ABSTRACT People with mental illness not only suffer from psychiatric symptoms but also have higher chances of having chronic diseases. Due to medical comorbidity, they tend to experience the decreased health-related quality of life (HRQOL). The benefits of physical activity are well known, but few studies have examined the role of physical activity between medical comorbidity and HRQOL among people with mental illness. The purpose of this study was to examine the effect of physical activity on psychological distress, medical comorbidity, and HRQOL. A total of 3,797 individuals with mental illness were selected from the 2013 Behavioral Risk Factor Surveillance System. Analyses included multiple regression, structural equation modeling, and bootstrapping to examine a moderated mediation effect. Medical comorbidity affects HRQOL as it is mediated by decreased psychological distress. Higher levels of physical activity diminished the impact of medical comorbidity on psychological distress, which in turn decreased the negative impact of medical comorbidity on HRQOL. Study findings highlight that increased levels of physical activity could benefit people with mental illness in decreasing psychological distress and improving HRQOL. The findings suggest that mental health service providers and stakeholders need to consider integrating physical activity interventions into services and comprehensive psychiatric rehabilitation.

中文翻译：

---

体育锻炼对合并精神疾病和健康状况者的心理困扰和与健康有关的生活质量的作用

摘要精神疾病患者不仅患有精神病症状，而且罹患慢性疾病的机会也更高。由于医学上的合并症，他们倾向于经历与健康相关的生活质量（HRQOL）下降。进行体育锻炼的好处众所周知，但是很少有研究检查体育锻炼在精神疾病患者中合并症和HRQOL之间的作用。这项研究的目的是检查体育锻炼对心理困扰，医学合并症和HRQOL的影响。从2013年行为危险因素监测系统中选出了3,797名精神疾病患者。分析包括多元回归，结构方程建模和自举，以检验适度的调解效果。医学合并症会影响HRQOL，因为它是由减少的心理困扰所介导的。较高水平的体育锻炼减少了合并症对心理困扰的影响，从而减少了合并症对HRQOL的负面影响。研究发现强调，增加体育锻炼水平可以使患有精神疾病的人减少心理困扰并改善HRQOL。研究结果表明，精神卫生服务提供者和利益相关者需要考虑将体育活动干预纳入服务和全面的精神病康复中。研究结果表明，增加体育锻炼水平可以使患有精神疾病的人受益，从而减少心理困扰并改善HRQOL。研究结果表明，精神卫生服务提供者和利益相关者需要考虑将体育活动干预纳入服务和全面的精神病康复中。研究发现强调，增加体育锻炼水平可以使患有精神疾病的人减少心理困扰并改善HRQOL。研究结果表明，精神卫生服务提供者和利益相关者需要考虑将体育活动干预纳入服务和全面的精神病康复中。