Exploring Sex Differences in Physical Activity Patterns Among Individuals with Schizophrenia Spectrum Disorders: Insights from the Diapason Project

Background: Schizophrenia spectrum disorders (SSD) affect females differently than males, yet there is limited research on Physical Activity (PA) levels and sex differences in patients with SSD. This study aimed at comparing PA levels between female and male SSD patients and controls. Methods: Altogether, 132 SSD residents and outpatients (48 females and 84 males) and 113 controls (46 females and 67 males) were assessed using standardised clinical tools. PA was monitored for seven consecutive days using a tri-axial ActiGraph GT9X accelerometer and quantified using the Euclidean Norm Minus One (ENMO) as an index of overall movement intensity. Descriptive and regression analyses were conducted. Results: Most patients were unemployed and overweight; males were less educated, less often divorced, smoking more, and using more antipsychotics than females (p < 0.05). Patients were less likely to be married, educated, employed, and had higher BMI and smoking rates than controls. Among patients, there were no significant sex differences in daily PA levels. In the control group, males showed slightly higher PA levels than females, although this difference did not reach statistical significance. Objective PA levels were not significantly associated with clinical outcomes in either female or male patients with SSD. Conclusions: Patients with SSD exhibited similarly low levels of objectively measured PA regardless of sex, suggesting a "flattening" phenomenon of sex differences in PA. These findings highlight the need for interventions aimed at promoting PA in individuals with SSD and support further research to identify factors influencing PA engagement across sexes.