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Maurus I, Wagner S, Spaeth J, Vogel A, Muenz S, Seitz V, von Philipsborn P, Solmi M, Firth J, Stubbs B, Vancampfort D, Hallgren M, Kurimay T, Gerber M, Correll CU, Gaebel W, Möller HJ, Schmitt A, Hasan A, Falkai P. EPA guidance on lifestyle interventions for adults with severe mental illness: A meta-review of the evidence. Eur Psychiatry 2024; 67:e80. [PMID: 39655999 DOI: 10.1192/j.eurpsy.2024.1766] [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] [Indexed: 12/18/2024] Open
Abstract
There is growing interest in lifestyle interventions as stand-alone and add-on therapies in mental health care due to their potential benefits for both physical and mental health outcomes. We evaluated lifestyle interventions focusing on physical activity, diet, and sleep in adults with severe mental illness (SMI) and the evidence for their effectiveness. To this end, we conducted a meta-review and searched major electronic databases for articles published prior to 09/2022 and updated our search in 03/2024. We identified 89 relevant systematic reviews and assessed their quality using the SIGN checklist. Based on the findings of our meta-review and on clinical expertise of the authors, we formulated seven recommendations. In brief, evidence supports the application of lifestyle interventions that combine behavioural change techniques, dietary modification, and physical activity to reduce weight and improve cardiovascular health parameters in adults with SMI. Furthermore, physical activity should be used as an adjunct treatment to improve mental health in adults with SMI, including psychotic symptoms and cognition in adults with schizophrenia or depressive symptoms in adults with major depression. To ameliorate sleep quality, cognitive behavioural informed interventions can be considered. Additionally, we provide an overview of key gaps in the current literature. Future studies should integrate both mental and physical health outcomes to reflect the multi-faceted benefits of lifestyle interventions. Moreover, our meta-review highlighted a relative dearth of evidence relating to interventions in adults with bipolar disorder and to nutritional and sleep interventions. Future research could help establish lifestyle interventions as a core component of mental health care.
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Affiliation(s)
- Isabel Maurus
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sarah Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Johanna Spaeth
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Anastasia Vogel
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Muenz
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Valentina Seitz
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Peter von Philipsborn
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Munich, Germany
- Pettenkofer School of Public Health, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ontario, Canada
- Regional Centre for the Treatment of Eating Disorders and On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada
- Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, University of Ottawa, Ontario, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Brendon Stubbs
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne, Australia
| | - Tamás Kurimay
- North-Buda Saint John Central Hospital, Buda Family Centered Mental Health Centre, Department of Psychiatry and Psychiatric Rehabilitation, Teaching Department of Semmelweis University, Budapest, Hungary
| | - Markus Gerber
- Department of Sport, Exercise and Health (DSBG), University of Basel, Switzerland
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- German Center for Mental Health (DZPG), Berlin, Germany
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Duesseldorf, Germany
- WHO Collaborating Centre DEU-131, LVR-Klinikum Düsseldorf, Duesseldorf, Germany
| | - Hans-Jürgen Möller
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, São Paulo, Brazil
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany
- German Center for Mental Health (DZPG), Munich/Augsburg, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- German Center for Mental Health (DZPG), Munich/Augsburg, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
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Ng R, El-Den S, Collins JC, McMillan SS, Hu J, Wheeler AJ, O'Reilly CL. Community pharmacists' views and experiences of delivering in-pharmacy medication reviews for people living with severe and persistent mental illness: a qualitative study. Int J Clin Pharm 2024; 46:862-871. [PMID: 38551748 PMCID: PMC11286626 DOI: 10.1007/s11096-024-01720-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/26/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND People living with severe and persistent mental illness (SPMI) often take multiple medications and are at risk of experiencing medication related problems. Medication review services have the potential to reduce inappropriate use of psychotropic medications and improve adherence. However, there is limited research regarding pharmacists' perspectives when providing such services. AIM To explore community pharmacists' views and experiences of providing an in-pharmacy medication review (MedsCheck) for people living with SPMI. METHOD Semi-structured interviews were conducted between November 2021 and May 2022 with community pharmacists participating in the comparator group of the PharMIbridge Randomised Controlled Trial (RCT), which aimed to improve medication adherence and manage physical health concerns for people living with SPMI. Interviews were recorded, transcribed, and analysed using inductive thematic analysis. RESULTS Fifteen semi-structured interviews were conducted with community pharmacists including pharmacy owners, managers and employee pharmacists. Most pharmacist participants who were interviewed (n = 10) were aged under 39 and more than half (n = 8) had 10 or more years of pharmacy experience. Five key themes were identified: 1) Pharmacists' roles in the management of SPMI in community pharmacy; 2) Mental health education and training; 3) Pharmacy resources; 4) Challenges with interprofessional collaboration and 5) Impact on professional relationships and consumer outcomes. CONCLUSION Pharmacists are motivated to support people living with SPMI. Mental health training, as well as arrangements regarding pharmacy workflow and appropriate remuneration are needed to enable pharmacists to better support people living with SPMI. Referral pathways should be directly accessible by community pharmacists to assist interprofessional collaboration.
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Affiliation(s)
- Ricki Ng
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Jack C Collins
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Sara S McMillan
- Centre for Mental Health and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, Australia
| | - Jie Hu
- Centre for Mental Health and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Amanda J Wheeler
- Centre for Mental Health and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
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Sampogna G, Luciano M, Di Vincenzo M, Toni C, D’Ambrosio E, Rampino A, Rossi A, Rossi R, Amore M, Calcagno P, Siracusano A, Niolu C, Dell’Osso L, Carpita B, Fiorillo A. Physical activity influences adherence to pharmacological treatments in patients with severe mental disorders: results from the multicentric, randomized controlled LIFESTYLE trial. Front Pharmacol 2023; 14:1285383. [PMID: 38152689 PMCID: PMC10752611 DOI: 10.3389/fphar.2023.1285383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/20/2023] [Indexed: 12/29/2023] Open
Abstract
Introduction: Poor adherence to pharmacological treatment is frequent in people with severe mental disorders and it often causes lack of effectiveness of many psychotropic drugs. Thus, efforts should be made to improve adherence to pharmacological treatments in patients with these disorders. Methods: In this paper, based on the LIFESTYLE randomized, controlled multicentric trial, we aim to: 1) assess the level of adherence in a real-world sample of patients with severe mental disorders; 2) evaluate differences in treatment adherence according to patients' socio-demographic and clinical characteristics; 3) evaluate the impact of an innovative psychosocial intervention, on patients' adherence to treatments. The Lifestyle Psychosocial Group Intervention consists of group sessions, focused on different lifestyle behaviours, including healthy diet; physical activity; smoking habits; medication adherence; risky behaviours; and regular circadian rhythms. At end of each session a 20-min moderate physical activity is performed by the whole group. Results: The sample consists of 402 patients, mainly female (57.1%, N = 229), with a mean age of 45.6 years (±11.8). Less than 40% of patients reported a good adherence to pharmacological treatments. Adherence to treatments was not influenced by gender, age, diagnosis and duration of illness. At the end of the intervention, patients receiving the experimental intervention reported a significant improvement in the levels of adherence to treatments (T0: 35.8% vs. T3: 47.6%, p < 0.005). Patients practicing moderate physical activity reported a two-point improvement in the levels of adherence [odds ratio (OR): 1,542; 95% confidence intervals (CI): 1,157-2,055; p < 0.001], even after controlling for several confounding factors. Discussion: The experimental lifestyle intervention, which can be easily implemented in the routine clinical practice of mental health centres, was effective in improving adherence to pharmacological treatments.
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Affiliation(s)
- Gaia Sampogna
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Matteo Di Vincenzo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Claudia Toni
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Enrico D’Ambrosio
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Rampino
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Mario Amore
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Pietro Calcagno
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alberto Siracusano
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Cinzia Niolu
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
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Stewart V, McMillan SS, Hu J, Collins JC, El-Den S, O'Reilly C, Wheeler AJ. Refining a taxonomy of goals planned between mental health consumers and community pharmacists. Res Social Adm Pharm 2023; 19:1391-1397. [PMID: 37468372 DOI: 10.1016/j.sapharm.2023.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/13/2023] [Accepted: 07/12/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND People living with severe and persistent mental illnesses are more likely to experience co-morbid health conditions. Health-related behavior change can be promoted by the use of goal planning within community pharmacy settings. OBJECTIVES To trial and refine a recently developed taxonomy to categorize goals co-designed between community pharmacists and people living with severe and persistent mental illnesses. This study also compared the data to the previously published taxonomy data to determine if the taxonomy could be applied across a range of mental health conditions. METHODS The published goal taxonomy was refined using data from a cluster randomized controlled trial (PharMIbridge). Community pharmacists provided an individualized support service using goal planning with people living with severe and persistent mental illnesses. Goals were categorized using the existing taxonomy and inconsistencies were used to modify and refine the taxonomy. Additionally, participant characteristics and categorization of goals were compared with results from the previous study. RESULTS 512 goals were reported by 158 consumer participants and categorized into five domains that included a diverse range of health behaviors (e.g., relationships, diet). Minor refinements to the taxonomy were made by replacing, adding or removing categories/descriptors. CONCLUSIONS Significant overlap between the goals of participants and the existing taxonomy was found, supporting the application of the taxonomy across different mental health conditions.
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Affiliation(s)
- Victoria Stewart
- Centre for Mental Health, Griffith University, Australia; Menzies Health Institute Queensland, Griffith University, Australia; School of Pharmacy and Medical Sciences, Griffith University, Australia.
| | - Sara S McMillan
- Centre for Mental Health, Griffith University, Australia; Menzies Health Institute Queensland, Griffith University, Australia; School of Pharmacy and Medical Sciences, Griffith University, Australia
| | - Jie Hu
- Centre for Mental Health, Griffith University, Australia; Menzies Health Institute Queensland, Griffith University, Australia; School of Pharmacy and Medical Sciences, Griffith University, Australia
| | - Jack C Collins
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Claire O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Amanda J Wheeler
- Menzies Health Institute Queensland, Griffith University, Australia; School of Pharmacy and Medical Sciences, Griffith University, Australia; Faculty of Health and Behavioural Sciences, University of Auckland, New Zealand
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Zhang MZ, Shi JX, Rao WM, Chen R, Yang HG, Wu NJ, He QQ. The mediating effects of social support on the association between depression and life satisfaction among patients with schizophrenia or bipolar disorder. Medicine (Baltimore) 2023; 102:e33531. [PMID: 37083814 PMCID: PMC10118370 DOI: 10.1097/md.0000000000033531] [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: 02/11/2023] [Accepted: 03/24/2023] [Indexed: 04/22/2023] Open
Abstract
Patients with schizophrenia or bipolar disorders in community had poor psychosocial functioning, social support, and life satisfaction. However, the interaction effects of social support and depression on life satisfaction remains unclear. Thus, we examined these associations among patients with schizophrenia or bipolar disorder. This cross-sectional study was conducted from October to December 2020 in Shenzhen, China. Information on social support, depression, and life satisfaction was assessed by standardized questionnaires through a face-to-face interview. Hierarchical multiple regression analysis was performed to estimate the associations of social support and depression with life satisfaction and to explore the mediation effect of social support. A total of 293 patients aged 39.7 ± 11.1 years (males: 47.1 %) were included in this study. Social support was positively associated with high life satisfaction (explaining 7.2% of the variance), while depression was negatively associated with life satisfaction (explaining 17.8% of the variance). Furthermore, social support mediated 12.5% of the association between depression and life satisfaction. Social support and depression were significantly associated with life satisfaction in patients with schizophrenia or bipolar disorders. Moreover, social support mediated the association between depression and life satisfaction in this population. Health interventions that benefit social support should be promoted to alleviate the negative impact of depression on their life satisfaction.
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Affiliation(s)
- Min-Zhe Zhang
- School of Public Health, Wuhan University, Wuhan, P. R. China
| | - Jun-Xia Shi
- Center of Prevention and Control of Pingshan, Shenzhen, P. R. China
| | - Wei-Ming Rao
- School of Public Health, Wuhan University, Wuhan, P. R. China
| | - Rui Chen
- School of Public Health, Wuhan University, Wuhan, P. R. China
| | - Hong-Guang Yang
- School of Public Health, Wuhan University, Wuhan, P. R. China
| | - Neng-Jian Wu
- Center of Prevention and Control of Pingshan, Shenzhen, P. R. China
| | - Qi-Qiang He
- School of Public Health, Wuhan University, Wuhan, P. R. China
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Wilson C, Carpenter JS, Nichles A, Zmicerevska N, Song YJC, McHugh C, Hamilton B, Hockey S, Crouse J, Koethe D, Scott EM, Hickie IB. Double-blind, randomised placebo-controlled clinical trial of metformin as an adjunct to a sleep-wake, activity and metabolically focused behavioural intervention to improve cardiometabolic outcomes and mood symptoms in youth with major mood syndromes: study protocol. BMJ Open 2023; 13:e064682. [PMID: 36810174 PMCID: PMC9945047 DOI: 10.1136/bmjopen-2022-064682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
INTRODUCTION Metformin is a medication likely to improve measures of cardiometabolic disturbance in young people with mental illness. Evidence also suggests metformin may improve depressive symptoms. This 52-week double-blind randomised control trial (RCT) aims to investigate the efficacy of metformin pharmacotherapy as an adjunct to a healthy lifestyle behavioural intervention in improving cardiometabolic outcomes, and depressive, anxiety and psychotic symptoms in youth with clinically diagnosed major mood syndromes. METHODS AND ANALYSIS At least 266 young people aged 16-25 presenting for mental healthcare for major mood syndromes who are also at risk for poor cardiometabolic outcomes will be invited to participate in this study. All participants will engage in a 12-week sleep-wake, activity and metabolically focused behavioural intervention programme. As an adjunctive intervention, participants will receive either metformin (500-1000 mg) or placebo pharmacotherapy for 52 weeks.Participants will undergo a series of assessments including: (1) self-report and clinician-administered assessments; (2) blood tests; (3) anthropometric assessments (height, weight, waist circumference and blood pressure); and (4) actigraphy. Univariate and multivariate tests (generalised mixed-effects models) will be used to examine changes in primary and secondary outcomes (and associations with predetermined predictor variables). ETHICS AND DISSEMINATION This study has been approved by the Sydney Local Health District Research Ethics and Governance Office (X22-0017). The results of this double-blind RCT will be disseminated into the scientific and broader community through peer-reviewed journals, conference presentations, social media and university websites. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ANZCTR) Number: ACTRN12619001559101p, 12 November 2019.
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Affiliation(s)
- Chloe Wilson
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | | | - Alissa Nichles
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Natalia Zmicerevska
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Yun Ju Christine Song
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Catherine McHugh
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Blake Hamilton
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Samuel Hockey
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Jacob Crouse
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Dagmar Koethe
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Elizabeth M Scott
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
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Kuipers S, Castelein S, Kronenberg L, Veer JV’, Boonstra N. A Human-Centered Design Approach to Develop Oral Health Nursing Interventions in Patients with a Psychotic Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3475. [PMID: 36834171 PMCID: PMC9960686 DOI: 10.3390/ijerph20043475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/11/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
In mental health, oral health is often given little attention. Mental health nurses (MHNs) are professionally the appropriate target group to support maintaining and increasing oral health. We aimed to develop and validate personas that reflect the attitudes and needs of MHNs regarding oral health in patients with a psychotic disorder. We used a human-centered design with contextual interviews (n = 10) to address the key issues of the problems and needs of MHNs working with patients with a psychotic disorder. We analyzed the data thematically and reflected on insights into unique personas, which were then validated by conducting semi-structured interviews (n = 19) and member checking. Four personas were found based on attitudes and perspectives, barriers, needs, suggestions for interventions, and site conditions regarding practicing oral care in this patient group. Our findings were as follows: the attitudes and perspectives differed from not feeling any responsibility to a holistic obligation, including oral health; suggestions for interventions for MHNs ranged from interventions focusing on improving skills and knowledge to using practical tools; most MHNs recognized themselves within a persona that had a holistic obligation that included oral health; in addition, the MHNs indicated that they considered the issue of oral health in this patient group important, but, in practice, took little responsibility for that role. These findings suggest that a toolkit with interventions for MHNs that are tailored to the personas that emerged from our research should be developed by MHNs in co-creation with designers. The differences between the perceived role and MHNs' practice in oral health highlighted the need for role clarification and professional leadership of MHNs regarding oral health, which should be considered when developing interventions.
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Affiliation(s)
- Sonja Kuipers
- Research Group Healthcare & Innovation in Psychiatry, Department of Healthcare, NHL Stenden University of Applied Sciences, Rengerslaan 8-10, 8900 CG Leeuwarden, The Netherlands
- Department of Experimental Psychopathology and Clinical Psychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
| | - Stynke Castelein
- Department of Experimental Psychopathology and Clinical Psychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
- Lentis Research, Lentis Psychiatric Institute, Hereweg 80, 9725 AG Groningen, The Netherlands
| | - Linda Kronenberg
- Dimence Mental Health Care, Burgemeester Roelenweg 9, 8021 EV Zwolle, The Netherlands
| | - Job van ’t Veer
- Research Group Digital Innovation in Care and Welfare, Department of Healthcare, NHL Stenden University of Applied Sciences, Rengerslaan 8-10, 8900 CG Leeuwarden, The Netherlands
| | - Nynke Boonstra
- Research Group Healthcare & Innovation in Psychiatry, Department of Healthcare, NHL Stenden University of Applied Sciences, Rengerslaan 8-10, 8900 CG Leeuwarden, The Netherlands
- KieN Early Intervention Service, Oosterkade 72, 8911 KJ Leeuwarden, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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Improving physical activity and diet in patients with severe mental disorders: Results from the LIFESTYLE multicentric, real-world randomized controlled trial. Psychiatry Res 2022; 317:114818. [PMID: 36088834 DOI: 10.1016/j.psychres.2022.114818] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/27/2022] [Accepted: 08/30/2022] [Indexed: 11/23/2022]
Abstract
Aims of the present study are to test the efficacy of a lifestyle group intervention, compared to a brief psychoeducational intervention, on levels of physical activity and dietary habits in a real-world sample of patients with severe mental disorders. The study, funded by the Italian Ministry of Education, has been carried out in six Italian University psychiatric outpatient units. All patients were randomly assigned to the experimental or control group and were assessed through standardized assessment instruments at baseline and six months after randomization. Of the 401 recruited patients, 43.3% had a diagnosis of bipolar disorder, 29.9% of psychosis and 26.9% of major depression. Patients were mainly female (57%), with a mean age of 45.6±11.8 years. Treated patients have almost 8 times the likelihood to show an increase of the total MET (OR: 8.02; p < .001) and of the walking MET (OR: 7.68; p < .001) and are more likely to increase the weekly consumption of vegetables (OR= 1.98, p < .05) and to reduce that of junk food (OR:0.23; p < .05). The present study support the notion that patients with severe mental disorders can improve their lifestyle behaviours and that, with appropriate support, they can achieve a healthy living.
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9
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Wu X, Xia L, Yang Y, Zhang L, Li M, Liu T, Liu Y, Cotes RO, Jiang F, Tang YL, Liu H. Mortality among psychiatric inpatients in China: A national survey. Asian J Psychiatr 2022; 77:103262. [PMID: 36181753 DOI: 10.1016/j.ajp.2022.103262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/28/2022] [Accepted: 09/14/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Patients with mental disorders are at increased risk of premature mortality. Psychiatric inpatients are a particularly vulnerable population, yet data on the mortality rate and causes of death among psychiatric inpatients in a national sample are scarce. METHODS We analyzed data collected from patients who died during psychiatric hospitalization in 2019 and 2020 from 41 psychiatric hospitals in China. RESULTS In total, 719 inpatients died over the study period. There were more deaths in 2019 (N = 409, 56.9%) compared to 2020 (N = 310, 43.1%). The mean age was 73.3 ± 16.5 years old, with males significantly younger than females (71.5 ± 16.9 vs. 75.9 ± 15.6, p < 0.001). Sudden death accounted for 11.5% of all deaths. The cause was unknown for 31.2% of cases. Among those with known causes of death, respiratory disorders were most common in patients with psychotic disorders (41.9%) and mood disorders (29.8%). Suicide accounted for 17.0% of deaths in patients with mood disorders. CONCLUSION Patients who died during psychiatric hospitalization were overall older (>70 years), and more than one in ten died due to sudden death. While respiratory disorders accounted for the largest proportion of known causes, the causes were unknown in nearly one-third. Death due to suicide, a preventable cause, remained common among patients with mood disorders. Evidence-based interventions should be implemented.
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Affiliation(s)
- Xiaodong Wu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yating Yang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Ling Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Mengdie Li
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Tingfang Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Robert O Cotes
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, USA
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China; Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China.
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, USA; Atlanta Veterans Affairs Medical Center, Decatur, Georgia, USA.
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China.
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10
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Sampogna G, Borgi M, Collacchi B, Cirulli F, Cerino S, Rullo S, Di Vincenzo M, Luciano M, Di Tommaso V, Moliterni S, Bichi A, Garside J, Kivistö S, Iarion A, Fiorillo A. Using sport-based interventions for people with severe mental disorders: results from the European EASMH study. Int Rev Psychiatry 2022; 34:837-847. [PMID: 36786110 DOI: 10.1080/09540261.2022.2106122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
People with severe mental disorders report significantly poorer physical health and a higher mortality rate compared with the general population. Several interventions have been proposed in order to challenge this mortality gap, the promotion of physical activities represents one of the most important strategies. In fact, in people with severe mental disorders, physical activity can improve body composition, quality of life, personal functioning, self-esteem, cognition, and cardiorespiratory fitness, as well as reducing affective, psychotic and anxiety symptoms, cardiometabolic burden and increase the global recovery. While sport-based programs are consistently being proposed as an integral part of effective personalized treatment approaches for people with severe mental disorders, their routine implementation is hampered by poor working task integration among different professionals and the lack of training programmes for sport professionals focused on people with severe mental disorders. In this paper, we will: (a) review the efficacy of exercise/sport-based interventions for people with severe mental disorders; (b) describe the main difficulties in engaging patients with severe mental disorders in these interventions; and (c) report the results of the first study on the best practices available in Europe in the field of sport and mental health carried out in the context of the European Alliance for Sport and Mental Health (EASMH) project. According to the EASMH survey, sport-based psychosocial interventions are not frequently available in mental health services, with significant differences at the European level. In the near future, it would be advisable to promote the integration and collaboration between mental health professionals and sport professionals, in order to improve the dissemination and availability of sport-based interventions in routine clinical practice. The EASMH project aims to fill this gap by creating a network of collaborators, researchers and stakeholders with different backgrounds in order to improve the dissemination of sport-based rehabilitation interventions and by developing an innovative training programme for sport coaches in order to improve their skills in interacting and building an effective relationship with people with severe mental disorders.
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Affiliation(s)
- Gaia Sampogna
- Department of Psychiatry, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Marta Borgi
- National Institute of Health, Rome, Italy.,European Culture and Sport Organization, ECOS, Rome; Italy
| | | | - Francesca Cirulli
- National Institute of Health, Rome, Italy.,European Culture and Sport Organization, ECOS, Rome; Italy
| | | | - Santo Rullo
- European Culture and Sport Organization, ECOS, Rome; Italy
| | - Matteo Di Vincenzo
- Department of Psychiatry, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | | | | | - Alberto Bichi
- The European Platform for Sport Innovation, EPSI, Brussels; Belgium
| | | | | | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania 'Luigi Vanvitelli', Naples, Italy
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11
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Reis da Silva DA, de Almeida LS, Correa LL, Pimentel RFW, Gomes AMT, Travassos AG, Viana AM, Cerqueira MMBDF, de Souza MC, de Sousa AR, Barbosa PJB, Coelho JMF, Magalhães LBNC, D’Oliveira Júnior A, Cavalcante Neto JL, Santos CS, França LCM, Brandão JDL, dos Santos LFDM, Gomes HF, Peres EM, Rossi TRA, Damasceno KSM, das Mercês MC, Fernandes SL, Soriano EDA, Maduro IPDNN, Brandão TS, Menezes AC, Santana AIC, das Merces MC. Prevalence and Factors Associated with Metabolic Syndrome in Patients at a Psychosocial Care Center: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10203. [PMID: 36011835 PMCID: PMC9407874 DOI: 10.3390/ijerph191610203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Metabolic syndrome (MS) is associated with greater risk of morbimortality and it has high prevalence in people with mental illness. OBJECTIVE Estimate the prevalence of Metabolic Syndrome (MS) and its associated factors in the patients of a Psychosocial Care Center (CAPS in Brazilian Portuguese) in the city of Salvador, state of Bahia, Brazil. METHOD Cross-sectional study set at CAPS in the city of Salvador-Bahia between August 2019 and February 2020. MS was evaluated according to the National Cholesterol Education Program's Adult Treatment Panel III. In addition to descriptive statistics, gross and adjusted prevalence ratios were described. RESULTS MS was found in 100 (35.2%) individuals, 116 (40.9%) were obese and 165 (58.1%) had increased waist circumference. Polypharmacy was identified in 63 (22.3%) patients and 243 (85.9%) used antipsychotics. Under gross evaluation, women (PR = 1.88; 95%CI: 1.35-2.63) and those who used antidepressants (PR = 1.41; 95%CI: 1.05-1.88) showed an association with MS. After logistic regression, depression (PR = 1.86; 95%CI: 1.38-2.51), acanthosis (PR = 1.50; 95%CI: 1.18-1.90), use of antipsychotics (PR = 1.88; 95%CI: 1.13-2.75), and hypertriglyceridemic waist (PR = 3.33; 95%CI: 2.48-4.46) were associated with MS. CONCLUSION The prevalence of MS signals multimorbidity among individuals with mental disorders and suggests a need for clinical screening.
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Affiliation(s)
| | - Ludmila Santana de Almeida
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
| | - Livia Lugarinho Correa
- Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (IEDE), Rio de Janeiro 22451-000, Rio de Janeiro, Brazil
| | - Rodrigo Fernandes Weyll Pimentel
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
- Hospital Universitário Professor Edgard Santos (HUPES/UFBA), Universidade Federal da Bahia, Salvador 40150-000, Bahia, Brazil
- Centro Universitário UnidomPedro, Salvador 40010-020, Bahia, Brazil
| | - Antonio Marcos Tosoli Gomes
- Faculdade de Enfermagem, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
| | - Ana Gabriela Travassos
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
- Centro Especializado em Diagnóstico, Assistência e Pesquisa (CEDAP), Secretaria de Saúde do Estado da Bahia, Salvador 40100-160, Bahia, Brazil
| | - Adriana Mattos Viana
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
| | - Monique Magnavita Borba da Fonseca Cerqueira
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
| | - Marcio Costa de Souza
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
| | - Anderson Reis de Sousa
- Escola de Enfermagem, Universidade Federal da Bahia (UFBA), Salvador 40110-060, Bahia, Brazil
| | - Paulo José Bastos Barbosa
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
| | - Julita Maria Freitas Coelho
- Centro Universitário UnidomPedro, Salvador 40010-020, Bahia, Brazil
- Instituto Federal da Bahia (IFBA), Simões Filho 43700-000, Bahia, Brazil
| | | | - Argemiro D’Oliveira Júnior
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
| | | | | | - Luiz Carlos Moraes França
- Faculdade de Enfermagem, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
| | - Juliana de Lima Brandão
- Faculdade de Enfermagem, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
| | | | - Helena Ferraz Gomes
- Faculdade de Enfermagem, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
| | - Ellen Marcia Peres
- Faculdade de Enfermagem, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
| | - Thais Regis Aranha Rossi
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
| | - Kairo Silvestre Meneses Damasceno
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
| | | | | | | | | | - Tatiana Santos Brandão
- Hospital Universitário Professor Edgard Santos (HUPES/UFBA), Universidade Federal da Bahia, Salvador 40150-000, Bahia, Brazil
| | - Amanda Cardoso Menezes
- Centro Universitário UnidomPedro, Salvador 40010-020, Bahia, Brazil
- Hospital Ana Nery (HAN), Salvador 40301-155, Bahia, Brazil
| | - Amália Ivine Costa Santana
- Hospital Universitário Professor Edgard Santos (HUPES/UFBA), Universidade Federal da Bahia, Salvador 40150-000, Bahia, Brazil
| | - Magno Conceição das Merces
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
- Centro Universitário UnidomPedro, Salvador 40010-020, Bahia, Brazil
- Faculdade de Tecnologia e Ciências (UNIFTC), Salvador 41741-590, Bahia, Brazil
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12
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Burrows T, Teasdale S, Rocks T, Whatnall M, Schindlmayr J, Plain J, Latimer G, Roberton M, Harris D, Forsyth A. Effectiveness of dietary interventions in mental health treatment: A rapid review of reviews. Nutr Diet 2022; 79:279-290. [PMID: 35796181 PMCID: PMC9545734 DOI: 10.1111/1747-0080.12754] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 05/16/2022] [Accepted: 05/24/2022] [Indexed: 12/30/2022]
Abstract
AIM This rapid review of reviews aimed to determine the extent of research undertaken on the effectiveness of dietary interventions for individuals with a mental disorder. METHODS Three databases (MEDLINE, Embase, Cochrane Reviews and Cochrane Trials) were searched to February 2021 for systematic reviews including experimental studies assessing the effectiveness of dietary interventions with physical or mental health related outcomes in adults or children with one or more of: severe mental illness, depression or anxiety, eating disorders, or substance use disorder. Results are presented descriptively. RESULTS The number of included reviews was 46 (67% in severe mental illness, 20% in depression and anxiety, 7% in eating disorders, and 7% in substance use disorders). Most reviews were published since 2016 (59%), and included studies conducted in adults (63%). Interventions in the eating disorders and severe mental illness reviews were predominantly education and behaviour change, whereas interventions in the substance use disorders, and depression and anxiety reviews were predominantly supplementation (e.g. omega-3). Twenty-eight and twelve of the reviews respectively reported mental health and dietary outcomes for one or more included studies. Most reviews in severe mental illness, and depression and anxiety reported conclusions supporting the positive effects of dietary intervention, including positive effects on weight-related or mental health outcomes, and on mental health outcomes, respectively. CONCLUSIONS A larger number of systematic reviews were identified which evaluated dietary interventions in individuals with severe mental illness, and depression and anxiety, compared with substance use disorders, and eating disorders. Dietary intervention is an important component of the treatment that should be available to individuals living with mental disorders, to support their physical and mental health.
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Affiliation(s)
- Tracy Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of NewcastleCallaghanNew South WalesAustralia
- Food and Nutrition ProgramHunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
| | - Scott Teasdale
- School of Psychiatry, UNSW SydneyKensingtonNew South WalesAustralia
- Mindgardens Neuroscience NetworkSydneyNew South WalesAustralia
| | - Tetyana Rocks
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, Deakin UniversityGeelongVictoriaAustralia
| | - Megan Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of NewcastleCallaghanNew South WalesAustralia
- Food and Nutrition ProgramHunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
| | | | - Janice Plain
- Mental Health Drug and AlcoholNorthern Sydney Local Health DistrictNorth RydeNew South WalesAustralia
| | - Georgina Latimer
- Department of Nursing and Allied HealthSchool of Health Sciences, Swinburne UniversityHawthornVictoriaAustralia
| | - Michelle Roberton
- Victorian Centre of Excellence in Eating Disorders, Royal Melbourne HospitalParkvilleVictoriaAustralia
| | - Deanne Harris
- Tamworth Rural Referral Hospital, Hunter New England HealthTamworthNew South WalesAustralia
| | - Adrienne Forsyth
- School of Allied Health, Human Services and Sport, La Trobe UniversityBundooraVictoriaAustralia
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13
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Sampogna G, Luciano M, Di Vincenzo M, Andriola I, D'Ambrosio E, Amore M, Serafini G, Rossi A, Carmassi C, Dell'Osso L, Di Lorenzo G, Siracusano A, Rossi R, Fiorillo A. The Complex Interplay Between Physical Activity and Recovery Styles in Patients With Severe Mental Disorders in a Real-World Multicentric Study. Front Psychiatry 2022; 13:945650. [PMID: 35898630 PMCID: PMC9309609 DOI: 10.3389/fpsyt.2022.945650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Compared with the general population, people with severe mental disorders have significantly worse physical health and a higher mortality rate, which is partially due to the adoption of unhealthy lifestyle behaviors, such as heavy smoking, use of alcohol or illicit drugs, unbalanced diet, and physical inactivity. These unhealthy behaviors may also play a significant role in the personal and functional recovery of patients with severe mental disorders, although this relationship has been rarely investigated in methodologically robust studies. In this paper, we aim to: a) describe the levels of physical activity and recovery style in a sample of patients with severe mental disorders; b) identify the clinical, social, and illness-related factors that predict the likelihood of patients performing physical activity. The global sample consists of 401 patients, with a main psychiatric diagnosis of bipolar disorder (43.4%, N = 174), psychosis spectrum disorder (29.7%; N = 119), or major depression (26.9%; N = 118). 29.4% (N = 119) of patients reported performing physical activity regularly, most frequently walking (52.1%, N = 62), going to the gym (21.8%, N = 26), and running (10.9%, N = 13). Only 15 patients (3.7%) performed at least 75 min of vigorous physical activity per week. 46.8% of patients adopted sealing over as a recovery style and 37.9% used a mixed style toward integration. Recovery style is influenced by gender (p < 0.05) and age (p < 0.05). The probability to practice regular physical activity is higher in patients with metabolic syndrome (Odds Ratio - OR: 2.1; Confidence Interval - CI 95%: 1.2-3.5; p < 0.050), and significantly lower in those with higher levels of anxiety/depressive symptoms (OR: 0.877; CI 95%: 0.771-0.998; p < 0.01). Globally, patients with severe mental disorders report low levels of physical activities, which are associated with poor recovery styles. Psychoeducational interventions aimed at increasing patients' motivation to adopt healthy lifestyle behaviors and modifying recovery styles may improve the physical health of people with severe mental disorders thus reducing the mortality rates.
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Affiliation(s)
- Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Matteo Di Vincenzo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Ileana Andriola
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Enrico D'Ambrosio
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Claudia Carmassi
- Psychiatric Unit, Department of Clinical and Experimental Medicine, AOUP, University of Pisa, Pisa, Italy
| | - Liliana Dell'Osso
- Psychiatric Unit, Department of Clinical and Experimental Medicine, AOUP, University of Pisa, Pisa, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Alberto Siracusano
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Rodolfo Rossi
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy.,Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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14
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Fiorillo A, Sartorius N. Mortality gap and physical comorbidity of people with severe mental disorders: the public health scandal. Ann Gen Psychiatry 2021; 20:52. [PMID: 34903254 PMCID: PMC8670051 DOI: 10.1186/s12991-021-00374-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 11/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients suffering from severe mental disorders, including schizophrenia, major depression and bipolar disorders, have a reduced life expectancy compared to the general population of up to 10-25 years. This mortality gap requires urgent actions from a public health perspective in order to be reduced. MAIN TEXT Factors associated with the high mortality rates in patients with severe mental disorders can be grouped into four groups: those related to the patients, to psychiatrists, to other non-psychiatrist medical doctors and to the healthcare system. Each of these factors should become the target of specific and dedicated interventions, in order to reduce the morbidity and mortality rate in patients with severe mental disorders. All these elements contribute to the neglect of physical comorbidity in patients with severe mental. In particular, the long-standing separation of psychiatry from other branches of medicine and the lack of specific training on this issue further contribute to the poor attention dedicated to management of physical comorbidities. Recently, several professional associations have invited national bodies regulating education of healthcare professionals to include the management of physical health of people with severe mental disorders in undergraduate and postgraduate educational programs. CONCLUSIONS The premature mortality in patients with severe mental disorders is a complex phenomenon resulting by the interaction of several protective and risk factors. Therefore, a multilevel approach is needed, in which the different stakeholders involved in health care provision establish workforces for the long-term management of physical and mental health conditions.
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Affiliation(s)
- Andrea Fiorillo
- Department of Psychiatry, University of Campania "L Vanvitelli", Naples, Italy.
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
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15
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Luciano M, Sampogna G, Amore M, Andriola I, Calcagno P, Carmassi C, Del Vecchio V, Dell'Osso L, Di Lorenzo G, Gelao B, Giallonardo V, Rossi A, Rossi R, Siracusano A, Fiorillo A. How to improve the physical health of people with severe mental illness? A multicentric randomized controlled trial on the efficacy of a lifestyle group intervention. Eur Psychiatry 2021; 64:e72. [PMID: 34812136 PMCID: PMC8715281 DOI: 10.1192/j.eurpsy.2021.2253] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background
People with severe mental illnesses (SMI) have a mortality rate two times higher compared to the general population, with a decade of years of life lost. In this randomized controlled trial (RCT), we assessed in a sample of people with bipolar disorder, major depressive disorder, and schizophrenia spectrum disorder, the efficacy of an innovative psychosocial group intervention compared to a brief psychoeducational group intervention on patients’ body mass index (BMI), body weight, waist circumference, Framingham and HOMA-IR indexes.
Methods
This is a multicentric RCT with blinded outcome assessments carried out in six Italian university centers. After recruitment patients were randomized to receive a 6-month psychosocial intervention to improve patients’ physical health or a brief psychoeducational intervention. All recruited patients were assessed with standardized assessment instruments at baseline and after 6 months. Anthropometric parameters and blood samples have also been collected.
Results
Four-hundred and two patients with a diagnosis of bipolar disorder (43.3%), schizophrenia or other psychotic disorder (29.9%), or major depression (26.9%) were randomly allocated to the experimental (N = 206) or the control group (N = 195). After 6 months, patients from the experimental group reported a significant reduction in BMI (odds ratio [OR]: 1.93, 95% confidence intervals [CI]: 1.31–2.84; p < 0.001), body weight (OR = 4.78, 95% CI: 0.80–28.27, p < 0.05), and waist circumference (OR = 5.43, 95% CI: 1.45–20.30, p < 0.05). Participants with impaired cognitive and psychosocial functioning had a worse response to the intervention.
Conclusions
The experimental group intervention was effective in improving the physical health in SMI patients. Further studies are needed to evaluate the feasibility of this intervention in real-world settings.
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Affiliation(s)
- Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - Ileana Andriola
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Pietro Calcagno
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valeria Del Vecchio
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giorgio Di Lorenzo
- Department of System Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Barbara Gelao
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | | | - Alessandro Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Rodolfo Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alberto Siracusano
- Department of System Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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16
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The impact of clinical and social factors on the physical health of people with severe mental illness: Results from an Italian multicentre study. Psychiatry Res 2021; 303:114073. [PMID: 34198214 DOI: 10.1016/j.psychres.2021.114073] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/15/2021] [Accepted: 06/19/2021] [Indexed: 12/18/2022]
Abstract
Our manuscript aims to: 1) assess physical health in a sample of patients with severe mental disorders; and 2) identify the psychopathological and psychosocial characteristics associated with an increased likelihood of having a poor physical health. The study, funded by the Italian Ministry of Education, has been carried out in psychiatric outpatient units of six Italian University sites. All recruited patients have been assessed through standardized assessment instruments. Moreover, anthropometric parameters have been obtained at recruitment and a blood samples have been collected to assess cardiometabolic parameters. Four-hundred and two patients with a primary diagnosis of bipolar disorder (43.3%), schizophrenia or other psychotic disorder (29.9%), or major depression (26.9%) were recruited. Internalized stigma, psychosocial functioning, quality of life, psychiatric hospitalizations, depressive/anxiety and manic symptoms and cognition were those domains more strongly associated with poor metabolic parameters, including high body mass index, HOMA and Framingham indexes and waist circumference. There were no statistically significant differences among the three diagnostic groups. Our findings highlight the importance of perceived stigma and quality of life on patients' physical health. This should be taken into account when developing plans for reducing the mortality rate in patients with severe mental disorders.
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17
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Wilson C, Nichles A, Zmicerevska N, Carpenter JS, Song YJC, McHugh C, Hamilton B, Hockey S, Scott EM, Hickie IB. Effect of an online healthy lifestyle psychoeducation programme to improve cardiometabolic outcomes and affective symptoms in youth receiving mental health care: study protocol for a pilot clinical trial. BMJ Open 2021; 11:e044977. [PMID: 34187819 PMCID: PMC8245471 DOI: 10.1136/bmjopen-2020-044977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Worsened cardiometabolic profiles in youth with mental ill health have been associated with a number of modifiable lifestyle risk factors. It is becoming increasingly evident that clinical interventions need to be multimodal in focus to improve mental health symptoms and the physical health symptoms in this already at-risk cohort. METHODS AND ANALYSIS This 12-week pilot clinical trial examines the efficacy, feasibility and acceptability of an adjunctive online psychoeducation programme for improving cardiometabolic risk parameters and affective symptoms in a transdiagnostic sample of at least 44 young people aged 16-25 years presenting for mental healthcare for mood and/or psychotic syndromes (including anxiety, depression, bipolar disorder and psychosis). Individuals will be invited to participate in a pilot clinical trial for a structured online psychoeducation programme incorporating nutritional, physical activity, sleep-wake and healthy lifestyle information, delivered fortnightly over six online modules. Participants will undergo a series of assessments including: (1) self-report and clinician administered assessments determining mental health symptomatology; (2) fasting blood tests to assess cardiometabolic markers (fasting insulin, fasting glucose and blood lipids); (3) anthropometric assessments (height, weight, waist circumference and blood pressure); and (4) sleep-wake behaviours and circadian rhythm assessments. Changes in scores for all cardiometabolic and affective measures will be assessed via paired samples t-tests, and correlations between change scores will be assessed via Pearson's or Spearman's correlations. Feasibility will be assessed via completion rates, and the acceptability of the programme will be assessed via programme satisfaction measures. ETHICS AND DISSEMINATION This pilot clinical trial has been approved by the Sydney Local Health District Research Ethics and Governance Office (X20-0228 & 2020/ETH01201). The results of this pilot clinical trial will be disseminated into the scientific and broader community through peer-reviewed journals, conference presentations, social media and university websites. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ANZCTR) Number: ACTRN12620000772943, Date 28 August 2020.
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Affiliation(s)
- Chloe Wilson
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Alissa Nichles
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Natalia Zmicerevska
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Joanne Sarah Carpenter
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Yun Ju Christine Song
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Catherine McHugh
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Blake Hamilton
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Samuel Hockey
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Elizabeth M Scott
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Ian B Hickie
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
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Björk A, Rönngren Y, Hellzen O, Wall E. The Importance of Belonging to a Context: A Nurse-Led Lifestyle Intervention for Adult Persons with ADHD. Issues Ment Health Nurs 2021; 42:216-226. [PMID: 32809885 DOI: 10.1080/01612840.2020.1793247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Living with attention deficit hyperactivity disorder (ADHD) and mental illness involves an increased risk of lifestyle-related diseases. Although there are several ways to provide support to adult persons with ADHD, there is a lack of non-medical strategies for this purpose. This study explore how adult persons with ADHD with mental illness experienced taking part in a nurse-led lifestyle intervention. Fifteen participants participated in a 52-week lifestyle intervention. The analysis revealed two main categories; Building trusting relationships and Health together. This nurse-led lifestyle intervention could be an alternative or complement to current approaches to promoting health in adults with ADHD.
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Affiliation(s)
- Annette Björk
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Ylva Rönngren
- Department of, Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Ove Hellzen
- Department of, Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Erika Wall
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
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Three-Dimensional Evaluation on Cortical Bone During Orthodontic Surgical Treatment. J Craniofac Surg 2021; 31:1637-1646. [PMID: 32502113 DOI: 10.1097/scs.0000000000006592] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Adult patients' severe malocclusions, especially the skeletal ones, cannot be exclusively solved by the orthodontic treatment and therefore a combined orthodontic-surgical treatment is necessary. Today, numerous software allows to plane and to visualize the final treatment results simulating the best therapeutic option. This is a retrospective experimental study that aims to analyze the changes in the buccal cortical bone in patients undergoing orthodontics surgeries and to evaluate the correlation between the dental movement and the changes in the relative bone cortex. The study sample consists of 32 subjects. By applying the CBCT radiographic examinations, the measurements were made in well-defined points of reference. The 3D study of the dental changes of position and the cortical buccal bone related variation, suggests how the determined orthodontic movement of the dental element does not achieve an easily predictable bone variation. Therefore, it also suggests that there is no direct proportionality relationship between the extent of bone apposition/reabsorption and dental movement.
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Björk A, Rönngren Y, Wall E, Vinberg S, Hellzen O, Olofsson N. A nurse-led lifestyle intervention for adult persons with attention-deficit/hyperactivity disorder (ADHD) in Sweden. Nord J Psychiatry 2020; 74:602-612. [PMID: 32493144 DOI: 10.1080/08039488.2020.1771768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Attention-deficit/hyperactivity disorder (ADHD) is associated with lifestyle-related diseases. Therefore, a nurse-led lifestyle intervention including interpersonal relationships, health education and cognitive support was developed to facilitate healthier lifestyle habits.Aim: The aim was to develop a lifestyle intervention and investigate its impact on mental and physical healthMethod: The 52-week intervention included 35 adults with ADHD. In a pre- and post-test design, symptoms of ADHD were measured with the Adult ADHD Self-Report Scale, quality of life was measured with the Adult ADHD Quality of Life scale and mental health was measured with the Hospital Anxiety and Depression scale. Lifestyle habits and dimensions of health were measured by the Lifestyle-Performance-Health Questionnaire and physical fitness was measured by the VO2 Max Test and calculations of waist circumference and body mass index. Result: Post-tests for a group of 25 persons showed positive changes following the intervention regarding weekly physical activity, quality of life and general and mental health. Lifestyle habit support was found to be important. The impact of the intervention should be confirmed in a long-term study with a control group.Conclusion: This intervention may be beneficial and may be implemented in a primary healthcare setting or in other open care units.
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Affiliation(s)
- Annette Björk
- Department of Health Sciences, Mid Sweden University, Sundsvall/Östersund, Sweden
| | - Ylva Rönngren
- Department of Nursing Sciences, Mid Sweden University, Sundsvall/Östersund, Sweden
| | - Erika Wall
- Department of Health Sciences, Mid Sweden University, Sundsvall/Östersund, Sweden
| | - Stig Vinberg
- Department of Health Sciences, Mid Sweden University, Sundsvall/Östersund, Sweden
| | - Ove Hellzen
- Department of Nursing Sciences, Mid Sweden University, Sundsvall/Östersund, Sweden
| | - Niclas Olofsson
- Department of Health Sciences, Mid Sweden University, Sundsvall/Östersund, Sweden
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Salvi V, Aguglia A, Barone-Adesi F, Bianchi D, Donfrancesco C, Dragogna F, Palmieri L, Serafini G, Amore M, Mencacci C. Cardiovascular risk in patients with severe mental illness in Italy. Eur Psychiatry 2020; 63:e96. [PMID: 33100262 PMCID: PMC7681153 DOI: 10.1192/j.eurpsy.2020.94] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Patients with severe mental illness (SMI), such as schizophrenia or bipolar disorders, are more frequently affected by metabolic syndrome and cardiovascular (CV) diseases than the general population, with a significant reduction in life expectancy. Beyond metabolic syndrome, quantifying the risk of CV morbidity in the long-term may help clinicians to put in place preventive strategies. In this study, we assessed 10-year CV risk in patients with SMI and healthy individuals using an algorithm validated on the Italian general population. METHODS Patients aged 35-69 years diagnosed with SMI were consecutively recruited from psychiatric acute care units. Single CV risk factors were assessed, and 10-year CV risk calculated by means of the CUORE Project 10-year CV risk algorithm, based on the combination of the following risk factors: age, systolic blood pressure, total and high-density lipoprotein cholesterol, diabetes, smoking habit, and hypertensive treatment. Patients' data were compared with those from the general population. The 10-year CV risk was log-transformed, and multivariable linear regression was used to estimate mean ratios, adjusting for age, and education. RESULTS Three hundred patients and 3,052 controls were included in the analysis. Among men, the 10-year CV risk score was very similar between patients with SMI and the general population (mean ratio [MR]: 1.02; 95%CI 0.77-1.37), whereas a 39% increase in 10-year CV risk was observed in women with SMI compared to the general population (MR: 1.39; 95%CI 1.16-1.66). CONCLUSIONS In our study, women with SMI were consistently more at risk than the general population counterpart, even at younger age.
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Affiliation(s)
- Virginio Salvi
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Davide Bianchi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Chiara Donfrancesco
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, National Institute of Health, Rome, Italy
| | - Filippo Dragogna
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, National Institute of Health, Rome, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Claudio Mencacci
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
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Steardo L, Luciano M, Sampogna G, Zinno F, Saviano P, Staltari F, Segura Garcia C, De Fazio P, Fiorillo A. Efficacy of the interpersonal and social rhythm therapy (IPSRT) in patients with bipolar disorder: results from a real-world, controlled trial. Ann Gen Psychiatry 2020; 19:15. [PMID: 32165907 PMCID: PMC7061484 DOI: 10.1186/s12991-020-00266-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/21/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Bipolar disorder (BD) is one of the most burdensome mental disorders, with a lifetime prevalence of 2.4%, with a prevalence of 0.6% for bipolar type I and 0.4% for bipolar type II. Several interventions have been developed to implement the treatment strategy of bipolar disorder, including the Interpersonal and Social Rhythm Therapy (IPSRT). This intervention has been specifically developed to manage patients' stressful life events, improve the disruptions of social and circadian rhythms and increase adherence to medications. The aim of the present study is to assess the efficacy of IPSRT on affective and anxiety psychopathology, social functioning, response to pharmacological treatment and affective morbidity index (AMI) in BD patients. METHODS BD patients were consecutively recruited at the Mood Disorder Unit of the University of Campania "Luigi Vanvitelli" and randomly assigned to the experimental group receiving the IPSRT or to the Treatment as Usual (TAU) group. Patients were assessed at baseline, after 3 and 6 months with several validated assessment tools and with the affective morbidity index. RESULTS At the end of the intervention, compared to controls, patients from the experimental group reported a significant improvement in anxious depressive and manic symptomatology, global functioning; and response to mood stabilizers. Patients in the IPSRT group reported a reduction at the AMI score. CONCLUSIONS IPSRT has been confirmed to be effective in improving the clinical symptomology of BD patients and in improving the affective morbidity index. Further studies with longer follow-up are needed in order to assess the stability of the results.Trial registration The study was approved by the local ethical review board (N001567/28.01.2018).
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Affiliation(s)
- Luca Steardo
- 1Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna Delle Grazie, 80138 Naples, Italy.,2Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Mario Luciano
- 1Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna Delle Grazie, 80138 Naples, Italy
| | - Gaia Sampogna
- 1Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna Delle Grazie, 80138 Naples, Italy
| | - Francesca Zinno
- 1Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna Delle Grazie, 80138 Naples, Italy
| | | | - Filippo Staltari
- 2Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Cristina Segura Garcia
- 4Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Pasquale De Fazio
- 2Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Andrea Fiorillo
- 1Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna Delle Grazie, 80138 Naples, Italy
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Cervino G, Fiorillo L, Monte IP, De Stefano R, Laino L, Crimi S, Bianchi A, Herford AS, Biondi A, Cicciù M. Advances in Antiplatelet Therapy for Dentofacial Surgery Patients: Focus on Past and Present Strategies. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E1524. [PMID: 31075947 PMCID: PMC6540095 DOI: 10.3390/ma12091524] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Nowadays, patients involved in antiplatelet therapy required special attention during oral surgery procedures, due to the antiplatelet drugs assumption. The motivations of the assumption may be different and related to the patient's different systemic condition. For this reason, accordingly to the current international guidelines, different protocols can be followed. The aim of this work is to analyze how the dentist's approach to these patients has changed from the past to the present, evaluating the risk exposure for the patients. METHODS This review paper considered different published papers in literature through quoted scientific channels, going in search of "ancient" works in such a way as to highlight the differences in the protocols undertaken. The analyzed manuscripts are in the English language, taking into consideration reviews, case reports, and case series in such a way as to extrapolate a sufficient amount of data and for evaluating the past therapeutic approaches compared to those of today. RESULTS Colleagues in the past preferred to subject patients to substitution therapy with low molecular weight anticoagulants, by suspending antiplatelet agents to treatment patients, often for an arbitrary number of days. The new guidelines clarify everything, without highlighting an increased risk of bleeding during simple oral surgery in patients undergoing antiplatelet therapy. CONCLUSION Either patients take these medications for different reasons, because of cardiovascular pathologies, recent cardiovascular events, or even for simple prevention, although the latest research shows that there is no decrease of cardiovascular accidents in patients who carry out preventive therapy. Surely, it will be at the expense of the doctor to assess the patient's situation and risk according to the guidelines. For simple oral surgery, it is not necessary to stop therapy with antiplatelet agents because the risk of bleeding has not increased, and is localized to a post-extraction alveolus or to an implant preparation, compared to patients who do not carry out this therapy. From an analysis of the results it emerges that the substitutive therapy should no longer be performed and that it is possible to perform oral surgery safely in patients who take antiplatelet drugs, after a thorough medical history. Furthermore, by suspending therapy, we expose our patients to more serious risks, concerning their main pathology, where present.
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Affiliation(s)
- Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina ME, Italy.
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina ME, Italy.
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121 Naples, Italy.
| | - Ines Paola Monte
- Department of General Surgery and Medical-Surgery Specialities, University of Catania, 95100 Catania CT, Italy.
| | - Rosa De Stefano
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina ME, Italy.
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121 Naples, Italy.
| | - Salvatore Crimi
- Department of General Surgery and Medical-Surgery Specialities, University of Catania, 95100 Catania CT, Italy.
| | - Alberto Bianchi
- Department of General Surgery and Medical-Surgery Specialities, University of Catania, 95100 Catania CT, Italy.
| | - Alan Scott Herford
- Department of Maxillofacial Surgery, Loma Linda University, Loma Linda, CA 92354, USA.
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgery Specialities, University of Catania, 95100 Catania CT, Italy.
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina ME, Italy.
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Naidoo P, Nyembezi A, Thomas E, Lachman A, Kagee A. Perceived barriers and facilitators for healthy behaviours among parents of adolescents receiving mental health care in a public hospital in Cape Town, South Africa: A qualitative study. J Child Adolesc Ment Health 2019; 31:39-50. [PMID: 30961448 DOI: 10.2989/17280583.2019.1584107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: To explore the perceived barriers and facilitators for healthy behaviours among parents and caregivers of adolescents receiving mental health care in Cape Town, South Africa. Method: Thirty-five qualitative in-depth interviews were conducted with parents and caregivers of adolescents receiving mental health treatment by six facilitators matched for language. The data was analysed using thematic analysis. Results: The participants were predominantly female (n = 28, 80%) and parents (n = 29, 83%) of the adolescents. Personal barriers to good health included unhealthy eating, substance use and physical inactivity. Environmental barriers were inherited medical conditions, the easy availability of unhealthy foods and the absence of recreational facilities in communities. Perceived facilitators to good health were parental role modelling, planning and preparing healthy meals, exercise opportunities providing by walking long distances to work, and doing physically demanding jobs and household chores. Conclusion: Parents and caregivers are essential to adolescents' healthy development as they may influence adolescent health behaviours. It is likely that the promotion of positive health behaviours may be achieved though family-based interventions.
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Affiliation(s)
- Pamela Naidoo
- a Department of Psychiatry , Stellenbosch University , Tygerberg , South Africa
| | - Anam Nyembezi
- b School of Public Health , University of the Western Cape , Bellville , South Africa
| | - Eileen Thomas
- a Department of Psychiatry , Stellenbosch University , Tygerberg , South Africa
| | - Anusha Lachman
- a Department of Psychiatry , Stellenbosch University , Tygerberg , South Africa
| | - Ashraf Kagee
- c Department of Psychology , Stellenbosch University , Stellenbosch , South Africa
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Fiorillo A, Luciano M, Pompili M, Sartorius N. Editorial: Reducing the Mortality Gap in People With Severe Mental Disorders: The Role of Lifestyle Psychosocial Interventions. Front Psychiatry 2019; 10:434. [PMID: 31281271 PMCID: PMC6595091 DOI: 10.3389/fpsyt.2019.00434] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 06/03/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programs, Geneva, Switzerland
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Poloni N, Ielmini M, Caselli I, Ceccon F, Bianchi L, Isella C, Callegari C. Medically Unexplained Physical Symptoms in Hospitalized Patients: A 9-Year Retrospective Observational Study. Front Psychiatry 2018; 9:626. [PMID: 30532714 PMCID: PMC6265408 DOI: 10.3389/fpsyt.2018.00626] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 11/05/2018] [Indexed: 12/18/2022] Open
Abstract
Introduction: "Medically Unexplained Physical Symptoms" (MUPS) defines a subgroup of patients presenting physical symptoms of unclear origin. The study aims to profile clinical and socio-demographic characteristics of patients with MUPS. Materials and Methods: This 9-years observational retrospective study assesses all patients admitted between 2008 and 2016 in the divisions of neurology and gastroenterology. Socio-demographic and clinical variables were evaluated: gender, age, diagnosis or diagnostic hypothesis, presence of psychiatric comorbidities, psychiatric evaluation, pharmacological treatment, number of admissions/visits. Results: Among 2,479 neurological patients 10.1% presented MUPS. Patients were more frequently women (63.5%), with a mean age of about 50 years. Reported symptoms were headache (22.6%), seizures (8.7%), vertigo (5.9%), fibromyalgia (5.5%), paresthesia (5.1%), visual disturbances (5.1%), amnesia (3.9%). The diagnosis was somatoform disorder in 6.3% of cases, conversion disorder in 2.7%, and somatic symptom disorder in 1.5% only. 2,560 outpatients were evaluated in gastroenterology division. 9.6% (n = 248) of patients had MUPS; 62.1% of them were women. The most affected age group ranged between 15 and 45 years. The most frequent diagnoses were functional abdominal pain (50%), dysmotility-like dyspepsia (26.6%), irritable bowel syndrome (10.4%), meteorism of unknown cause (2.4%), hiccup (1.6%), burning mouth syndrome (1.2%). No patients received a diagnosis of somatic symptom disorder. Discussion: Patients with MUPS are more often women, of middle age, with self-referred specific symptomatology. While neurological patients received a diagnostic-therapeutic approach in line with the literature, gastroenterological patients mainly received antipsychotics. A more comprehensive assessment and a development of psychoeducational interventions are needed to improve patients' quality and quantity of life.
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Affiliation(s)
| | | | | | | | | | | | - Camilla Callegari
- Section of Psychiatry, Department of Medicine and Surgery, University of Insubria, Varese, Italy
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Berardelli I, Corigliano V, Hawkins M, Comparelli A, Erbuto D, Pompili M. Lifestyle Interventions and Prevention of Suicide. Front Psychiatry 2018; 9:567. [PMID: 30459660 PMCID: PMC6232529 DOI: 10.3389/fpsyt.2018.00567] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/18/2018] [Indexed: 12/26/2022] Open
Abstract
Over the past years, there has been a growing interest in the association between lifestyle psychosocial interventions, severe mental illness, and suicide risk. Patients with severe mental disorders have higher mortality rates, poor health states, and higher suicide risk compared to the general population. Lifestyle behaviors are amenable to change through the adoption of specific psychosocial interventions, and several approaches have been promoted. The current article provides a comprehensive review of the literature on lifestyle interventions, mental health, and suicide risk in the general population and in patients with psychiatric disorders. For this purpose, we investigated lifestyle behaviors and lifestyle interventions in three different age groups: adolescents, young adults, and the elderly. Several lifestyle behaviors including cigarette smoking, alcohol use, and sedentary lifestyle are associated with suicide risk in all age groups. In adolescents, growing attention has emerged on the association between suicide risk and internet addiction, cyberbullying and scholastic and family difficulties. In adults, psychiatric symptoms, substance and alcohol abuse, weight, and occupational difficulties seems to have a significant role in suicide risk. Finally, in the elderly, the presence of an organic disease and poor social support are associated with an increased risk of suicide attempt. Several factors may explain the association between lifestyle behaviors and suicide. First, many studies have reported that some lifestyle behaviors and its consequences (sedentary lifestyle, cigarette smoking underweight, obesity) are associated with cardiometabolic risk factors and with poor mental health. Second, several lifestyle behaviors may encourage social isolation, limiting the development of social networks, and remove individuals from social interactions; increasing their risk of mental health problems and suicide.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Valentina Corigliano
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Michael Hawkins
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Anna Comparelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Denise Erbuto
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Rönngren Y, Björk A, Audulv Å, Enmarker I, Kristiansen L, Haage D. Educational nurse-led lifestyle intervention for persons with mental illness. Int J Ment Health Nurs 2018; 27:1022-1031. [PMID: 29171905 DOI: 10.1111/inm.12410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2017] [Indexed: 12/17/2022]
Abstract
Although persons with severe mental illness face an increased risk of mortality and of developing negative health outcomes, research has shown that lifestyle interventions can sufficiently support their health. In response, this study examined a nurse-led lifestyle intervention developed in cooperation with members of municipal and county councils to gauge its impact on the quality of life, cognitive performance, walking capacity, and body composition of persons with severe mental illness. Lasting 26 weeks and involving 38 persons with severe mental illness, the intervention prioritised two components: the interpersonal relationships of persons with severe mental illness, staff, and group leaders and group education about physical and mental health. Pre-post intervention measurements of quality of life collected with the Manchester Short Assessment of Quality of Life, cognitive performance with the Frontal Systems Behaviour Scale, walking capacity with a 6-min walk test, and body composition in terms of waist circumference and body mass index were analysed using a nonparametric test Wilcoxon signed-rank test. Results suggest that the intervention afforded significant improvements in the health-related variables of quality of life, cognitive performance, walking capacity, and waist circumference for persons with severe mental illness. However, long-term studies with control groups and that examine parameters related to cardiovascular risk factors are essential to ensure the sustained impact of the intervention.
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Affiliation(s)
- Ylva Rönngren
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Annette Björk
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Åsa Audulv
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Ingela Enmarker
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.,Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.,Center for Care Research, Mid-Norway, Steinkjer, Norway
| | | | - David Haage
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
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Frank GKW, Favaro A, Marsh R, Ehrlich S, Lawson EA. Toward valid and reliable brain imaging results in eating disorders. Int J Eat Disord 2018; 51:250-261. [PMID: 29405338 PMCID: PMC7449370 DOI: 10.1002/eat.22829] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 01/13/2018] [Accepted: 01/14/2018] [Indexed: 12/14/2022]
Abstract
Human brain imaging can help improve our understanding of mechanisms underlying brain function and how they drive behavior in health and disease. Such knowledge may eventually help us to devise better treatments for psychiatric disorders. However, the brain imaging literature in psychiatry and especially eating disorders has been inconsistent, and studies are often difficult to replicate. The extent or severity of extremes of eating and state of illness, which are often associated with differences in, for instance hormonal status, comorbidity, and medication use, commonly differ between studies and likely add to variation across study results. Those effects are in addition to the well-described problems arising from differences in task designs, data quality control procedures, image data preprocessing and analysis or statistical thresholds applied across studies. Which of those factors are most relevant to improve reproducibility is still a question for debate and further research. Here we propose guidelines for brain imaging research in eating disorders to acquire valid results that are more reliable and clinically useful.
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Affiliation(s)
- Guido K. W. Frank
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, Colorado,Neuroscience Program, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Angela Favaro
- Department of General Psychology, University of Padova, Padova, Italy
| | - Rachel Marsh
- Department of Psychiatry, The New York State Psychiatric Institute and the College of Physicians and Surgeons at Columbia University, New York, New York
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany,Department of Child and Adolescent Psychiatry, Eating Disorder Treatment and Research Center, Technische Universität Dresden, Dresden, Germany
| | - Elizabeth A. Lawson
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts,Harvard Medical School, Boston, Massachusetts
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Sampogna G, Fiorillo A, Luciano M, Del Vecchio V, Steardo L, Pocai B, Barone M, Amore M, Pacitti F, Dell'Osso L, Di Lorenzo G, Maj M. A Randomized Controlled Trial on the Efficacy of a Psychosocial Behavioral Intervention to Improve the Lifestyle of Patients With Severe Mental Disorders: Study Protocol. Front Psychiatry 2018; 9:235. [PMID: 29930520 PMCID: PMC6001842 DOI: 10.3389/fpsyt.2018.00235] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 05/15/2018] [Indexed: 01/21/2023] Open
Abstract
UNLABELLED Patients with severe mental disorders die on average 20 years prior to the general population. This mortality gap is mainly due to the higher prevalence of physical diseases and the adoption of unhealthy lifestyle behaviors.The LIFESTYLE trial aims to evaluate the efficacy of a new psychosocial group intervention (including psychoeducational, motivational, and problem-solving techniques) focused on healthy lifestyle behavior compared to a brief educational group intervention in a community sample of patients with severe mental disorders. The trial is a national-funded, multicentric, randomized controlled trial with blinded outcome assessments, which is carried out in six outpatient units of the Universities of Campania "Luigi Vanvitelli" in Naples, Bari, Genova, L'Aquila, Pisa, and Rome-Tor Vergata. All patients are assessed at the following time points: baseline (T0); 2 months post-randomization (T1); 4 months post-randomization (T2); 6 months post-randomization (T3); 12 months post-randomization (T4); and 24 months post-randomization (T5). T1 and T2 assessments include only anthropometric tests. The BMI, a reliable and feasible anthropometric parameter, has been selected as primary outcome. In particular, the mean value of BMI at 6 months from baseline (T3) will be evaluated through a Generalized Estimated Equation model. The work hypothesis is that the LIFESTYLE psychosocial group intervention will be more effective than the brief educational group intervention in reducing the BMI. We expect a mean difference between the two groups of at least one point (and standard deviation of two points) at BMI. Secondary outcomes are: the improvement in dietary patterns, in smoking habits, in sleeping habits, physical activity, personal and social functioning, severity of physical comorbidities, and adherence to medications. The expected sample size consists of 420 patients (70 patients for each of the six participating centers), and they are allocated with a 1:1 ratio randomization, stratified according to center, age, gender, and educational level. Heavy smoking, sedentary behavior, and unhealthy diet pattern are very frequent and are associated with a reduced life expectancy and higher levels of physical comorbidities in people with severe mental disorders. New interventions are needed and we hope that the LIFESTYLE protocol will help to fill this gap. TRIAL REGISTRATION NUMBER 2015C7374S.
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Affiliation(s)
- Gaia Sampogna
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Valeria Del Vecchio
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luca Steardo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Benedetta Pocai
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marina Barone
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Francesca Pacitti
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giorgio Di Lorenzo
- Department of System Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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Fiorillo A, Carpiniello B, De Giorgi S, La Pia S, Maina G, Sampogna G, Spina E, Tortorella A, Vita A. Assessment and Management of Cognitive and Psychosocial Dysfunctions in Patients With Major Depressive Disorder: A Clinical Review. Front Psychiatry 2018; 9:493. [PMID: 30364225 PMCID: PMC6193102 DOI: 10.3389/fpsyt.2018.00493] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 09/20/2018] [Indexed: 12/20/2022] Open
Abstract
Background: Full functional recovery is defined as a state in which patients are again able to enjoy their usual activities, return to work, and take care of themselves, and it should represent the end goal of treatment in patients with major depressive disorder (MDD). Patients with MDD report many unmet needs, including residual cognitive symptoms, lack of improvement in psychosocial functioning and life satisfaction, even during mood symptom remission. In this paper, we aim to: (a) identify the available assessment tools for evaluating cognitive and psychosocial functioning in patients with MDD; (b) provide an overview of therapeutic options that can improve full functional recovery in MDD also by improving cognitive symptoms. Methods: The relevant databases MEDLINE, ISI Web of Knowledge - Web of Science Index, Cochrane Reviews Library and PsychoINFO were searched for identifying papers on validated tools for the assessment of cognitive and personal functioning in patients with MDD. Results: New assessment tools (such as the THINC-it TOOL, the COBRA, the SCIP-D, and the UPSA-D) have been developed for evaluating the cognitive dysfunction in MDD patients. Adopting these tools in the clinical routine practice is useful to evaluate the improvement in cognitive functioning and, therefore, the achievement of full functioning recovery. The optimal management of patients with MDD include the combination of pharmacological compounds and psychosocial interventions for achieving full functional recovery in patients with MDD. Conclusions: Full functional recovery must be the target of any treatment programme for patients with MDD. In order to achieve this goal, it is necessary to develop personalized treatment and integrate psychosocial and psychopharmacological interventions.
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Affiliation(s)
- Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Bernardo Carpiniello
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | | | | | - Giuseppe Maina
- AOU San Luigi Gonzaga, University of Turin, Turin, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Edoardo Spina
- Department of Clinical and Experimental Pharmacology, University of Messina, Messina, Italy
| | | | - Antonio Vita
- Neuroscience Section, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
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Barker LC, Kurdyak P, Jacob B, Vigod SN. Quality of Diabetes Care for Individuals with Comorbid Chronic Psychotic Illness: A Sex-Based Analysis. J Womens Health (Larchmt) 2017; 27:290-296. [PMID: 29211592 DOI: 10.1089/jwh.2017.6490] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Diabetes is common among individuals with chronic psychotic illness, yet they receive lower quality of diabetes care than those without psychosis. Men usually receive higher quality diabetes care than women, but whether this holds true in chronic psychotic illness populations is unknown. We aimed to determine whether quality of diabetes care differs between men and women with chronic psychotic illness. METHODS This population-based cohort study used Ontario health administrative data to compare women and men with comorbid chronic psychotic illness and diabetes mellitus (2011-2013). The primary outcome was adherence to diabetes monitoring guidelines, defined as ≥1 retinal exam, ≥4 hemoglobin A1c (HbA1c) tests, and ≥1 dyslipidemia test during a 2-year period. Logistic regression models compared women to men to generate adjusted odds ratios (aOR) and confidence intervals (95% CI), adjusting for potential confounding variables. RESULTS Women with chronic psychotic illness (n = 13,972) were slightly more likely to receive guideline-adherent diabetes monitoring than men (n = 12,287) (25.2% vs. 23.0%; aOR 1.20, 95% CI 1.10-1.30), including a greater likelihood of receiving ≥1 retinal exam (aOR 1.13, 95% CI 1.08-1.19) and ≥4 HbA1c tests (aOR 1.06, 95% CI 1.01-1.12). There was no difference in receipt of ≥1 dyslipidemia test (aOR 1.04, 95% CI 0.99-1.11). CONCLUSIONS Quality of diabetes monitoring is similarly poor in women and men with chronic psychotic illness, with women receiving only marginally more optimal monitoring than men. This differs from patterns in the general population, and could have implications when designing and implementing interventions to improve diabetes care in women and men with chronic psychotic illness.
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Affiliation(s)
| | - Paul Kurdyak
- 1 Department of Psychiatry, University of Toronto , Toronto, Canada .,2 Institute for Clinical Evaluative Sciences , Toronto, Canada .,3 Centre for Addiction and Mental Health , Toronto, Canada
| | - Binu Jacob
- 3 Centre for Addiction and Mental Health , Toronto, Canada
| | - Simone N Vigod
- 1 Department of Psychiatry, University of Toronto , Toronto, Canada .,2 Institute for Clinical Evaluative Sciences , Toronto, Canada .,4 Women's College Research Institute , Women's College Hospital, Toronto, Canada
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