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Mohanty K, Gandhi S, Krishna Prasad M, John AP, Bhaskarapillai B, Malo P, Thirthalli J. Effectiveness of lifestyle intervention on prevention/management of antipsychotic-induced weight gain among persons with severe mental illness: A systematic review and meta-analysis. J Health Psychol 2024; 29:690-706. [PMID: 38251661 DOI: 10.1177/13591053241227384] [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] [Indexed: 01/23/2024] Open
Abstract
Individualized lifestyle interventions using motivational interviewing (MI) approach are recommended for persons with severe mental illness (SMI) for effective weight management. The aim of this meta-analysis was to assess the effectiveness of various lifestyle interventions that addressed obesity among persons with SMI. Twelve RCTs were assessed by individual reviewers using revised cochrane risk-of-bias tool (RoB 2). The standardized mean difference (SMD) was calculated with a 95% CI. The age of participants was between 18 and 70 years. Waist circumference showed an SMD of -0.09 (-0.22, 0.03), weight -0.03 (-0.10, 0.15) and BMI -0.07 (-0.07, 0.22). The findings in this meta-analysis revealed that though lifestyle interventions were statistically insignificant in reducing antipsychotic induced weight gain among persons with SMI, they show changes in intervention group. Psychosocial management along with lifestyle interventions, and MI are effective in the management of antipsychotic induced weight gain.
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Wazni L, Gifford W, Perron A, Vandyk A. Understanding the Physical Health Problems of People with Psychotic Disorders Using Digital Storytelling. Issues Ment Health Nurs 2023; 44:690-701. [PMID: 37549316 DOI: 10.1080/01612840.2023.2229435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
People with psychotic disorders struggle to be heard and express concerns beyond their mental health, especially concerns related to the side effects of treatment. Using digital storytelling, this study aimed to uncover and expose the underlying systems that oppress people with psychotic disorders from meeting their physical health needs. The stories revealed two themes: body as a contested site and biological entity with society, and (in)visible patient and paternalism. Spivak's theory of subalternity provided the theoretical basis for a critical analysis and discussion of the experiences. More research is required to highlight the power relations and structures that lead to health disparity in psychiatry.
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Affiliation(s)
- Liquaa Wazni
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Wendy Gifford
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Amélie Perron
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Amanda Vandyk
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
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Green CR, Elwyn R, Hill N, Johnston-Ataata K, Kokanović R, Maylea C, McLoughlan G, Roberts R, Thomas SDM. A critical review of research into mental health consumers' perspectives on their physical health: Is there an absence of consumers in the design, conduct, analysis and reporting of this research? Front Public Health 2023; 10:982339. [PMID: 36814954 PMCID: PMC9939465 DOI: 10.3389/fpubh.2022.982339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/28/2022] [Indexed: 02/08/2023] Open
Abstract
We conducted a critical review, using systematic methods, of the literature examining mental health consumer perspectives on their physical and mental health in academic research published between 2005 and 2021. This review examined the inclusion, extent, type and centrality of consumer perspectives regarding their mental and physical health. The search produced 1,865 papers from which 116 met the inclusion criteria. Studies predominantly focused on consumers' individual experiences of their physical and mental health, including but not limited to their understandings and experiences of medication and associated risk factors. They also captured some social aspects of mental health consumers' physical health, including factors that impacted individual agency, stigma, and social and interpersonal factors. Structural factors affecting physical and mental health, such as accessibility of services and financial constraints, were also identified. The review revealed that in comparison to clinician perspectives, the direct representation of consumer perspectives was lacking. Similarly, while clinician and carer perspectives on structural factors were investigated, the consumer perspective in this area was missing. The review also found few genuine codesigned or coproduced research studies. To better identify and respond to the health needs as prioritized by consumers, this paper argues it is imperative that future studies prioritize codesigned and coproduced research. It is argued that a focus on "services as provided" rather than "services as received" has contributed to a lack of progress in addressing the life expectancy gap for consumers. It is recommended that journals, ethics committees and research policy organizations develop guidelines and standards to inform best practice in research on consumer perspectives and experience and to support the implementation of codesigned and/or coproduced approaches in future research. Respecting and including consumers as equal partners in the research process will lead to more meaningful insights to inform policy and practice and reduce the life expectancy gap for people living with mental health concerns.
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Affiliation(s)
- Chloe R. Green
- School of Law, La Trobe University, Melbourne, VIC, Australia
| | - Rosiel Elwyn
- Psychology and Social Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia
| | - Nicholas Hill
- School of Social and Political Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Kate Johnston-Ataata
- School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia
| | - Renata Kokanović
- School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia
| | - Chris Maylea
- School of Law, La Trobe University, Melbourne, VIC, Australia
| | - Grace McLoughlan
- School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia
| | - Russell Roberts
- School of Business, Charles Sturt University, Bathurst, NSW, Australia
| | - Stuart D. M. Thomas
- School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia
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Sonethavy M, Morvillers JM. Promotion de la santé en psychiatrie et santé mentale : l’exemple du syndrome métabolique et des pratiques infirmières. Rech Soins Infirm 2022; 147:55-66. [DOI: 10.3917/rsi.147.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Soberay A, Tolle LW, Kienitz E, Olson A. The Hope Health and Wellness Clinic: Outcomes of Individuals with Serious Mental Illness in a Bidirectional Integrated Care Clinic. Community Ment Health J 2021; 57:675-683. [PMID: 33125636 DOI: 10.1007/s10597-020-00730-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 10/16/2020] [Indexed: 10/23/2022]
Abstract
The integrated health home, the Hope Health and Wellness Clinic, provides comprehensive primary and behavioral health services to adult clients of a Community Mental Health Center in Aurora, Colorado. A program evaluation of the effectiveness of this clinic was conducted over a 4 year period. Physical health data (Body Mass Index BMI, HbA1c, cholesterol, blood pressure, and waist circumference measurements) and self-report data (social connectedness, everyday functioning, psychological distress, perceived health, satisfaction with services) were tracked across time. Individuals enrolled (N = 534) experienced significant improvements over time in LDL and total cholesterol, as well as self-reported social connectedness, everyday functioning, perceived health, and psychological distress. At risk individuals demonstrated significant improvements in HDL cholesterol, triglycerides, blood pressure, tobacco and alcohol use. Individuals with serious mental illness show improvements in physical health and self-reported health after being involved in bidirectional integrated care.
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Affiliation(s)
- Adam Soberay
- Aurora Research Institute, 791 Chambers Road, Aurora, CO, USA
| | - Lauren Woodward Tolle
- University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Aurora, CO, 80045, USA.
| | - Eliza Kienitz
- Aurora Mental Health Center, 791 Chambers Rd Aurora, Aurora, CO, 80011, USA
| | - Amber Olson
- Aurora Mental Health Center, 791 Chambers Rd Aurora, Aurora, CO, 80011, USA
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Nash A, Kingstone T, Farooq S, Tunmore J, Chew-Graham CA. Switching antipsychotics to support the physical health of people with severe mental illness: a qualitative study of healthcare professionals' perspectives. BMJ Open 2021; 11:e042497. [PMID: 33637542 PMCID: PMC7919576 DOI: 10.1136/bmjopen-2020-042497] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The side effects of antipsychotic medications (APs) can increase the risk of developing physical health conditions. Some APs pose a higher risk than others. Evidence suggests switching to lower risk APs can support physical health outcomes. We sought to explore the views of healthcare professionals about switching antipsychotics to support physical health in people with severe mental illness (SMI). DESIGN A qualitative study with semi-structured interviews conducted with general practitioners (GPs), psychiatrists and mental health nurses. The main focus was to explore participants' views on the physical health of people with SMI, the impact of APs and decision-making about switching medication to support physical health. Data were analysed thematically using principles of constant comparison. SETTINGS Participants recruited through primary care and one mental health trust in the West Midlands. PARTICIPANTS Interviews were conducted with 9 GPs, 10 psychiatrists and 4 mental health nurses. RESULTS Awareness and knowledge of AP side-effects and risk profiles varied considerably between primary and secondary care clinicians. GPs reported limited awareness, while psychiatrists and nurses demonstrated a comprehensive understanding of AP risk profiles and side-effects. Mental health and control of symptoms were prioritised. Switching to promote physical health was considered as a reactive intervention, once side-effects or complications developed. There were a range of views over where responsibility lay for monitoring physical health and consideration of switching. Collaboration between primary and secondary care was identified as a way to address this. CONCLUSIONS This study presents multidisciplinary perspectives on awareness, decision making, perceived responsibility and barriers to switching APs to support physical health. Collaborative approaches that involve liaison between primary and secondary care, but tailored to the individual patient, may support switching, and present an opportunity to intervene to address the physical health inequalities experienced by individuals with SMI.
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Affiliation(s)
- Annabel Nash
- Research and Innovation Department, Midlands Partnership NHS Foundation Trust, Stafford, UK
- School of Life Sciences and Education, Staffordshire University, Stoke-on-Trent, UK
| | - Tom Kingstone
- Research and Innovation Department, Midlands Partnership NHS Foundation Trust, Stafford, UK
- School of Medicine, Keele University, Keele, UK
| | - Saeed Farooq
- Research and Innovation Department, Midlands Partnership NHS Foundation Trust, Stafford, UK
- School of Medicine, Keele University, Keele, UK
| | - Jessica Tunmore
- Research and Innovation Department, Midlands Partnership NHS Foundation Trust, Stafford, UK
- School of Medicine, Keele University, Keele, UK
| | - Carolyn A Chew-Graham
- Research and Innovation Department, Midlands Partnership NHS Foundation Trust, Stafford, UK
- School of Medicine, Keele University, Keele, UK
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Blomqvist M, Ivarsson A, Carlsson IM, Sandgren A, Jormfeldt H. Health Effects of an Individualized Lifestyle Intervention for People with Psychotic Disorders in Psychiatric Outpatient Services: A Two Year Follow-up. Issues Ment Health Nurs 2019; 40:839-850. [PMID: 31393742 DOI: 10.1080/01612840.2019.1642425] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
People with psychotic disorders experience to a great extent avoidable physical illnesses and early mortality. The aim of the study was to investigate the potential effects for this group of participating in a lifestyle intervention. A multi-component nurse-led lifestyle intervention using quasi-experimental design was performed. Changes in biomedical and clinical measurements, self-reported health, symptoms of illness and health behavior were investigated. Multilevel modeling was used to statistically test differences in changes over time. Statistically significant changes were found in physical activity, HbA1c and waist circumference. A lifestyle intervention for people with severe mental illness can be beneficial for increasing physical activity.
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Affiliation(s)
- Marjut Blomqvist
- School of Health and Welfare, Halmstad University , Halmstad , Sweden
| | - Andreas Ivarsson
- School of Health and Welfare, Halmstad University , Halmstad , Sweden
| | | | - Anna Sandgren
- Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University , Växjö , Sweden
| | - Henrika Jormfeldt
- School of Health and Welfare, Halmstad University , Halmstad , Sweden
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Bjornestad J, Lavik KO, Davidson L, Hjeltnes A, Moltu C, Veseth M. Antipsychotic treatment – a systematic literature review and meta-analysis of qualitative studies. J Ment Health 2019; 29:513-523. [DOI: 10.1080/09638237.2019.1581352] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Jone Bjornestad
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Kristina O. Lavik
- Department of Psychiatry, District General Hospital of F⊘rde, F⊘rde, Norway
| | | | - Aslak Hjeltnes
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Christian Moltu
- Department of Psychiatry, District General Hospital of F⊘rde, F⊘rde, Norway
| | - Marius Veseth
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
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