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Luciano M, Sampogna G, D'Ambrosio E, Rampino A, Amore M, Calcagno P, Rossi A, Rossi R, Carmassi C, Dell'Osso L, Bianciardi E, Siracusano A, Della Rocca B, Di Vincenzo M, Fiorillo A. One-year efficacy of a lifestyle behavioural intervention on physical and mental health in people with severe mental disorders: results from a randomized controlled trial. Eur Arch Psychiatry Clin Neurosci 2024; 274:903-915. [PMID: 37665401 PMCID: PMC11127886 DOI: 10.1007/s00406-023-01684-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/14/2023] [Indexed: 09/05/2023]
Abstract
This multicentric randomized controlled trial (RCT), carried out in six Italian University mental health sites, aims to test the efficacy of a six-month psychosocial intervention (LYFESTYLE) on Body Mass Index (BMI), body weight, waist circumference, fasting glucose, triglycerides, cholesterol, Framingham and HOmeostasis Model Assessment of insulin resistance (HOMA-IR) indexes in patients with schizophrenia, bipolar disorder, and major depression. Moreover, the efficacy of the intervention has also been tested on several other physical and mental health domains. Patients were randomly allocated to receive the six-month experimental intervention (LIFESTYLE) or a behavioural control intervention. All enrolled patients were assessed at baseline and after one year. We recruited 401 patients (206 in the experimental and 195 in the control group) with a diagnosis of schizophrenia or other psychotic disorder (29.9%), bipolar disorder (43.3%), or major depression (26.9%). At one year, patients receiving the experimental intervention reported an improvement in body mass index, body weight, waist circumference, HOMA-IR index, anxiety and depressive symptoms and in quality of life. Our findings confirm the efficacy of the LIFESTYLE intervention in improving physical and mental health-related outcomes in patients with severe mental illnesses after one year.
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Affiliation(s)
- M Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie 80039, Naples, Italy.
| | - G Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie 80039, Naples, Italy
| | - E D'Ambrosio
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - A Rampino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - M Amore
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - P Calcagno
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - A Rossi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - R Rossi
- Department of System Medicine, University of Rome Tor Vergata, Rome, Italy
| | - C Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - L Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - E Bianciardi
- Department of System Medicine, University of Rome Tor Vergata, Rome, Italy
| | - A Siracusano
- Department of System Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Bianca Della Rocca
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie 80039, Naples, Italy
| | - M Di Vincenzo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie 80039, Naples, Italy
| | - A Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie 80039, Naples, Italy
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Fabiano N, Gupta A, Wong S, Tran J, Mohammad IY, Bal S, Fiedorowicz JG, Firth J, Stubbs B, Vancampfort D, Schuch FB, Carr LJ, Shorr R, Cortese S, Manchia M, Hartman CA, Høye A, Fusar-Poli P, Koyanagi A, Vieta E, Nielsen RE, Holt RI, Correll CU, Du Rietz E, Taipale H, Lehto K, Larrson H, Nordentoft M, Dragioti E, Skonieczna-Żydecka K, Solmi M. Physical activity, suicidal ideation, suicide attempt and death among individuals with mental or other medical disorders: A systematic review of observational studies. Neurosci Biobehav Rev 2024; 158:105547. [PMID: 38246231 DOI: 10.1016/j.neubiorev.2024.105547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/19/2023] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
A growing body of research has demonstrated the potential role for physical activity as an intervention across mental and other medical disorders. However, the association between physical activity and suicidal ideation, attempts, and deaths has not been systematically appraised in clinical samples. We conducted a PRISMA 2020-compliant systematic review searching MEDLINE, EMBASE, and PsycINFO for observational studies investigating the influence of physical activity on suicidal behavior up to December 6, 2023. Of 116 eligible full-text studies, seven (n = 141691) were included. Depression was the most frequently studied mental condition (43%, k = 3), followed by chronic pain as the most common other medical condition (29%, k = 2). Two case-control studies examined suicide attempts and found an association between physical activity and a reduced frequency of such attempts. However, in studies examining suicidal ideation (k = 3) or suicide deaths (k = 2), no consistent associations with physical activity were observed. Overall, our systematic review found that physical activity may be linked to a lower frequency of suicide attempts in non-prospective studies involving individuals with mental disorders.
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Affiliation(s)
- Nicholas Fabiano
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Arnav Gupta
- Department of Medicine, University of Calgary, Calgary, AB, Canada; College of Public Health, Kent State University, Kent, OH, United States
| | - Stanley Wong
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jason Tran
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Shan Bal
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Jess G Fiedorowicz
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada; Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Brendon Stubbs
- EXI, People's Mission Hall, Whitechapel Road, London, UK; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Felipe B Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil; Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile; Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucas J Carr
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, United States
| | - Risa Shorr
- Library Services, The Ottawa Hospital, Ottawa, ON, Canada
| | - Samuele Cortese
- Centre for Innovation in Mental Health, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK
| | - Mirko Manchia
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09124 Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax NS B3H 4R2, Canada
| | - Catharina A Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulationn (ICPE), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Anne Høye
- Department of Psychiatry, UiT The Arctic University of Norway, Tromsø, Norway; Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; OASIS service, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; National Institute for Health Research Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; Catalan Institution for Research and Advanced Studies, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Eduard Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - René Ernst Nielsen
- Aalborg University Hospital, Department of Psychiatry, Aalborg, Denmark; Aalborg University, Aalborg, Denmark
| | - Richard Ig Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, UK; Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Christoph U Correll
- Charité - Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany; The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA
| | - Ebba Du Rietz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Heidi Taipale
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland; Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kelli Lehto
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Henrik Larrson
- Department of Medical Sciences, Örebro Universitet, Örebro, Sweden
| | - Merete Nordentoft
- Core-Copenhagen Research Center for Mental Health, Copenhagen University Hospital, Denmark
| | - Elena Dragioti
- Research Laboratory of Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece; Pain and Rehabilitation Centre and Department of Medical and Health Sciences, Linköping University, 581 85 Linköping, Sweden
| | | | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada; Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Charité - Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany.
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Luu B, Gupta A, Fabiano N, Wong S, Fiedorowicz JG, Fidler L, Shorr R, Solmi M. Influence of pulmonary rehabilitation on symptoms of anxiety and depression in interstitial lung disease: A systematic review of randomized controlled trials. Respir Med 2023; 219:107433. [PMID: 37863339 DOI: 10.1016/j.rmed.2023.107433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/27/2023] [Accepted: 10/17/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Interstitial lung diseases (ILDs) cause fibrosis of lung parenchyma, leading to impaired quality of life, dyspnea, and functional decline. Individuals with ILD experience a high prevalence of anxiety and depression. Recent research has demonstrated pulmonary rehabilitation (PR) alleviates symptoms of anxiety and depression in those with COPD. RESEARCH QUESTION What is the influence of PR on symptoms of anxiety and depression in individuals with ILD? STUDY DESIGN We conducted a PRISMA-2020-compliant systematic review of randomized controlled trials (RCTs) investigating PR's effect on anxiety and depression in patients with ILD. We searched MEDLINE, EMBASE, Cochrane, and PsycINFO from inception until April 3, 2023. A narrative synthesis was conducted where a quantitative approach was not feasible. RESULTS Five RCTs (n = 281) were included. Idiopathic pulmonary fibrosis (IPF) was the most common type of ILD (k = 3). One study reported clinically-significant improvements in symptoms of anxiety among patients with IPF, and two studies for symptoms of depression among patients with sarcoidosis. Dropout rates were similar between intervention and control groups. All studies were at a high risk of bias. INTERPRETATION Pulmonary rehabilitation is not detrimental to anxiety or depression for patients with ILD, and may improve symptoms of anxiety in IPF and depression in sarcoidosis. However, no conclusion can be drawn from available evidence, which is limited by heterogeneous populations/interventions, sample sizes and unexpectedly low prevalences of clinically-significant anxiety or depression. Further adequately powered RCTs that focus on anxiety and depressive symptoms as primary outcomes are needed.
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Affiliation(s)
- Brandon Luu
- Department of Internal Medicine, University of Toronto, Toronto, ON, Canada
| | - Arnav Gupta
- Department of Internal Medicine, University of Calgary, Calgary, AB, Canada; College of Public Health, Kent State University, Kent, OH, United States
| | - Nicholas Fabiano
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Stanley Wong
- Department of Psychiatry, University of Toronto, Toronto, OH, Canada
| | - Jess G Fiedorowicz
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada; Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, ON, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Lee Fidler
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Risa Shorr
- Library Services, The Ottawa Hospital, Ottawa, ON, Canada
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada; Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, ON, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
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