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Nagata S, McCormick B, Brusilovskiy E, Salzer MS. Community participation as a predictor of depressive symptoms among individuals with serious mental illnesses. Int J Soc Psychiatry 2022; 68:1689-1697. [PMID: 34894828 DOI: 10.1177/00207640211052182] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND People with serious mental illnesses have elevated levels of depressive symptoms. Limited engagement in meaningful activities, such as work, social interactions, volunteering, and participation in faith, are one plausible explanation for this. Increased community participation over time may be associated with decreased depressive symptoms. AIM Examine whether an increase in participation over time predicts a decrease in depression after controlling for depression at the baseline. METHODS Participants were 183 adults with schizophrenia spectrum, bipolar disorder, or major depressive disorder who completed the Hopkins Symptom Index - Depression subscale and the Temple University Community Participation Measure. Participants completed these measures at baseline and either a 12- or 24-month follow-up timepoint. Multiple regression analyses were conducted with the depression score as a dependent variable and changes in community participation as a predictor variable. Demographics, baseline depression score, and time interval between baseline and last observation were entered as control variables. RESULTS Endorsing more activities as important, participating in more important areas that are important, and participating 'enough' in more important areas over time were each significant predictors of decreases in depression. CONCLUSION These findings enhance the connection between community participation and depression and suggest that a focus on participation may be important in terms of boosting both community functioning and treatment goals.
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Affiliation(s)
- Shinichi Nagata
- Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA.,Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Bryan McCormick
- Department of Health and Rehabilitation Sciences, Temple University, Philadelphia, PA, USA
| | - Eugene Brusilovskiy
- Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA
| | - Mark S Salzer
- Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA
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2
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Aucoin M, LaChance L, Clouthier SN, Cooley K. Dietary modification in the treatment of schizophrenia spectrum disorders: A systematic review. World J Psychiatry 2020; 10:187-201. [PMID: 32874956 PMCID: PMC7439299 DOI: 10.5498/wjp.v10.i8.187] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/25/2020] [Accepted: 07/19/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Schizophrenia spectrum disorders impact functioning, reduce quality of life and increase the risk of physical illness and premature mortality. Nutritional intervention studies aimed at decreasing body weight have demonstrated efficacy in improving metabolic outcomes; however, few studies have explored the impact of interventions designed to modify diet on mental health outcomes.
AIM To synthesize the existing experimental studies of adjunctive diet modification as an intervention in the treatment of psychotic disorders, analyze findings related to effectiveness and safety, highlight knowledge gaps and limitations, and set forward recommendations for future research studies.
METHODS An extensive a priori search strategy was developed and the databases Embase, Embase Classic, Ovid MEDLINE were searched. Screening and data extraction were completed in duplicate. Studies included in this analysis were experimental studies of an adjunctive dietary intervention (overall dietary pattern or education on dietary change) for treatment of schizophrenia spectrum disorders. No restrictions were placed on control groups or blinding. The studies were required to report a mental health outcome.
RESULTS Twenty-five clinical trials were identified, along with two additional protocols and two meta-analyses. Nineteen of the clinical trials reported improvement in one or more mental health domain including psychosis symptoms, cognition, and quality of life. A high level of heterogeneity was found with respect to patient population, intervention, and study design. All of the studies included lifestyle or psychosocial components in addition to dietary modification. The nutrition advice provided to participants was poorly described overall and compliance was not assessed. The studies that showed benefit tended to have a smaller sample size and were less likely to be randomized but were more likely to use a group delivery intervention.
CONCLUSION Further research assessing effectiveness and efficacy of clearly reported dietary interventions is warranted, especially those using rigorous methodology, modifying diet in isolation and assessing participant compliance.
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Affiliation(s)
- Monique Aucoin
- Department of Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto M2K 1E2, Canada
| | - Laura LaChance
- Department of Psychiatry, McGill University, Montreal H3A 0G4, Canada
- Centre for Addiction and Mental Health, Toronto M6R 1A1, Canada
| | - Sam N Clouthier
- Department of Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto M2K 1E2, Canada
| | - Kieran Cooley
- Department of Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto M2K 1E2, Canada
- Department of Public Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo 2007, Australia
- Department of Doctoral Acupuncture and Chinese Medicine, Pacific College of Health Science, San Diego, CA 92108, United States
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3
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Gao N, Eissenstat SJ, Giacobbe G. Poor physical health: A major barrier to employment among individuals with serious mental illness. JOURNAL OF VOCATIONAL REHABILITATION 2020. [DOI: 10.3233/jvr-191063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ni Gao
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - SunHee J. Eissenstat
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Giovanna Giacobbe
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
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Alexander E, McGinty EE, Wang NY, Dalcin A, Jerome GJ, Miller ER, Dickerson F, Charleston J, Young DR, Gennusa JV, Goldsholl S, Cook C, Appel LJ, Daumit GL. Effects of a behavioural weight loss intervention in people with serious mental illness: Subgroup analyses from the ACHIEVE trial. Obes Res Clin Pract 2019; 13:205-210. [PMID: 30852244 PMCID: PMC7255457 DOI: 10.1016/j.orcp.2019.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/01/2019] [Accepted: 02/08/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Persons with serious mental illnesses (SMI) such as schizophrenia and bipolar disorder have an increased risk of obesity and related chronic diseases and die 10-20years earlier than the overall population, primarily due to cardiovascular disease. In the ACHIEVE trial, a behavioural weight loss intervention led to clinically significant weight loss in persons with SMI. As the field turns its attention to intervention scale-up, it is important to understand whether the effectiveness of behavioural weight loss interventions for people with SMI, like ACHIEVE, differ for specific subgroups. METHODS This study examined whether the effectiveness of the ACHIEVE intervention differed by participant characteristics (e.g. age, sex, race, psychiatric diagnosis, body mass index) and/or their weight-related attitudes and behaviours (e.g. eating, food preparation, and shopping habits). We used likelihood-based mixed effects models to examine whether the baseline to 18 month effects of the ACHIEVE intervention differed across subgroups. RESULTS No statistically significant differences were found in the effectiveness of the ACHIEVE intervention across any of the subgroups examined. CONCLUSIONS These findings suggest that the ACHIEVE behavioural weight loss intervention is broadly applicable to the diverse population of individuals with SMI.
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Affiliation(s)
- Eleanore Alexander
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States.
| | - Emma E McGinty
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States
| | - Nae-Yuh Wang
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Arlene Dalcin
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Gerald J Jerome
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Department of Kinesiology, Towson University, Baltimore, MD, 21252, United States
| | - Edgar R Miller
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Faith Dickerson
- Stanley Research Program, Sheppard Pratt Health System, Baltimore, MD 21204, United States
| | - Jeanne Charleston
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Deborah R Young
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, 91024, United States
| | - Joseph V Gennusa
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States
| | - Stacy Goldsholl
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States
| | - Courtney Cook
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Gail L Daumit
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
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Bartels SJ, Aschbrenner KA, Pratt SI, Naslund JA, Scherer EA, Zubkoff L, Cohen MJ, Williams GE, Wolfe RS, Jue K, Brunette MF. Implementation of a Lifestyle Intervention for People With Serious Mental Illness in State-Funded Mental Health Centers. Psychiatr Serv 2018; 69:664-670. [PMID: 29606077 DOI: 10.1176/appi.ps.201700368] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate health outcomes of a state-supported implementation in community mental health settings of an evidence-based lifestyle intervention for overweight and obese adults with serious mental illness. METHODS Weight and fitness outcomes were evaluated for 122 overweight or obese adults with serious mental illness in four community mental health centers (CMHCs) that were participating in a phased statewide implementation of the In SHAPE lifestyle intervention. Six- and 12-month outcomes were compared between two CMHCs that implemented In SHAPE in the first 12 months and two CMHCs with similar characteristics that implemented In SHAPE in a subsequent phase in the statewide implementation 12 months later. RESULTS Participants in the two In SHAPE sites (N=63 participants) lost significantly more weight (p=.003) and showed greater improvement in fitness (p=.011) compared with participants at the two usual care control sites (N=59 participants). At six months, nearly half (49%) of In SHAPE participants and at 12 months more than half (60%) of In SHAPE participants showed clinically significant cardiovascular risk reduction defined as ≥5% weight loss or improved fitness (>50 m [164 feet] increase on the six-minute walk test). The difference between the In SHAPE and control groups was not statistically significant. CONCLUSIONS This natural experiment demonstrated promising public health benefits of a practical implementation of health promotion programming for overweight and obese adults with serious mental illness and offers a potential model for reducing risk of early mortality among individuals served by state-funded mental health centers nationwide.
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Affiliation(s)
- Stephen J Bartels
- Dr. Bartels, Dr. Aschbrenner, Dr. Pratt, Dr. Zubkoff, Ms. Williams, Ms. Wolfe, and Dr. Brunette are with the Department of Psychiatry, and Dr. Scherer is with the Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. Dr. Bartels is also with the Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, where Dr. Scherer is affiliated. Dr. Zubkoff is also with the Engineering Resource Center, White River Junction Department of Veterans Affairs Medical Center, White River Junction, Vermont. Dr. Naslund is with the Department of Global Health and Social Medicine, Harvard Medical School, Boston. Mr. Cohen is with MJC Health Solutions LLC, Amherst, New Hampshire. Mr. Jue is with Ken Jue Consulting, Keene, New Hampshire
| | - Kelly A Aschbrenner
- Dr. Bartels, Dr. Aschbrenner, Dr. Pratt, Dr. Zubkoff, Ms. Williams, Ms. Wolfe, and Dr. Brunette are with the Department of Psychiatry, and Dr. Scherer is with the Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. Dr. Bartels is also with the Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, where Dr. Scherer is affiliated. Dr. Zubkoff is also with the Engineering Resource Center, White River Junction Department of Veterans Affairs Medical Center, White River Junction, Vermont. Dr. Naslund is with the Department of Global Health and Social Medicine, Harvard Medical School, Boston. Mr. Cohen is with MJC Health Solutions LLC, Amherst, New Hampshire. Mr. Jue is with Ken Jue Consulting, Keene, New Hampshire
| | - Sarah I Pratt
- Dr. Bartels, Dr. Aschbrenner, Dr. Pratt, Dr. Zubkoff, Ms. Williams, Ms. Wolfe, and Dr. Brunette are with the Department of Psychiatry, and Dr. Scherer is with the Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. Dr. Bartels is also with the Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, where Dr. Scherer is affiliated. Dr. Zubkoff is also with the Engineering Resource Center, White River Junction Department of Veterans Affairs Medical Center, White River Junction, Vermont. Dr. Naslund is with the Department of Global Health and Social Medicine, Harvard Medical School, Boston. Mr. Cohen is with MJC Health Solutions LLC, Amherst, New Hampshire. Mr. Jue is with Ken Jue Consulting, Keene, New Hampshire
| | - John A Naslund
- Dr. Bartels, Dr. Aschbrenner, Dr. Pratt, Dr. Zubkoff, Ms. Williams, Ms. Wolfe, and Dr. Brunette are with the Department of Psychiatry, and Dr. Scherer is with the Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. Dr. Bartels is also with the Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, where Dr. Scherer is affiliated. Dr. Zubkoff is also with the Engineering Resource Center, White River Junction Department of Veterans Affairs Medical Center, White River Junction, Vermont. Dr. Naslund is with the Department of Global Health and Social Medicine, Harvard Medical School, Boston. Mr. Cohen is with MJC Health Solutions LLC, Amherst, New Hampshire. Mr. Jue is with Ken Jue Consulting, Keene, New Hampshire
| | - Emily A Scherer
- Dr. Bartels, Dr. Aschbrenner, Dr. Pratt, Dr. Zubkoff, Ms. Williams, Ms. Wolfe, and Dr. Brunette are with the Department of Psychiatry, and Dr. Scherer is with the Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. Dr. Bartels is also with the Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, where Dr. Scherer is affiliated. Dr. Zubkoff is also with the Engineering Resource Center, White River Junction Department of Veterans Affairs Medical Center, White River Junction, Vermont. Dr. Naslund is with the Department of Global Health and Social Medicine, Harvard Medical School, Boston. Mr. Cohen is with MJC Health Solutions LLC, Amherst, New Hampshire. Mr. Jue is with Ken Jue Consulting, Keene, New Hampshire
| | - Lisa Zubkoff
- Dr. Bartels, Dr. Aschbrenner, Dr. Pratt, Dr. Zubkoff, Ms. Williams, Ms. Wolfe, and Dr. Brunette are with the Department of Psychiatry, and Dr. Scherer is with the Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. Dr. Bartels is also with the Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, where Dr. Scherer is affiliated. Dr. Zubkoff is also with the Engineering Resource Center, White River Junction Department of Veterans Affairs Medical Center, White River Junction, Vermont. Dr. Naslund is with the Department of Global Health and Social Medicine, Harvard Medical School, Boston. Mr. Cohen is with MJC Health Solutions LLC, Amherst, New Hampshire. Mr. Jue is with Ken Jue Consulting, Keene, New Hampshire
| | - Michael J Cohen
- Dr. Bartels, Dr. Aschbrenner, Dr. Pratt, Dr. Zubkoff, Ms. Williams, Ms. Wolfe, and Dr. Brunette are with the Department of Psychiatry, and Dr. Scherer is with the Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. Dr. Bartels is also with the Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, where Dr. Scherer is affiliated. Dr. Zubkoff is also with the Engineering Resource Center, White River Junction Department of Veterans Affairs Medical Center, White River Junction, Vermont. Dr. Naslund is with the Department of Global Health and Social Medicine, Harvard Medical School, Boston. Mr. Cohen is with MJC Health Solutions LLC, Amherst, New Hampshire. Mr. Jue is with Ken Jue Consulting, Keene, New Hampshire
| | - Gail E Williams
- Dr. Bartels, Dr. Aschbrenner, Dr. Pratt, Dr. Zubkoff, Ms. Williams, Ms. Wolfe, and Dr. Brunette are with the Department of Psychiatry, and Dr. Scherer is with the Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. Dr. Bartels is also with the Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, where Dr. Scherer is affiliated. Dr. Zubkoff is also with the Engineering Resource Center, White River Junction Department of Veterans Affairs Medical Center, White River Junction, Vermont. Dr. Naslund is with the Department of Global Health and Social Medicine, Harvard Medical School, Boston. Mr. Cohen is with MJC Health Solutions LLC, Amherst, New Hampshire. Mr. Jue is with Ken Jue Consulting, Keene, New Hampshire
| | - Rosemarie S Wolfe
- Dr. Bartels, Dr. Aschbrenner, Dr. Pratt, Dr. Zubkoff, Ms. Williams, Ms. Wolfe, and Dr. Brunette are with the Department of Psychiatry, and Dr. Scherer is with the Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. Dr. Bartels is also with the Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, where Dr. Scherer is affiliated. Dr. Zubkoff is also with the Engineering Resource Center, White River Junction Department of Veterans Affairs Medical Center, White River Junction, Vermont. Dr. Naslund is with the Department of Global Health and Social Medicine, Harvard Medical School, Boston. Mr. Cohen is with MJC Health Solutions LLC, Amherst, New Hampshire. Mr. Jue is with Ken Jue Consulting, Keene, New Hampshire
| | - Kenneth Jue
- Dr. Bartels, Dr. Aschbrenner, Dr. Pratt, Dr. Zubkoff, Ms. Williams, Ms. Wolfe, and Dr. Brunette are with the Department of Psychiatry, and Dr. Scherer is with the Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. Dr. Bartels is also with the Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, where Dr. Scherer is affiliated. Dr. Zubkoff is also with the Engineering Resource Center, White River Junction Department of Veterans Affairs Medical Center, White River Junction, Vermont. Dr. Naslund is with the Department of Global Health and Social Medicine, Harvard Medical School, Boston. Mr. Cohen is with MJC Health Solutions LLC, Amherst, New Hampshire. Mr. Jue is with Ken Jue Consulting, Keene, New Hampshire
| | - Mary F Brunette
- Dr. Bartels, Dr. Aschbrenner, Dr. Pratt, Dr. Zubkoff, Ms. Williams, Ms. Wolfe, and Dr. Brunette are with the Department of Psychiatry, and Dr. Scherer is with the Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. Dr. Bartels is also with the Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, where Dr. Scherer is affiliated. Dr. Zubkoff is also with the Engineering Resource Center, White River Junction Department of Veterans Affairs Medical Center, White River Junction, Vermont. Dr. Naslund is with the Department of Global Health and Social Medicine, Harvard Medical School, Boston. Mr. Cohen is with MJC Health Solutions LLC, Amherst, New Hampshire. Mr. Jue is with Ken Jue Consulting, Keene, New Hampshire
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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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Naslund JA, Whiteman KL, McHugo GJ, Aschbrenner KA, Marsch LA, Bartels SJ. Lifestyle interventions for weight loss among overweight and obese adults with serious mental illness: A systematic review and meta-analysis. Gen Hosp Psychiatry 2017; 47:83-102. [PMID: 28807143 PMCID: PMC5575752 DOI: 10.1016/j.genhosppsych.2017.04.003] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 04/04/2017] [Accepted: 04/05/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis to estimate effects of lifestyle intervention participation on weight reduction among overweight and obese adults with serious mental illness. METHOD We systematically searched electronic databases for randomized controlled trials comparing lifestyle interventions with other interventions or usual care controls in overweight and obese adults with serious mental illness, including schizophrenia spectrum or mood disorders. Included studies reported change in weight [kg] or body mass index (BMI) [kg/m2] from baseline to follow-up. Standardized mean differences (SMD) were calculated for change in weight from baseline between intervention and control groups. RESULTS Seventeen studies met inclusion criteria (1968 participants; 50% male; 66% schizophrenia spectrum disorders). Studies were grouped by intervention duration (≤6-months or ≥12-months). Lifestyle interventions of ≤6-months duration showed greater weight reduction compared with controls as indicated by effect size for weight change from baseline (SMD=-0.20; 95% CI=-0.34, -0.05; 10 studies), but high statistical heterogeneity (I2=90%). Lifestyle interventions of ≥12-months duration also showed greater weight reduction compared with controls (SMD=-0.24; 95% CI=-0.36, -0.12; 6 studies) with low statistical heterogeneity (I2=0%). CONCLUSION Lifestyle interventions appear effective for treating overweight and obesity among people with serious mental illness. Interventions of ≥12-months duration compared to ≤6-months duration appear to achieve more consistent outcomes, though effect sizes are similar for both shorter and longer duration interventions.
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Affiliation(s)
- John A Naslund
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, United States; Health Promotion Research Center at Dartmouth, Lebanon, NH, United States.
| | - Karen L Whiteman
- Health Promotion Research Center at Dartmouth, Lebanon, NH, United States
| | - Gregory J McHugo
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Kelly A Aschbrenner
- Health Promotion Research Center at Dartmouth, Lebanon, NH, United States; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Lisa A Marsch
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States; Center for Technology and Behavioral Health, Dartmouth College, Lebanon, NH, United States
| | - Stephen J Bartels
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, United States; Health Promotion Research Center at Dartmouth, Lebanon, NH, United States; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States; Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
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