others. At a time in which our mental and physical health needs are more critical than ever, the relationship between sedentary behaviour and low mood is of particular importance. The current situation represents a good opportunity for us all to change habits to implement a less sedentary lifestyle, for now and the future. This can start with changes we can make at home during lockdown.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #712245
    Database COVID19

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  9. Article ; Online: Automated Virtual Reality Cognitive Therapy (gameChange) in Inpatient Psychiatric Wards: Qualitative Study of Staff and Patient Views Using an Implementation Framework.

    Brown, Poppy / Waite, Felicity / Lambe, Sinead / Jones, Julia / Jenner, Lucy / Diamond, Rowan / Freeman, Daniel

    JMIR formative research

    2022  Volume 6, Issue 4, Page(s) e34225

    Abstract: Background: Automated virtual reality (VR) therapy could allow a greater number of patients to receive evidence-based psychological therapy. The aim of the gameChange VR therapy is to help patients overcome anxious avoidance of everyday social ... ...

    Abstract Background: Automated virtual reality (VR) therapy could allow a greater number of patients to receive evidence-based psychological therapy. The aim of the gameChange VR therapy is to help patients overcome anxious avoidance of everyday social situations. gameChange has been evaluated with outpatients, but it may also help inpatients prepare for discharge from psychiatric hospital.
    Objective: The aim of this study is to explore the views of patients and staff on the provision of VR therapy on psychiatric wards.
    Methods: Focus groups or individual interviews were conducted with patients (n=19) and National Health Service staff (n=22) in acute psychiatric wards. Questions were derived from the nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability framework. Expectations of VR therapy were discussed, and participants were then given the opportunity to try out the gameChange VR therapy before they were asked questions that focused on opinions about the therapy and feasibility of adoption.
    Results: There was great enthusiasm for the use of gameChange VR therapy on psychiatric wards. It was considered that gameChange could help build confidence, reduce anxiety, and "bridge that gap" between the differences of being in hospital and being discharged to the community. However, it was reflected that the VR therapy may not suit everyone, especially if they are acutely unwell. VR on hospital wards for entertainment and relaxation was also viewed positively. Participants were particularly impressed by the immersive quality of gameChange and the virtual coach. It was considered that a range of staff groups could support VR therapy delivery. The staff thought that implementation would be facilitated by having a lead staff member, having ongoing training accessible, and involving the multidisciplinary team in decision-making for VR therapy use. The most significant barrier to implementation identified by patients and staff was a practical one: access to sufficient, private space to provide the therapy.
    Conclusions: Patients and staff were keen for VR to be used on psychiatric wards. In general, patients and staff viewed automated VR therapy as possible to implement within current care provision, with few significant barriers other than constraints of space. Patients and staff thought of many further uses of VR on psychiatric wards. The value of VR therapy on psychiatric wards now requires systematic evaluation.
    International registered report identifier (irrid): RR2-10.2196/20300.
    Language English
    Publishing date 2022-04-12
    Publishing country Canada
    Document type Journal Article
    ISSN 2561-326X
    ISSN (online) 2561-326X
    DOI 10.2196/34225
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Physical activity in a pandemic: A new treatment target for psychological therapy

    Diamond, Rowan / Waite, Felicity

    Psychol. psychother

    Abstract: The COVID-19 pandemic and its management are placing significant new strains on people's well-being, particularly those with pre-existing mental health conditions. Physical activity has been shown to improve mental as well as physical health. Increasing ... ...

    Abstract The COVID-19 pandemic and its management are placing significant new strains on people's well-being, particularly those with pre-existing mental health conditions. Physical activity has been shown to improve mental as well as physical health. Increasing activity levels should be prioritized as a treatment target, especially when the barriers to exercise are greater than ever. Promoting physical activity has not traditionally been the remit of psychologists. Yet psychological theory and therapeutic techniques can be readily applied to address physical inactivity. We present theoretical perspectives and therapy techniques relating to (1) beliefs about physical activity, (2) motivation to be physically active, and (3) the sense of reward achieved through being physically active. We outline strategies to initiate and maintain physical activity during the COVID-19 pandemic, thereby benefitting mental and physical health. COVID-19 is demanding rapid and substantial change across the whole health care system. Psychological therapists can respond creatively by addressing physical activity, a treatable clinical target which delivers both mental and physical health benefits. PRACTITIONER POINTS: Physical activity is essential for our mental and physical health. Yet COVID-19 presents novel barriers to physical activity. Psychological theory and techniques to address beliefs, motivation, and reward can be applied to increase physical activity during COVID-19. Physical activity is an important clinical target to sustain and improve mental health, especially in the current pandemic.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #616904
    Database COVID19

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