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Monk NJ, Cunningham R, Stanley J, Crengle S, Fitzjohn J, Kerdemelidis M, Lockett H, McLachlan AD, Waitoki W, Lacey C. The physical health and premature mortality of Indigenous Māori following first-episode psychosis diagnosis: A 15-year follow-up study. Aust N Z J Psychiatry 2024:48674241270981. [PMID: 39169471 DOI: 10.1177/00048674241270981] [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] [Indexed: 08/23/2024]
Abstract
BACKGROUND People experiencing psychosis are at greater risk of physical health conditions and premature mortality. It is likely that Indigenous Māori youth, who experience additional systemic inequities caused by settler-colonisation, face even greater physical health and mortality risks following a diagnosis of first-episode psychosis. OBJECTIVE Compare Māori and non-Māori for risk of hospitalisation and mortality for up to 15 years following first-episode psychosis diagnosis. METHODS A cohort (N = 14,122) of young people (16-24 years) with first-episode psychosis diagnosis between 2001 and 2019 were identified. Using crude Kaplan-Meier and adjusted Cox proportional hazards models, Māori (n = 5211) and non-Māori (n = 8911) were compared on hospitalisation and mortality outcomes for up to 15 years. RESULTS In the 15 years following first-episode psychosis diagnosis, Māori had higher adjusted risk of all-cause mortality (hazard ratio = 1.21, 95% confidence interval = [1.01, 1.45]), hospitalisation with diabetes (hazard ratio = 1.44, 95% confidence interval = [1.15, 1.79]), injury/poisoning (hazard ratio = 1.11, 95% confidence interval = [1.05, 1.16]), general physical health conditions (hazard ratio = 1.07, 95% confidence interval = [1.02, 1.13]) and also appeared to be at greater risk of cardiovascular hospitalisations (hazard ratio = 1.34, 95% confidence interval = [0.97, 1.86]). Kaplan-Meier plots show hospitalisation and mortality inequities emerging approximately 4-7 years following first-episode psychosis diagnosis. CONCLUSIONS Māori are at greater risk for hospitalisation and premature mortality outcomes following first-episode psychosis. Early screening and intervention, facilitated by culturally safe health service delivery, is needed to target these inequities early.
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Affiliation(s)
- Nathan J Monk
- Department of Māori/Indigenous Health Innovation, University of Otago, Christchurch, New Zealand
| | - Ruth Cunningham
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - James Stanley
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Sue Crengle
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Christchurch, New Zealand
| | - Julie Fitzjohn
- Specialist Mental Health Service, Te Whatu Ora - Waitaha Canterbury, Christchurch, New Zealand
| | - Melissa Kerdemelidis
- Population Health Gain, Service Improvement and Innovation, Te Whatu Ora - Waitaha Canterbury, Christchurch, New Zealand
| | - Helen Lockett
- Department of Public Health, University of Otago, Wellington, New Zealand
- Te Pou, Wellington, New Zealand
| | - Andre D McLachlan
- Centre for Health and Social Practice, Waikato Institute of Technology, Hamilton, New Zealand
| | - Waikaremoana Waitoki
- Faculty of Māori and Indigenous Studies, The University of Waikato, Hamilton, New Zealand
| | - Cameron Lacey
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Mudd MK, Angelotta C. Nutrition Education in Psychiatry Residency Programs: A Call to Action. J Nutr 2024; 154:2431-2436. [PMID: 38825041 DOI: 10.1016/j.tjnut.2024.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/06/2024] [Accepted: 05/30/2024] [Indexed: 06/04/2024] Open
Abstract
The burden of disease attributable to mental health is expected to rise in the coming decades. Poor nutritional status is considered a modifiable risk factor for general mental health. In fact, nutrition interventions are now accepted as a core strategy in mental healthcare to combat physical health inequalities and life-expectancy gap in people with certain psychiatric disorders. However, most psychiatrists are not familiar with evidence for the potential therapeutic benefits of diet in psychiatric illness, and this may be related to sparse nutrition education for physicians. Thus, there is a need to integrate nutritional management in psychiatric practice, but there is a gap in medical education that would support this practice. Here, we discuss evidence for and challenges in 1) assessing diet quality in psychiatric illness, 2) recommending improvements in diet quality and specific dietary patterns in psychiatric illness, and 3) recommending dietary supplements in psychiatric illness. This discussion serves as a call to develop nutrition curricula within psychiatry residency programs.
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Affiliation(s)
- Marta Karolina Mudd
- Department of Psychiatry, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
| | - Cara Angelotta
- Department of Psychiatry, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Mishu MP, Aggarwal V, Shiers D, Peckham E, Johnston G, Joury E, Chew‐Graham CA, Goodall K, Elliott E, French P, Harris R, Laverty L, Palmier‐Claus J. Developing a Consensus Statement to Target Oral Health Inequalities in People With Severe Mental Illness. Health Expect 2024; 27:e14163. [PMID: 39097761 PMCID: PMC11297907 DOI: 10.1111/hex.14163] [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: 04/02/2024] [Revised: 06/19/2024] [Accepted: 07/17/2024] [Indexed: 08/05/2024] Open
Abstract
INTRODUCTION Oral diseases are more prevalent in people with severe mental illness (SMI) compared to those without mental illnees. A greater focus on oral health is needed to reverse unacceptable but often neglected oral health inequality in people with SMI. This provided the impetus for developing 'The Right to Smile' consensus statement. We aimed to develop and disseminate a consensus statement to address oral health inequality, highlighting the main areas for concern and recommending an evidence-based 5-year action plan to improve oral health in people with SMI. METHODS The Right to Smile consensus statement was developed by experts from several professional disciplines and practice settings (mental, dental and public health) and people with lived experience, including carers. Stakeholders participated in a series of online workshops to develop a rights-based consensus statement. Subsequent dissemination activities were conducted to maximise its reach and impact. RESULTS The consensus statement was developed to focus on how oral health inequalities could be addressed through a set of 5-year improvement targets for practice, policy and training. The consensus was reached on three 5-year action plans: 'Any assessment of physical health in people experiencing SMI must include consideration of oral health', 'Access to dental services for people with SMI needs to improve' and 'The importance of oral health for people experiencing SMI should be recognised in healthcare training, systems, and structures'. CONCLUSION This consensus statement urges researchers, services and policymakers to embrace a 5-year action plan to improve oral health for people with SMI. PATIENT OR PUBLIC CONTRIBUTION The team included people with lived experience of SMI, their carers/family members and mental and dental health service providers. They were involved in every stage of developing the consensus statement, from conception to development and dissemination.
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Affiliation(s)
| | | | - David Shiers
- Psychosis Research UnitGreater Manchester Mental Health NHS TrustManchesterUK
- University of ManchesterManchesterUK
- School of MedicineKeele UniversityKeeleUK
| | | | | | - Easter Joury
- Institute of DentistryQueen Mary University of LondonLondonUK
| | | | - Katie Goodall
- School of Nursing & Public HealthManchester Metropolitan UniversityManchesterUK
| | | | - Paul French
- Manchester Metropolitan University, Pennine Care NHSManchesterUK
| | - Rebecca Harris
- University of LiverpoolLiverpoolUK
- Royal Liverpool University NHS Foundation Trust, Department of Public Health, Policy and Systems, Institute of Population HealthUniversity of LiverpoolLiverpoolUK
| | - Louise Laverty
- NIHR Applied Research Collaboration Greater Manchester (NIHR ARC GM)—Digital Health, Centre for Health InformaticsUniversity of ManchesterManchesterUK
| | - Jasper Palmier‐Claus
- Spectrum Centre for Mental Health ResearchLancaster UniversityLancasterUK
- Lancashire & South Cumbria NHS Foundation TrustLancashireUK
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Kennedy L, Holt T, Hunter A, Golshan S, Cadenhead K, Mirzakhanian H. Development of an anti-inflammatory diet for first-episode psychosis (FEP): a feasibility study protocol. Front Nutr 2024; 11:1397544. [PMID: 39131737 PMCID: PMC11310932 DOI: 10.3389/fnut.2024.1397544] [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: 03/07/2024] [Accepted: 06/17/2024] [Indexed: 08/13/2024] Open
Abstract
Background Evidence suggests inflammation plays a role in the pathophysiology of psychosis even in early illness, indicating a potential avenue for anti-inflammatory interventions that simultaneously address high rates of metabolic disease in this population. The aim of this study is to design a novel anti-inflammatory diet intervention (DI) that is feasible to implement in a first-episode psychosis (FEP) population. Methods Eligible FEP Participants are aged 15-30. The DI is currently being refined through a multi-phase process that includes the recruitment of focus groups that provide insight into feasibility of measures and nutritional education, as well as the implementation of the DI. The phases in the study are the Development Phase, Formative Phase, and the Feasibility Phase. Results The Development phase has resulted in the creation of a flexible DI for FEP based on existing research on nutritional health and informed by providers. This study has just completed the Formative phase, recruiting eligible participants to join focus groups that gleaned information about dietary habits, preferences, and food environments to further refine the DI. Conclusion Findings from earlier phases have advised the current Feasibility Phase in which this novel DI is being administered to a small cohort of FEP participants (N = 12) to determine acceptability of the DI from a lived experience perspective. Naturalistic changes in inflammatory biomarkers, metabolic health, and symptoms will also be measured.
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Affiliation(s)
- Leda Kennedy
- Department of Psychiatry, University of California San Diego, La Jolla, San Diego, CA, United States
| | - Tiffany Holt
- Center for Integrative Medicine, University of California San Diego, La Jolla, San Diego, CA, United States
| | - Anna Hunter
- Center for Integrative Medicine, University of California San Diego, La Jolla, San Diego, CA, United States
| | - Shahrokh Golshan
- Center for Integrative Medicine, University of California San Diego, La Jolla, San Diego, CA, United States
| | - Kristin Cadenhead
- Department of Psychiatry, University of California San Diego, La Jolla, San Diego, CA, United States
| | - Heline Mirzakhanian
- Department of Psychiatry, University of California San Diego, La Jolla, San Diego, CA, United States
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Pantoja-Arévalo L, Gesteiro E, Pérez-Ruiz M, López-Seoane J, Wusterhausen P, Matthias T, Urrialde R, González-Gross M. The multifactorial approach and the food allergen-specific substitutive diet as a tool to manage and ameliorate adverse reactions to foodstuffs in adulthood: study protocol for a randomized controlled trial-the ALASKA study. Trials 2024; 25:494. [PMID: 39033266 PMCID: PMC11264907 DOI: 10.1186/s13063-024-08307-2] [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: 03/31/2024] [Accepted: 07/01/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Adverse reactions to foodstuffs (ARFS), specifically food allergy (FA) and food intolerance (FI), are increasing worldwide and represent a major public health concern. Thus, ARFS management, its identification, evaluation, and intervention, must provide a comprehensive solution. OBJECTIVES (a) To develop a multifactorial strategy for ARFS management in adults with FA and/or FI; (b) to describe the multiple influential variables in ARFS within the realm of ARFS management; and (c) to design a personalized food allergen-specific substitutive diet (FASSD), as a 6-month dietary treatment option for adults with ARFS and as a component of ARFS management. METHODS The ALASKA study will consider the following main variables as part of the ARFS management: (1) demographics and clinical information; (2) symptomatology, food and beverages intake and physical activity; (3) hematobiochemical study; (4) immunology; (5) enzymatic activity; (6) anthropometry, body composition, and physical fitness; (7) QoL; (8) 6-month intervention; (9) end of the study; and (10) other assessments. The FASSD will be designed with special emphasis on the commonly lacking micronutrients in the ARFS population: niacin, Mg, K, P, Ca, Zn, B12, folate, Fe, and fiber. DISCUSSION The ALASKA study protocol has been developed as a global strategy to manage and evaluate ARFS in Spanish adults older than 18 years of age. Approaching ARFS with multiple assessments, as influencing factors, will lead to a novel strategy for ARFS management. The FASSD has been designed as a personalized tool to avoid crucial micronutrient deficiencies that a current strict food allergen avoidance or elimination diet may provoke. TRIAL REGISTRATION The protocol has been approved by the Ethics Committee of the UPM (REF.20200602) and registered on ClinicalTrials.gov (NCT05802017).
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Affiliation(s)
- Lisset Pantoja-Arévalo
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, 28040, Madrid, Spain.
| | - Eva Gesteiro
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, 28040, Madrid, Spain
| | - Margarita Pérez-Ruiz
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, 28040, Madrid, Spain
| | - Jaime López-Seoane
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, 28040, Madrid, Spain
| | - Patricia Wusterhausen
- Department of Research and Development, Aesku.Diagnostics GmbH, 55234, Wendelsheim, Germany
| | - Torsten Matthias
- Department of Research and Development, Aesku.Diagnostics GmbH, 55234, Wendelsheim, Germany
| | - Rafael Urrialde
- Department of Genetics, Physiology and Microbiology, Faculty of Biological Sciences, Universidad Complutense de Madrid, 28040, Madrid, Spain
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, Universidad CEU San Pablo, 28003, Madrid, Spain
- Department of Nutrition, Faculty of Nursing, Universidad de Valladolid, 47002, Valladolid, Spain
| | - Marcela González-Gross
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, 28040, Madrid, Spain
- Biomedical Research Center of Pathophysiology of Obesity and Nutrition-CIBERobn, Carlos III Health Institute, 28029, Madrid, Spain
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Ishii H, Yamada H, Sato R, Hayashi W, Nakamura D, Sugita S, Tazaki T, Takashio O, Inamoto A, Iwanami A. Obesity-associated factors in psychiatric outpatients: A multicenter questionnaire survey. Neuropsychopharmacol Rep 2024. [PMID: 39010283 DOI: 10.1002/npr2.12465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/11/2024] [Accepted: 06/15/2024] [Indexed: 07/17/2024] Open
Abstract
The prevalence of obesity is increasing worldwide, resulting in various health issues such as hypertension, dyslipidemia, diabetes mellitus, heart disease, and a lower life expectancy. Importantly, several psychiatric disorders and the use of psychotropic medications have been linked to obesity, and the possible risk factors need further investigation. This study examined the prevalence of obesity and its associated factors using a self-administered questionnaire. Participants were recruited from three outpatient clinics and individuals who met one or more of the ICD-10 F0-F9, G4 diagnoses were included. In total, 1384 participants completed the questionnaire about their lifestyle. Statistical analysis compared the demographic and clinical characteristics of the individuals who were obese (Body Mass Index: BMI ≥25) and those who were non-obese (BMI <25). The results revealed that the factors associated with obesity in psychiatric outpatients were being male, prolonged treatment duration, eating out frequently, and use of both second- and first-generation antipsychotics. The study emphasized the importance of closely monitoring BMI in individuals with multiple obesity-related factors.
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Affiliation(s)
- Hiroki Ishii
- Department of Psychiatry, Graduate School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, East Hospital, Showa University Hospital, Shinagawa-ku, Tokyo, Japan
| | - Hiroki Yamada
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, Showa University Northern Yokohama Hospital, Tsuzuki-ku, Yokohama, Japan
- Shinrin Koen Mental Clinic, Namekawa-cho, Hiki-gun, Saitama, Japan
| | - Ryotaro Sato
- Department of Psychiatry, Graduate School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, East Hospital, Showa University Hospital, Shinagawa-ku, Tokyo, Japan
| | - Wakaho Hayashi
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Showa University Karasuyama Hospital, Setagaya-ku, Tokyo, Japan
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Dan Nakamura
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Showa University Karasuyama Hospital, Setagaya-ku, Tokyo, Japan
| | - Shutaro Sugita
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Showa University Karasuyama Hospital, Setagaya-ku, Tokyo, Japan
| | - Taro Tazaki
- Department of Psychiatry, Graduate School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Showa University Karasuyama Hospital, Setagaya-ku, Tokyo, Japan
| | - Osamu Takashio
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, East Hospital, Showa University Hospital, Shinagawa-ku, Tokyo, Japan
| | - Atsuko Inamoto
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, Showa University Northern Yokohama Hospital, Tsuzuki-ku, Yokohama, Japan
| | - Akira Iwanami
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Showa University Karasuyama Hospital, Setagaya-ku, Tokyo, Japan
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Liwinski T, Bocek I, Schmidt A, Kowalinski E, Dechent F, Rabenschlag F, Moeller J, Sarlon J, Brühl AB, Nienaber A, Lang UE, Huber CG. Sustainability initiatives in inpatient psychiatry: tackling food waste. Front Psychiatry 2024; 15:1374788. [PMID: 39026524 PMCID: PMC11254754 DOI: 10.3389/fpsyt.2024.1374788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 06/17/2024] [Indexed: 07/20/2024] Open
Abstract
Background Food plays a dual role in promoting human health and environmental sustainability. Yet, current food systems jeopardize both. Food waste poses a major global challenge due to its significant economic, social, and environmental impacts. Healthcare facilities generate the largest amounts of food waste compared to other forms of catering provision. Food waste correlates with environmental unsustainability and diminished patient satisfaction, compounding the prevalent challenge of hospital malnutrition and contributing to suboptimal patient outcomes. Materials and methods In a three-year interventional study (2020-2022) at a psychiatric tertiary care center, we assessed and mitigated food waste using evidence-based measures. We conducted systematic food wastage audits over three years (2020-2022) in May and June, each lasting four weeks. Costs were analyzed comprehensively, covering food, staff, infrastructure, and disposal. Environmental impact was assessed using Umweltbelastungspunkte (UBP) and CO2e/kg emissions, alongside water usage (H2O - l/kg). Results Economic losses due to food wastage were substantial, primarily from untouched plates and partially consumed dinners, prompting meal planning adjustments. Despite a >3% increase in meals served, both food waste mass and costs decreased by nearly 6%. Environmental impact indicators showed a reduction >20%. Vegetables, salad, and fruits constituted a significant portion of waste. Overproduction minimally contributed to waste, validating portion control efficacy. Conclusion Our study highlights significant economic and environmental losses due to hospital food waste, emphasizing the importance of resource efficiency. The strategies outlined offer promising avenues for enhanced efficiency. The decrease in food waste observed over the three-year period underscores the potential for improvement.
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Affiliation(s)
- Timur Liwinski
- University Psychiatric Clinics Basel, Clinic for Adults, University of Basel, Basel, Switzerland
| | - Iona Bocek
- University Psychiatric Clinics Basel, Clinic for Adults, University of Basel, Basel, Switzerland
| | - Andreas Schmidt
- University Psychiatric Clinics Basel, Clinic for Adults, University of Basel, Basel, Switzerland
| | - Eva Kowalinski
- University Psychiatric Clinics Basel, Clinic for Adults, University of Basel, Basel, Switzerland
| | - Frieder Dechent
- University Psychiatric Clinics Basel, Clinic for Adults, University of Basel, Basel, Switzerland
| | - Franziska Rabenschlag
- University Psychiatric Clinics Basel, Clinic for Adults, University of Basel, Basel, Switzerland
| | - Julian Moeller
- University Psychiatric Clinics Basel, Clinic for Adults, University of Basel, Basel, Switzerland
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Jan Sarlon
- University Psychiatric Clinics Basel, Clinic for Adults, University of Basel, Basel, Switzerland
| | - Annette B. Brühl
- University Psychiatric Clinics Basel, Clinic for Adults, University of Basel, Basel, Switzerland
| | - André Nienaber
- University Psychiatric Clinics Basel, Clinic for Adults, University of Basel, Basel, Switzerland
- Central Institute of Mental Health, Medical Faculty Mannheim and University of Heidelberg, Mannheim, Germany
| | - Undine E. Lang
- University Psychiatric Clinics Basel, Clinic for Adults, University of Basel, Basel, Switzerland
| | - Christian G. Huber
- University Psychiatric Clinics Basel, Clinic for Adults, University of Basel, Basel, Switzerland
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Vaqué-Crusellas C, Ribot B, Corominas-Díaz A, Prat-Vigué G, Vila-Martí A, Torres-Moreno M, Serra-Millàs M, Foguet-Boreu Q. Effectiveness of Culinary Nutrition Workshops on the Mood and Nutritional Interest of Inpatients With Mental Disorder. Cureus 2024; 16:e64691. [PMID: 39156399 PMCID: PMC11327369 DOI: 10.7759/cureus.64691] [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] [Accepted: 07/11/2024] [Indexed: 08/20/2024] Open
Abstract
Background Promoting healthy eating habits through nutrition education programs is crucial to improving the overall health of people with mental disorders. This study aims to assess the effectiveness of culinary nutrition workshops on the mood and nutritional interest of hospitalized adults with mental disorders (MD) from the acute psychiatric unit of two general hospitals in Catalonia, Spain. Methods A pilot randomized control trial (RCT) was conducted with MD inpatient. Participants were randomly assigned to two groups: the intervention group received weekly culinary nutrition workshops with flexible participation and the control group continued routinary care. The interest in nutrition was analysed with an ad hoc item pre and post-intervention period. Mood changes were studied with a visual analog scale and analysed pre- and post-intervention periods as well as before and after every session. An ad hoc questionnaire was also used to assess the satisfaction of participants with the intervention. The obtained data were analysed at both descriptive and inferential levels. Results We included 81 participants, with a mean age of 45.3 (SD: 17.0); 66.7% were women, with 41 assigned to the intervention group and 40 to the control group. At the end of every culinary nutrition workshop, a statistically significant improvement in mood was observed in the intervention group (5.9 vs. 7.4 points, p<0.001). However, there were no significant differences in mood changes between the control and intervention groups after the intervention period (control group: 1.0 vs. intervention group: 1.5, p=0.473), while the nutritional interest was significantly improved after the intervention period intergroups (control group: 4.1 vs. intervention group: 37.2, p<0.001). The intervention was excellently valued by the participants regarding content, space, and health professionals, and generated interest and motivation, with scores above 9 on all these items. Conclusion The improvement of interest in nutrition and the satisfaction of hospitalised people with MD with the nutrition culinary workshops emphasize the need to design more comprehensive RCTs in hospitals and rehabilitation centers.
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Affiliation(s)
- Cristina Vaqué-Crusellas
- Department of Social Sciences and Community Health, Faculty of Health Sciences and Welfare, University of Vic - Central University of Catalonia (UVic-UCC), Vic, ESP
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, ESP
| | - Blanca Ribot
- Department of Applied Health Sciences, Faculty of Health Sciences and Welfare, University of Vic - Central University of Catalonia (UVic-UCC), Vic, ESP
| | - Antoni Corominas-Díaz
- Department of Psychiatry, University of Vic - Central University of Catalonia (UVic-UCC), Vic, ESP
| | - Gemma Prat-Vigué
- Department of Psychiatry, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, ESP
| | - Anna Vila-Martí
- Department of Experimental and Methodological Sciences, Faculty of Health Sciences and Welfare, University of Vic - Central University of Catalonia (UVic-UCC), Vic, ESP
| | - Míriam Torres-Moreno
- Department of Experimental and Methodological Sciences, Faculty of Health Sciences and Welfare, University of Vic - Central University of Catalonia (UVic-UCC), Vic, ESP
| | | | - Quintí Foguet-Boreu
- Department of Psychiatry, Faculty of Health Sciences and Welfare, University of Vic - Central University of Catalonia (UVic-UCC), Vic, ESP
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9
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Moetteli S, Mueller-Stierlin AS. [Dietary Interventions In Psychiatry - A Neglected Opportunity to Promote Healthy Lifestyles]. PSYCHIATRISCHE PRAXIS 2024; 51:235-237. [PMID: 38991523 DOI: 10.1055/a-2315-2739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Affiliation(s)
- Sonja Moetteli
- Zentrum Psychiatrische Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD), Köniz, Schweiz
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10
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Kang J, Wu J, Aggarwal VR, Shiers D, Doran T, Palmier-Claus J. Investigating the Relationship between Oral Health and Severe Mental Illness: Analysis of NHANES 1999-2016. Dent J (Basel) 2024; 12:191. [PMID: 39056978 PMCID: PMC11276391 DOI: 10.3390/dj12070191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 06/07/2024] [Accepted: 06/18/2024] [Indexed: 07/28/2024] Open
Abstract
OBJECTIVES To explore whether: (i) people with severe mental illness (SMI) experience worse oral health than the general population, and (ii) the risk factors for poor oral health in people with SMI. METHODS Cross-sectional data were extracted from the National Health and Nutrition Examination Survey (1999-2016), including on self-rated oral health, oral pain, tooth loss, periodontitis stage, and number of decayed, missing, and filled teeth. Candidate risk factors for poor oral health included demographic characteristics, lifestyle factors, physical health comorbidities, and dental hygiene behaviours. Ordinal logistic regression and zero-inflated negative binomial models were used to explore predictors of oral health outcomes. RESULTS There were 53,348 cases included in the analysis, including 718 people with SMI. In the fully adjusted model, people with SMI were more likely to suffer from tooth loss (OR 1.60, 95% CI: 1.34-1.92). In people with SMI, risk factors identified for poor oral health outcomes were older age, white ethnicity, lower income, smoking history, and diabetes. Engaging in physical activity and daily use of dental floss were associated with better oral health outcomes. CONCLUSIONS People with SMI experience higher rates of tooth loss than the general population, and certain subgroups are particularly at risk. Performing regular physical exercise and flossing may lower the risk of poor oral health, while smoking and diabetes may increase the risk. These findings suggest opportunities for targeted prevention and early intervention strategies to mitigate adverse oral health outcomes in people with SMI.
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Affiliation(s)
- Jing Kang
- Faculty of Dentistry, Oral, and Craniofacial Sciences, King’s College London, London SE1 9RT, UK
| | - Jianhua Wu
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London E1 4NS, UK
| | | | - David Shiers
- Division of Psychology & Mental Health, University of Manchester, Manchester M13 9PL, UK;
| | - Tim Doran
- Health Services & Policy, University of York, York YO10 5DD, UK;
| | - Jasper Palmier-Claus
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster LA1 4YW, UK;
- Lancashire & South Cumbria NHS Foundation Trust, Lancashire PR5 6AW, UK
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11
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Giles EL, Stevens H, McGeechan GJ, Walker L, Pakunwanich N, Whittaker V, Smith J. Evaluating the nutrition and body mass index clinical link pathway in mental health and learning disability services: A mixed-methods study. PLoS One 2024; 19:e0303893. [PMID: 38870198 PMCID: PMC11175514 DOI: 10.1371/journal.pone.0303893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 05/03/2024] [Indexed: 06/15/2024] Open
Abstract
This research involved an evaluation of the Nutrition and Body Mass Index Clinical Link Pathway (NBMI CLiP) implemented in practice across Severe Mental Illness and/or learning disabilities ward in Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV), to understand how the NBMI CLiP is used, inpatient staff feedback on the CLiP for supporting service users to manage their weight, and whether using the NBMI CLiP impacted on staffs' own weight management. To account for the uneven distribution of the secondary data, descriptive statistics such as medians and the inter-quartile range were conducted to assess anychanges in recording of Body Mass Index, nutrition screening (SANSI) and intervention planss. Staff survey data investigated barriers and facilitators to using the NBMI CLiP in practice and the impact on their own weight management. Secondary data analysis found most wards improved recording of BMI, SANSI and Intervention Planning. Forensic Learning Disabilities, Adult Learning Disabilities, mixed gender wards and North Yorkshire and York Operational Directorate indicated the greatest improvement. Survey results (n = 55) found three times as many participants (n = 12, 75%) found the NBMI CLiP easy or very easy to use; most fully understood it (n = 13, 81.20%) and were confident or very confident to carry out a SANSI Screen (n = 14, 87.50%) or a recovery focused intervention plan (n = 9, 56.20%). Open-text responses, analysed using content analysis, indicated a need for further training of staff on the NBMI CLiP. It is recommended that to support weight management across these wards, that a nudge or choice architecture approach to weight management is adopted, supported by training delivered by a dietitian.
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Affiliation(s)
- Emma L. Giles
- School of Health and Life Sciences, Teesside University, Middlesborough, United Kingdom
| | - Heidi Stevens
- School of Health and Life Sciences, Teesside University, Middlesborough, United Kingdom
| | - Grant J. McGeechan
- School of Social Sciences, Humanities, and Law, Teesside University, Middlesborough, United Kingdom
| | - Lauren Walker
- School of Social Sciences, Humanities, and Law, Teesside University, Middlesborough, United Kingdom
| | - Narut Pakunwanich
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | - Vicki Whittaker
- School of Health and Life Sciences, Teesside University, Middlesborough, United Kingdom
| | - Jo Smith
- School of Health and Life Sciences, Teesside University, Middlesborough, United Kingdom
- The Research and Development Team, Tees, Esk and Wear Valleys NHS Foundation Trust, Middlesbrough, United Kingdom
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12
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Jenkins PE, Proctor K, Snuggs S. Dietary intake of adults with eating disorders: A systematic review and meta-analysis. J Psychiatr Res 2024; 175:393-404. [PMID: 38772131 DOI: 10.1016/j.jpsychires.2024.05.038] [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: 11/08/2023] [Revised: 04/09/2024] [Accepted: 05/15/2024] [Indexed: 05/23/2024]
Abstract
Studies have confirmed the link between altered dietary intake and eating disorders (EDs), although no systematic assessment of this research exists. Rigorous synthesis of dietary intake in anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), and similar EDs is needed to explore similarities and differences. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, we conducted a systematic review and quantitative synthesis of studies of dietary intake. Searches of three electronic databases resulted in thirty-nine included studies. Meta-analyses of subsets of these studies were undertaken to summarise macronutrient intake across AN, BN, and BED. Study quality was assessed using the American Academy of Nutrition and Dietetics Quality Criteria Checklist, with ratings either Positive (k = 27) or Neutral (k = 12). Adults with AN had low energy intake and those with BED reported elevated macronutrient intake. Individuals with BN reported wide variation in energy intake, including some of the highest estimates. Individuals with AN were likely to under-consume key micronutrients, with sodium potentially over-consumed in BN and BED. Vitamin D was under-consumed across all disorders. This meta-analysis highlights important diagnostic differences and synthesises dietary intake in EDs, with particular relevance to risk assessment and treatment.
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Affiliation(s)
- Paul E Jenkins
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6ES, UK, United Kingdom.
| | - Katy Proctor
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6ES, UK, United Kingdom
| | - Sarah Snuggs
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6ES, UK, United Kingdom
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13
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Costa CFFA, Ferreira-Gomes J, Barbosa F, Sampaio-Maia B, Burnet PWJ. Importance of good hosting: reviewing the bi-directionality of the microbiome-gut-brain-axis. Front Neurosci 2024; 18:1386866. [PMID: 38812976 PMCID: PMC11133738 DOI: 10.3389/fnins.2024.1386866] [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: 02/27/2024] [Accepted: 04/29/2024] [Indexed: 05/31/2024] Open
Abstract
Gut microorganisms have been shown to significantly impact on central function and studies that have associated brain disorders with specific bacterial genera have advocated an anomalous gut microbiome as the pathophysiological basis of several psychiatric and neurological conditions. Thus, our knowledge of brain-to-gut-to microbiome communication in this bidirectional axis seems to have been overlooked. This review examines the known mechanisms of the microbiome-to-gut-to-brain axis, highlighting how brain-to-gut-to-microbiome signaling may be key to understanding the cause of disrupted gut microbial communities. We show that brain disorders can alter the function of the brain-to-gut-to-microbiome axis, which will in turn contribute to disease progression, while the microbiome-to gut-to brain direction presents as a more versatile therapeutic axis, since current psychotropic/neurosurgical interventions may have unwanted side effects that further cause disruption to the gut microbiome. A consideration of the brain-to-gut-to-microbiome axis is imperative to better understand how the microbiome-gut-brain axis overall is involved in brain illnesses, and how it may be utilized as a preventive and therapeutic tool.
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Affiliation(s)
- Carolina F. F. A. Costa
- ICBAS-School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
- NanoBiomaterials for Targeted Therapies, INEB-Institute of Biomedical Engineering, i3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Joana Ferreira-Gomes
- Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
- IBMC-Institute for Molecular and Cell Biology, i3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Benedita Sampaio-Maia
- NanoBiomaterials for Targeted Therapies, INEB-Institute of Biomedical Engineering, i3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
- Faculty of Dental Medicine, University of Porto, Porto, Portugal
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14
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Rog J, Wingralek Z, Nowak K, Grudzień M, Grunwald A, Banaszek A, Karakula-Juchnowicz H. The Potential Role of the Ketogenic Diet in Serious Mental Illness: Current Evidence, Safety, and Practical Advice. J Clin Med 2024; 13:2819. [PMID: 38792361 PMCID: PMC11122005 DOI: 10.3390/jcm13102819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/30/2024] [Accepted: 05/05/2024] [Indexed: 05/26/2024] Open
Abstract
The ketogenic diet (KD) is a high-fat, low-carbohydrate diet that mimics the physiological state of fasting. The potential therapeutic effects in many chronic conditions have led to the gaining popularity of the KD. The KD has been demonstrated to alleviate inflammation and oxidative stress, modulate the gut microbiota community, and improve metabolic health markers. The modification of these factors has been a potential therapeutic target in serious mental illness (SMI): bipolar disorder, major depressive disorder, and schizophrenia. The number of clinical trials assessing the effect of the KD on SMI is still limited. Preliminary research, predominantly case studies, suggests potential therapeutic effects, including weight gain reduction, improved carbohydrate and lipid metabolism, decrease in disease-related symptoms, increased energy and quality of life, and, in some cases, changes in pharmacotherapy (reduction in number or dosage of medication). However, these findings necessitate further investigation through larger-scale clinical trials. Initiation of the KD should occur in a hospital setting and with strict care of a physician and dietitian due to potential side effects of the diet and the possibility of exacerbating adverse effects of pharmacotherapy. An increasing number of ongoing studies examining the KD's effect on mental disorders highlights its potential role in the adjunctive treatment of SMI.
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Affiliation(s)
- Joanna Rog
- Laboratory of Human Metabolism Research, Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 66 Str., 02-787 Warsaw, Poland
| | - Zuzanna Wingralek
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Głuska 1 Str., 20-469 Lublin, Poland; (Z.W.); (K.N.); (M.G.); (A.B.); (H.K.-J.)
| | - Katarzyna Nowak
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Głuska 1 Str., 20-469 Lublin, Poland; (Z.W.); (K.N.); (M.G.); (A.B.); (H.K.-J.)
| | - Monika Grudzień
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Głuska 1 Str., 20-469 Lublin, Poland; (Z.W.); (K.N.); (M.G.); (A.B.); (H.K.-J.)
| | - Arkadiusz Grunwald
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Głuska 1 Str., 20-469 Lublin, Poland; (Z.W.); (K.N.); (M.G.); (A.B.); (H.K.-J.)
| | - Agnieszka Banaszek
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Głuska 1 Str., 20-469 Lublin, Poland; (Z.W.); (K.N.); (M.G.); (A.B.); (H.K.-J.)
| | - Hanna Karakula-Juchnowicz
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Głuska 1 Str., 20-469 Lublin, Poland; (Z.W.); (K.N.); (M.G.); (A.B.); (H.K.-J.)
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15
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Li J, Hu R, Luo H, Guo Y, Zhang Z, Luo Q, Xia P. Associations between dietary habits and bipolar disorder: a diet-wide mendelian randomization study. Front Psychiatry 2024; 15:1388316. [PMID: 38800064 PMCID: PMC11116565 DOI: 10.3389/fpsyt.2024.1388316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Background Diet/nutrition is critically important in the pathogenesis, progression, and treatment outcomes of various mental disorders. Current research predominantly focuses on the role of diet in the development and treatment of depression, with less attention given to the relationship between diet and Bipolar Disorder (BD). Method We employed Mendelian Randomization (MR) to investigate the relationship between 28 dietary habits and BD. An analysis was conducted using publicly available genome-wide association study data from the UK Biobank dataset. Various dietary habits were analyzed as exposures with BD as the outcome, mainly using the Inverse Variance Weighted (IVW) method. Results Intake of non-oily fish and sponge pudding both have a positive association with BD. Oily fish, dried fruit, apples, salt, and cooked vegetables intake also appeared potentially risky for BD, although the possibility of false positives cannot be ruled out. Sensitivity analysis further confirmed the robustness of these findings. Conclusion Our research provides evidence of a relationship between various dietary habits and BD. It underscores the need for careful dietary management and balance to reduce the risk of BD, suggesting caution with dietary preferences for fish and sponge pudding. Furthermore, more detailed studies are needed to further understand the potential impacts of high-sugar and high-protein diets on BD development.
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Affiliation(s)
- Junyao Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Renqin Hu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huirong Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yanwei Guo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zheng Zhang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Pingyou Xia
- Yongchuan District Mental Health Center, Chongqing, China
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16
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Goh XX, Tee SF, Tang PY, Chee KY, Loh KKW. Impact of body mass index elevation, Vitamin D receptor polymorphisms and antipsychotics on the risk of Vitamin D deficiency in schizophrenia patients. J Psychiatr Res 2024; 175:350-358. [PMID: 38761517 DOI: 10.1016/j.jpsychires.2024.05.005] [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: 01/08/2024] [Revised: 03/27/2024] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Abstract
Antipsychotics with weight gain as side effect and vitamin D receptor dysfunction associated with single nucleotide polymorphisms (VDR SNPs) may have different effects on vitamin D status. Hence, present study aimed to investigate the relationship between vitamin D with body mass index (BMI), antipsychotics and VDR SNPs (rs2228570, rs1544410, rs7975232 and rs731236) in Malaysian patients with schizophrenia. Serum vitamin D level was measured using competitive enzyme-linked immunosorbent assay kit. VDR SNPs were analyzed using polymerase chain reaction-restriction fragment length polymorphism. We found significantly lower serum vitamin D level in patients with schizophrenia (p < 0.01), especially those taking atypical antipsychotics (p = 0.02) and combined antipsychotics (p = 0.02) and obese (BMI ≥27.5 kg/m2) patients (p = 0.04) after adjustment for covariates. For VDR SNPs, the CT genotype of rs1544410, CA genotype of rs7975232, and AA and AG genotypes of rs731236 may contribute to the significant decreased serum vitamin D level in patients (p < 0.05). Nevertheless, these relationships may differ by populations or medical conditions. The hypotheses of volumetric dilution and sequestration of vitamin D may explain the lower vitamin D level in obese patients. In addition, lifestyle factors such as poor diet and lack of physical activity with less sunlight exposure may cause reduced vitamin D level among patients. As patients in present study were prescribed with various antipsychotics, the effect of each antipsychotic on vitamin D level could not be determined. Thus, future studies should investigate the effect of different types of antipsychotics and obesity on vitamin D level in schizophrenia.
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Affiliation(s)
- Xue Xin Goh
- Department of Chemical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Bandar Sungai Long, Cheras, 43000, Kajang, Malaysia
| | - Shiau Foon Tee
- Department of Chemical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Bandar Sungai Long, Cheras, 43000, Kajang, Malaysia.
| | - Pek Yee Tang
- Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Bandar Sungai Long, Cheras, 43000, Kajang, Malaysia
| | - Kok Yoon Chee
- Department of Psychiatry and Mental Health, Hospital Kuala Lumpur, Jalan Pahang, 50586, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Kenny Kien Woon Loh
- Medic Clinic (Family Medicine Specialist Clinic), Jalan Menjalara Idaman, Bandar Menjalara, Kepong, 52200, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
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17
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Merino D, Gérard AO, Destere A, Saidessalam H, Askenazy F, Montastruc F, Drici MD, Thümmler S. Cardiac and metabolic safety profile of antipsychotics in youths: A WHO safety database analysis. Psychiatry Res 2024; 334:115786. [PMID: 38387164 DOI: 10.1016/j.psychres.2024.115786] [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: 08/24/2023] [Revised: 02/03/2024] [Accepted: 02/10/2024] [Indexed: 02/24/2024]
Abstract
A significant heterogeneity prevails in antipsychotics (APs) safety monitoring recommendations. Youths are deemed more vulnerable to cardiometabolic side effects. We aimed to assess age-dependent reporting of cardiac and metabolic disorders in youths, relying on the WHO safety database (VigiBase®). VigiBase® was queried for all reports of cardiac, glucose, lipid and nutritional disorders involving APs. Patients <18 years were classified as pediatric population. Disproportionality analyses relied on the Information Component (IC): the positivity of the lower end of its 95 % confidence interval was required to suspect a signal. We yielded 4,672 pediatric reports. In disproportionality analysis, nutritional disorders were leading in youths (IC 3.9 [3.9-4.0]). Among healthcare professionals' reports, stronger signals were detected in youths than in adults. Children had the greatest signal with nutritional disorders (IC 4.7 [4.6-4.8]). In adolescents, aripiprazole was ascribed to non-alcoholic steatohepatitis (NASH). Our findings, based on real-world data, support the hypothesis of a greater propensity for nutritional disorders in youths, despite limitations of pharmacovigilance studies. We suggest specific safety profiles, such as aripiprazole and NASH. Pending more answers from population-based studies, a careful anamnesis should seek for risk factors before AP initiation. A cautious monitoring is warranted to allow earlier identification of side effects.
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Affiliation(s)
- Diane Merino
- University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice, CHU-Lenval, Nice, France; Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital CHU de Nice, Nice, France; Université Côte d'Azur, CoBTeK, Nice, France
| | - Alexandre O Gérard
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital CHU de Nice, Nice, France; Université Côte d'Azur, Laboratory of Molecular Physio Medicine (LP2M), UMR 7370, CNRS, Nice, France
| | - Alexandre Destere
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital CHU de Nice, Nice, France; Université Côte d'Azur, Inria, CNRS, Laboratoire J.A. Dieudonné, Maasai team, Nice, France
| | - Haitam Saidessalam
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital CHU de Nice, Nice, France
| | - Florence Askenazy
- University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice, CHU-Lenval, Nice, France; Université Côte d'Azur, CoBTeK, Nice, France
| | - François Montastruc
- Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance and Pharmacoepidemiology, Faculty of Medicine, Toulouse University Hospital, Toulouse, France
| | - Milou-Daniel Drici
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital CHU de Nice, Nice, France
| | - Susanne Thümmler
- University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice, CHU-Lenval, Nice, France; Université Côte d'Azur, CoBTeK, Nice, France.
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Bertossi F. A Possible Role of Akkermansia muciniphila in the Treatment of Olanzapine-Induced Weight Gain. Cureus 2024; 16:e55733. [PMID: 38463411 PMCID: PMC10921070 DOI: 10.7759/cureus.55733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2024] [Indexed: 03/12/2024] Open
Abstract
Second-generation antipsychotics are mainly used in both acute and long-term treatment of major psychiatric disorders. Although better tolerated than first-generation antipsychotic drugs, they can frequently induce weight gain and metabolic disorders, of these, olanzapine is one of the drugs more likely to induce these side effects. There is consistent evidence of the role of gut microbiota in modulating the gut-brain axis with complex crosstalk with the host involving satiety signaling pathways, food intake behavior, and weight and metabolic regulation. Second-generation antipsychotics induce important gut microbiota modification thus contributing together with the central and peripheral receptors blockade mechanism to weight gain induction and metabolic impairment. These drugs can alter the composition of gut microbiota and induce dysbiosis, often reducing the concentration of Akkermansia muciniphila, a bacterium that is also decreased in patients with diabetes, obesity, metabolic syndrome, or chronic inflammatory diseases. Probiotic administration can be a safe and well-tolerated approach to modulate microbiota and offer an integrative strategy in psychiatric patients suffering antipsychotic side effects. Multiple strain probiotics and Akkermansia muciniphila alone have been administered both in mice models and in clinical populations demonstrating efficacy on antipsychotic-induced metabolic impairment and showing a contribution in reducing induced weight gain. Akkermansia muciniphila can improve several parameters altered by olanzapine administration, such as weight gain, insulin resistance, hyperglycemia, liver function, systemic inflammation, and gut barrier function. Although we do not have jet trials in the psychiatric population, this probiotic may be a complementary approach to treating olanzapine-induced weight gain and metabolic side effects.
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Affiliation(s)
- Francesca Bertossi
- Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, ITA
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19
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Navab FS, Hadi A, Jahlan I, Askari G, Khorvash F, Arab A. Is there a link between the inflammatory potential of a diet and mental health among patients with migraine? Findings from a cross-sectional survey. Nutr Neurosci 2024:1-9. [PMID: 38321698 DOI: 10.1080/1028415x.2024.2312305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
AIMS In this study, we aimed to evaluate the relationship between the dietary inflammatory index (DII) and mental health outcomes among patients with migraine headaches. METHODS In this cross-sectional study, 262 subjects were included. The dietary intakes were collected using a validated 168-item semi-quantitative food frequency questionnaire. Items were scored according to their inflammatory potential, so a higher DII indicated a more pro-inflammatory diet. The association between DII and the mental health of participants was investigated using multinomial logistic regression and odds ratio (OR) with a corresponding 95% confidence interval (CI) was reported. RESULTS Overall, 224 women and 38 men, with a mean (standard error) DII of -2.96 (0.06), age of 36.1 (0.53) years, and BMI of 25.55 (0.21) kg/m2, comprised our study population. DII was positively associated with a higher risk of depression in patients with the highest adherence to a pro-inflammatory diet compared to those with the lowest adherence (OR = 1.76; 95%CI: 1.04, 3.00; Ptrend = 0.035). Adjustments for age, sex, marital status, smoking status, migraine headache index score, number of family members, mean arterial pressure, medication, physical activity, and BMI intensified the association in a way that the risk of depression was 2.03 times higher in patients with the highest adherence to a pro-inflammatory diet compared to those with the lowest adherence to a pro-inflammatory diet (OR = 2.03; 95%CI: 1.18, 3.49; Ptrend = 0.011). CONCLUSION Our findings suggest that depression was positively associated with adherence to a pro-inflammatory diet. However, no significant association was observed between anxiety and stress with DII.
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Affiliation(s)
- Fatemeh Sadat Navab
- Student Research Committee, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Hadi
- Halal Research Center of IRI, Food and Drug Administration, Ministry of Health and Medical Education, Tehran, Iran
| | - Ibtesam Jahlan
- Maternal and Child Health Nursing Department, King Saud University, Riyadh, Saudi Arabia
| | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariborz Khorvash
- Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arman Arab
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
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20
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Ehntholt A, Fu E, Pope LG, Rotter M, Compton MT. Introducing the Staff-Administered Meal Independence Rating Scale for Use Among Patients With Serious Mental Illnesses. J Nerv Ment Dis 2024; 212:71-75. [PMID: 37788339 DOI: 10.1097/nmd.0000000000001732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
ABSTRACT For individuals living with serious mental illnesses (SMIs), inadequate meal preparation skills can hinder the ability to live independently; yet rating scales tailored for this population are lacking. We describe development, item analysis, and initial reliability and validity of the Staff-Administered Meal Independence Rating Scale (SAMIRS). After item development involving expert consultation, two rounds of pilot testing ( n = 188, n = 293) were conducted in inpatient and residential settings (transitional living residences [TLRs] and community residences [CRs]). For initial testing of convergent validity, Pearson correlations with Specific Levels of Functioning (SLOF) scale items were computed. Exploratory factor analysis revealed a single factor; Cronbach's alpha was high (0.98). The mean SAMIRS score varied by setting: CR residents scored higher than those in TLRs or inpatient units. Scores were highly correlated with SLOF items measuring community living skills. Although further study is warranted, the SAMIRS could be a useful tool in rating functional needs pertaining to meal independence among individuals with SMI.
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Affiliation(s)
| | - En Fu
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
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21
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Nasab MG, Heidari A, Sedighi M, Shakerian N, Mirbeyk M, Saghazadeh A, Rezaei N. Dietary inflammatory index and neuropsychiatric disorders. Rev Neurosci 2024; 35:21-33. [PMID: 37459114 DOI: 10.1515/revneuro-2023-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/24/2023] [Indexed: 01/10/2024]
Abstract
Neuropsychiatric disorders (NPDs) are considered a potential threat to mental health. Inflammation predominantly plays a role in the pathophysiology of NPDs. Dietary patterns are widely postulated to be involved in the physiological response to inflammation. This review aims to discuss the literature on how dietary inflammatory index (DII) is related to inflammation and, consequently, NPDs. After comprehensive scrutiny in different databases, the articles that investigated the relation of DII score and various NPDs and psychological circumstances were included. The association between dietary patterns and mental disorders comprising depression, anxiety, and stress proved the role of a proinflammatory diet in these conditions' exacerbation. Aging is another condition closely associated with DII. The impact of proinflammatory and anti-inflammatory diet on sleep quality indicated related disorders like sleep latency and day dysfunctions among the different populations are in relation with the high DII score. The potential effects of genetic backgrounds, dietary patterns, and the gut microbiome on DII are discussed as well. To plan preventive or therapeutic interventions considering the DII, these factors, especially genetic variations, should be considered as there is a growing body of literature indicating the role of personalized medicine in different NPDs. To the best of our knowledge, there is a limited number of RCTs on this subject, so future research should evaluate the causality via RCTs and look for therapeutic interventions with an eye on personalized medicine using information about DII in NPDs.
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Affiliation(s)
- Mahsa Golshani Nasab
- Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tabriz, Iran
| | - Arash Heidari
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mohammadreza Sedighi
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Shakerian
- Student Research Committee, School of Rehabilitation, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Ahvaz, Iran
| | - Mona Mirbeyk
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Amene Saghazadeh
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Meta Cognition Interest Group (MCIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network (USERN), Tehran, Iran
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22
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Allcock L, Mantzioris E, Villani A. Adherence to a Mediterranean Diet Is Inversely Associated with Anxiety and Stress but Not Depression: A Cross-Sectional Analysis of Community-Dwelling Older Australians. Nutrients 2024; 16:366. [PMID: 38337651 PMCID: PMC10857277 DOI: 10.3390/nu16030366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/07/2023] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Diet quality may be an important modifiable risk factor for mental health disorders. However, these findings have been inconsistent, particularly in older adults. We explored the independent associations between adherence to a Mediterranean diet (MedDiet) and severity of symptoms related to depression, anxiety and stress in older adults from Australia. This was a cross-sectional analysis of older Australians ≥ 60 years. MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS), and the Depression, Anxiety and Stress Scale (DASS-21) was used to assess the severity of negative emotional symptoms. A total of n = 294 participants were included in the final analyses (70.4 ± 6.2 years). Adherence to a MedDiet was inversely associated with the severity of anxiety symptoms (β = -0.118; CI: -0.761, -0.012; p = 0.043) independent of age, gender, BMI, physical activity, sleep, cognitive risk and ability to perform activities of daily living. Furthermore, MedDiet adherence was inversely associated with symptoms of stress (β = -0.151; CI: -0.680, -0.073; p = 0.015) independent of age, gender, BMI, physical activity and sleep. However, no relationship between MedDiet adherence and depressive symptoms was observed. We showed that adherence to a MedDiet is inversely associated with the severity of symptoms related to anxiety and stress but not depression. Exploring these findings with the use of longitudinal analyses and robust clinical trials are needed to better elucidate these findings in older adults.
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Affiliation(s)
- Lisa Allcock
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia;
| | - Evangeline Mantzioris
- Clinical and Health Sciences & Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA 5000, Australia;
| | - Anthony Villani
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia;
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23
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Johnstad PG. Unhealthy behaviors associated with mental health disorders: a systematic comparative review of diet quality, sedentary behavior, and cannabis and tobacco use. Front Public Health 2024; 11:1268339. [PMID: 38249418 PMCID: PMC10797041 DOI: 10.3389/fpubh.2023.1268339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/14/2023] [Indexed: 01/23/2024] Open
Abstract
Background There are well-established literatures documenting the associations between mental disorders and unhealthy behaviors such as poor diet quality, sedentary behavior, and cannabis and tobacco use. Few studies have attempted to understand the respective findings in light of each other, however. Objective The purpose of this review was to assemble comparable data for each behavior-disorder association and assess the associations in terms of their overall strength. The review aimed to include a representative, but not exhaustive, range of studies that would allow for explorative comparisons. Methods Eligible studies were identified via Pubmed searches and citation searching, restricted to publications no older than 2015 written in English. To obtain comparable data, only studies that reported findings as odds ratios were included, and risk of bias related to study samples, behavioral measurement disparities, and control variables was assessed via sensitivity analyses. Findings for each disorder were compared on the basis of different measures of central tendency. Results From 3,682 records, 294 studies were included. The review found evidence of associations between each of the four unhealthy behaviors and psychosis, depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD), while personality disorder was only investigated in relation to cannabis and tobacco use. In overall comparison, the associations were generally of similar strength, and only the association between cannabis use and personality disorder was exceptional in terms of being significantly stronger than its counterparts across disorders and across behaviors. Analyses of bias risk identified some influence from behavioral measurement disparities and lack of adequate statistical control, but findings were generally robust across a range of sensitivity analyses. Conclusion This explorative and comparative review found that poor diet quality, sedentary behavior, and cannabis and tobacco use are about equally strongly associated with a range of different mental disorders. Given the general nature of these associations, we should probably understand them to reflect a general and shared etiology. However, the findings in this review should be regarded as tentative until confirmed by more comprehensive investigations.
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24
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Nadalin S, Zatković L, Peitl V, Karlović D, Vilibić M, Silić A, Dević Pavlić S, Buretić-Tomljanović A. An association between PPARα-L162V polymorphism and increased plasma LDL cholesterol levels after risperidone treatment. Prostaglandins Leukot Essent Fatty Acids 2024; 200:102604. [PMID: 38113727 DOI: 10.1016/j.plefa.2023.102604] [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: 09/19/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023]
Abstract
Peroxisome proliferator-activated receptor alpha (PPARα) and antipsychotic medications both influence polyunsaturated fatty acids (PUFA) homeostasis, and thus PPARα polymorphism may be linked to antipsychotic treatment response. Here we investigated whether the functional leucine 162 valine (L162V) polymorphism in PPARα influenced antipsychotic treatment in a group of psychosis patients (N = 186), as well as in a patient subgroup with risperidone, paliperidone, or combination treatment (N = 65). Antipsychotic-naïve first-episode patients and nonadherent chronic individuals were genotyped by polymerase chain reaction analysis. At baseline, and after 8 weeks of treatment with various antipsychotic medications, we assessed the patients' Positive and Negative Syndrome Scale (PANSS) scores; PANSS factors; and metabolic syndrome-related parameters, including fasting plasma lipid and glucose levels, and body mass index. In the total patient group, PPARα polymorphism did not affect PANSS psychopathology or metabolic parameters. However, in the subgroup of patients with risperidone, paliperidone, or combination treatment, PPARα polymorphism influenced changes in plasma LDL cholesterol. Specifically, compared to PPARα-L162L homozygous patients, PPARα-L162V heterozygous individuals exhibited significantly higher increases of LDL cholesterol levels after antipsychotic treatment. The PPARα polymorphism had a strong effect size, but a relatively weak contribution to LDL cholesterol level variations (∼12.8 %).
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Affiliation(s)
- Sergej Nadalin
- Department of Psychiatry, General Hospital "Dr. Josip Benčević", Slavonski Brod, Croatia; School of Medicine, Catholic University of Croatia, Zagreb, Croatia.
| | - Lena Zatković
- Hospital Pharmacy, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Vjekoslav Peitl
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Dalibor Karlović
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Maja Vilibić
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Ante Silić
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Sanja Dević Pavlić
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Alena Buretić-Tomljanović
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
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25
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Šoher L, Cvijetić Stokanović M, Prša S, Miškulin M, Kenjerić D. Adherence to Dietary Recommendations in Organized Living Beneficiaries with Severe Mental Disorders and Their Caregivers. Nutrients 2023; 16:143. [PMID: 38201972 PMCID: PMC10780574 DOI: 10.3390/nu16010143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/22/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
People with severe mental disorders often require special care. Other than institutionalized care, some organizations provide housing options and special care in the form of organized living. Few studies provide a detailed description of nutrient intake in this type of care. The aim of this prospective study was to assess nutritional status and adherence to dietary recommendations in both people with mental disorders (beneficiaries) and their caregivers. Across three levels of care, 46 beneficiaries and 19 caregivers participated in the study. The mean intakes of energy (kcal/day) and macro- and micronutrients (g/day) were estimated from a 3-day dietary record and compared with dietary reference values (DRVs) set by the European Food Safety Authority (EFSA). The majority of participants did not meet energy intake recommendations (kcal/day). The contribution of total fat to energy intake (% E) was higher than recommended in both beneficiaries and caregivers with 42.1 ± 4.4% and 38.5 ± 6.5%, respectively. A total of 45.2% of beneficiaries and 61.1% of caregivers had their carbohydrate intake within the recommended range. Fiber intake was well below the recommendations (25 g/day) in all groups. Across all levels of care, lower micronutrient intake for pantothenic acid, biotin, folate, potassium, magnesium, copper, selenium, and iodine was observed. Based on the current results, the development and implementation of nutritional guidelines may be targeted to specific populations and nutrient intakes.
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Affiliation(s)
- Lidija Šoher
- Department of Food and Nutrition Research, Faculty of Food Technology Osijek, Josip Juraj Strossmayer University of Osijek, Franje Kuhača 18, 31000 Osijek, Croatia; (L.Š.); (M.C.S.)
| | - Milica Cvijetić Stokanović
- Department of Food and Nutrition Research, Faculty of Food Technology Osijek, Josip Juraj Strossmayer University of Osijek, Franje Kuhača 18, 31000 Osijek, Croatia; (L.Š.); (M.C.S.)
| | - Sara Prša
- Center for Providing Community Services Osijek „ME just like YOU“, Martina Divalta 2, 31000 Osijek, Croatia;
| | - Maja Miškulin
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Daniela Kenjerić
- Department of Food and Nutrition Research, Faculty of Food Technology Osijek, Josip Juraj Strossmayer University of Osijek, Franje Kuhača 18, 31000 Osijek, Croatia; (L.Š.); (M.C.S.)
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26
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Nian SY, Hirani V, Ardill-Young O, Ward PB, Curtis J, Teasdale SB. The resting metabolic rate of people with severe mental illness: a systematic review and meta-analysis. Br J Nutr 2023; 130:2025-2038. [PMID: 37157830 DOI: 10.1017/s0007114523001162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
People with severe mental illness (SMI), including schizophrenia and related psychoses and bipolar disorder, are at greater risk for obesity compared with people without mental illness. An altered resting metabolic rate (RMR) may be a key driving factor; however, published studies have not been systematically reviewed. This systematic review and meta-analysis aimed to determine whether the RMR of people with SMI assessed by indirect calorimetry differs from (i) controls, (ii) predictive equations and (iii) after administration of antipsychotic medications. Five databases were searched from database inception to March 2022. Thirteen studies providing nineteen relevant datasets were included. Study quality was mixed (62 % considered low quality). In the primary analysis, RMR in people with SMI did not differ from matched controls (n 2, standardised mean difference (SMD) = 0·58, 95 % CI -1·01, 2·16, P = 0·48, I2 = 92 %). Most predictive equations overestimated RMR. The Mifflin-St. Jeor equation appeared to be most accurate (n 5, SMD = -0·29, 95 % CI -0·73, 0·14, P = 0·19, I2 = 85 %). There were no significant changes in RMR after antipsychotic administration (n 4, SMD = 0·17, 95 % CI -0·21, 0·55, P = 0·38, I2 = 0 %). There is little evidence to suggest there is a difference in RMR between people with SMI and people without when matched for age, sex, BMI and body mass, or that commencement of antipsychotic medication alters RMR.
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Affiliation(s)
- Serena Y Nian
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Camperdown2006, NSW, Australia
| | - Vasant Hirani
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Camperdown2006, NSW, Australia
| | - Oliver Ardill-Young
- Discipline of Psychiatry and Mental Health, University of New South Wales, Botany St, Kensington2031, NSW, Australia
- Mindgardens Neuroscience Network, Margarete Ainsworth Building, Barker St, Randwick2031, NSW, Australia
| | - Philip B Ward
- Discipline of Psychiatry and Mental Health, University of New South Wales, Botany St, Kensington2031, NSW, Australia
- Schizophrenia Research Unit, South Western Sydney Local Health District and Ingham Institute of Applied Medical Research, Liverpool Hospital, Liverpool2170, NSW, Australia
| | - Jackie Curtis
- Discipline of Psychiatry and Mental Health, University of New South Wales, Botany St, Kensington2031, NSW, Australia
- Mindgardens Neuroscience Network, Margarete Ainsworth Building, Barker St, Randwick2031, NSW, Australia
| | - Scott B Teasdale
- Discipline of Psychiatry and Mental Health, University of New South Wales, Botany St, Kensington2031, NSW, Australia
- Mindgardens Neuroscience Network, Margarete Ainsworth Building, Barker St, Randwick2031, NSW, Australia
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27
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Kwobah E, Koen N, Mwangi A, Atwoli L, Stein DJ. Prevalence of lifestyle cardiovascular risk factors and estimated framingham 10-year risk scores of adults with psychotic disorders compared to controls at a referral hospital in Eldoret, Kenya. BMC Psychiatry 2023; 23:909. [PMID: 38053103 PMCID: PMC10699058 DOI: 10.1186/s12888-023-05409-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 11/27/2023] [Indexed: 12/07/2023] Open
Abstract
INTRODUCTION Lifestyle factors such as smoking, alcohol use, suboptimal diet, and inadequate physical activity have been associated with increased risk of cardiovascular diseases. There are limited data on these risk factors among patients with psychosis in low- and middle-income countries. OBJECTIVES This study aimed to establish the prevalence of lifestyle cardiovascular risk factors, and the 10-year cardiovascular risk scores and associated factors in patients with psychosis compared to controls at Moi Teaching and Referral Hospital in Eldoret, Kenya. METHODS A sample of 297 patients with schizophrenia, schizoaffective disorder, or bipolar mood disorder; and 300 controls matched for age and sex were included in this analysis. A study specific researcher-administered questionnaire was used to collect data on demographics, antipsychotic medication use, smoking, alcohol intake, diet, and physical activity. Weight, height, abdominal circumference, and blood pressure were also collected to calculate the Framingham 10-year Cardiovascular Risk Score (FRS), while blood was drawn for measurement of glucose level and lipid profile. Pearson's chi-squared tests and t-tests were employed to assess differences in cardiovascular risk profiles between patients and controls, and a linear regression model was used to determine predictors of 10-year cardiovascular risk in patients. RESULTS Compared to controls, patients with psychosis were more likely to have smoked in their lifetimes (9.9% vs. 3.3%, p = 0.006) or to be current smokers (13.8% vs. 7%, p = 0.001). Over 97% of patients with psychosis consumed fewer than five servings of fruits and vegetables per week; 78% engaged in fewer than three days of vigorous exercise per week; and 48% sat for more than three hours daily. The estimated 10-year risk of CVD was relatively low in this study: the FRS in patients was 3.16, compared to 2.93 in controls. The estimated 10-year cardiovascular risk in patients was significantly associated with female sex (p = 0.007), older patients (p < 0.001), current tobacco smoking (p < 0.001), and metabolic syndrome (p < 0.001). CONCLUSION In the setting of Eldoret, there is suboptimal physical exercise and intake of healthy diet among patients with psychosis and controls. While the estimated risk score among patients is relatively low in our study, these data may be useful for informing future studies geared towards informing interventions to promote healthy lifestyles in this population.
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Affiliation(s)
- Edith Kwobah
- Department of Psychiatry, Moi Teaching and Referral Hospital, Eldoret, Kenya.
| | - Nastassja Koen
- Department of Psychiatry and Mental Health & Neuroscience Institute, South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Ann Mwangi
- Department of Mathematics, Physics and Computing, School of Science and Aerospace Studies, Moi University, Eldoret, Eldoret, Kenya
| | - Lukoye Atwoli
- Brain and Mind Institute, Department of Medicine, The Aga Khan University, East Africa, Nairobi, Kenya
| | - Dan J Stein
- South Africa Medical Research (SAMRC) Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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28
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Seeman MV. Women with Schizophrenia Have Difficulty Maintaining Healthy Diets for Themselves and Their Children: A Narrative Review. Behav Sci (Basel) 2023; 13:967. [PMID: 38131823 PMCID: PMC10740554 DOI: 10.3390/bs13120967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/16/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
Severe psychiatric disorders such as schizophrenia are inevitably linked to unemployment, meagre per capita income, and residence in disadvantaged, poorly resourced neighbourhoods. This means difficult access to healthy food and is particularly problematic for pregnant women and mothers with children to feed. The necessity of taking antipsychotic drugs is an additional barrier to healthy eating because these drugs are associated with serious cognitive, psychological, behavioural, and metabolic sequelae. Being ill with psychosis makes it extremely difficult to maintain a healthy diet; nutritional deficiencies result, as do medical complications. The results of present literature review confirm the gravity of the problem and suggest a number of potentially useful clinical interventions.
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Affiliation(s)
- Mary V Seeman
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 3G4, Canada
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29
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Appuhamy KK, Podmore D, Mitchell A, Ahmed HU, Ashworth M, Boehnke JR, Chongtham V, Chowdhury AH, Garcia OP, Holt RIG, Huque R, Muliyala KP, Onstenk EK, Rajan S, Shiers D, Siddiqi N, Manjunatha S, Zavala GA. Risk factors associated with overweight and obesity in people with severe mental illness in South Asia: cross-sectional study in Bangladesh, India, and Pakistan. J Nutr Sci 2023; 12:e116. [PMID: 38033510 PMCID: PMC10687724 DOI: 10.1017/jns.2023.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/13/2023] [Accepted: 10/20/2023] [Indexed: 12/02/2023] Open
Abstract
Obesity is one of the major contributors to the excess mortality seen in people with severe mental illness (SMI) and in low- and middle-income countries people with SMI may be at an even greater risk. In this study, we aimed to determine the prevalence of obesity and overweight in people with SMI and investigate the association of obesity and overweight with sociodemographic variables, other physical comorbidities, and health-risk behaviours. This was a multi-country cross-sectional survey study where data were collected from 3989 adults with SMI from three specialist mental health institutions in Bangladesh, India, and Pakistan. The prevalence of overweight and obesity was estimated using Asian BMI thresholds. Multinomial regression models were then used to explore associations between overweight and obesity with various potential determinants. There was a high prevalence of overweight (17·3 %) and obesity (46·2 %). The relative risk of having obesity (compared to normal weight) was double in women (RRR = 2·04) compared with men. Participants who met the WHO recommendations for fruit and vegetable intake had 2·53 (95 % CI: 1·65-3·88) times greater risk of having obesity compared to those not meeting them. Also, the relative risk of having obesity in people with hypertension is 69 % higher than in people without hypertension (RRR = 1·69). In conclusion, obesity is highly prevalent in SMI and associated with chronic disease. The complex relationship between diet and risk of obesity was also highlighted. People with SMI and obesity could benefit from screening for non-communicable diseases, better nutritional education, and context-appropriate lifestyle interventions.
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Affiliation(s)
| | | | - Alex Mitchell
- Department of Health Sciences, University of York, York, UK
| | | | - Mark Ashworth
- School of Lifecourse and Population Sciences, King's College, London, UK
| | - Jan R. Boehnke
- Department of Health Sciences, University of York, York, UK
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Virtu Chongtham
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | | | - Olga P. Garcia
- Facultad de Ciencias Naturales, Universidad Autonoma de Queretaro, Santiago de Querétaro, Mexico
| | - Richard I. G. Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | | | | | | | - Sukanya Rajan
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - David Shiers
- Psychosis Research Unit, Greater Manchester Mental Health NHS Trust, Manchester, UK
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- School of Medicine, Keele University, Keele, UK
| | - Najma Siddiqi
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, York, UK
- Bradford District Care NHS Foundation Trust, Bradford, UK
| | - S. Manjunatha
- National Institute of Mental Health and Neurosciences, Bangalore, India
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30
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Du Z, Guo S, Sun Y, Zhou Q, Jiang Y, Shen Y, Zhu H, Zhou Z, Zhou H. Causal relationships between dietary habits and five major mental disorders: A two-sample Mendelian randomization study. J Affect Disord 2023; 340:607-615. [PMID: 37598719 DOI: 10.1016/j.jad.2023.08.098] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE To explore the causal relationship between dietary habits and five major mental disorders using the two-sample Mendelian randomization (MR) analysis. METHODS This study was based on the summary data of the genome-wide association study (GWAS) on diet and five major mental disorders in the European population. The genetic locus data of five major mental disorders (mania, bipolar disorder, manic depression, depression, schizophrenia) from those who never eat eggs, dairy, wheat, and sugar were used. Two-sample MR analysis was conducted to evaluate the causal relationship between diet and five major mental disorders. RESULTS This study revealed a causal relationship between "Never eat Wheat products" and all five types of mental disorders (mania, bipolar disorder, manic depression, depression, schizophrenia), demonstrating a significant negative correlation (P < 0.05). However, no significant causal relationship was observed between "Never eat Sugar or foods/drinks containing sugar" and any of the five mental disorders (P > 0.05). Furthermore, the study found that the statement "Never eat eggs, dairy, wheat, sugar: I eat all of the above" had a causal relationship with mania, bipolar disorder, and manic depression, showing a significant positive correlation (P < 0.05). However, this statement did not exhibit a significant causal relationship with depression and schizophrenia (P > 0.05). CONCLUSION There was a negative correlation between never eating wheat products and the five mental disorders (mania, bipolar disorder, manic depression, depression, schizophrenia), indicating that never eating wheat products may reduce the risk of mental disorders.
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Affiliation(s)
- Zhiqiang Du
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Shuaiyi Guo
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Yifan Sun
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Qin Zhou
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Ying Jiang
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Yuan Shen
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Haohao Zhu
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China.
| | - Zhenhe Zhou
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China.
| | - Hongliang Zhou
- Department of Psychology, The Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China.
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31
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Sawyer C, McKeon G, Hassan L, Onyweaka H, Martinez Agulleiro L, Guinart D, Torous J, Firth J. Digital health behaviour change interventions in severe mental illness: a systematic review. Psychol Med 2023; 53:6965-7005. [PMID: 37759417 PMCID: PMC10719689 DOI: 10.1017/s0033291723002064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/13/2023] [Accepted: 07/03/2023] [Indexed: 09/29/2023]
Abstract
The use of digital technologies as a method of delivering health behaviour change (HBC) interventions is rapidly increasing across the general population. However, the role in severe mental illness (SMI) remains overlooked. In this study, we aimed to systematically identify and evaluate all of the existing evidence around digital HBC interventions in people with an SMI. A systematic search of online electronic databases was conducted. Data on adherence, feasibility, and outcomes of studies on digital HBC interventions in SMI were extracted. Our combined search identified 2196 titles and abstracts, of which 1934 remained after removing duplicates. Full-text screening was performed for 107 articles, leaving 36 studies to be included. From these, 14 focused on physical activity and/or cardio-metabolic health, 19 focused on smoking cessation, and three concerned other health behaviours. The outcomes measured varied considerably across studies. Although over 90% of studies measuring behavioural changes reported positive changes in behaviour/attitudes, there were too few studies collecting data on mental health to determine effects on psychiatric outcomes. Digital HBC interventions are acceptable to people with an SMI, and could present a promising option for addressing behavioural health in these populations. Feedback indicated that additional human support may be useful for promoting adherence/engagement, and the content of such interventions may benefit from more tailoring to specific needs. While the literature does not yet allow for conclusions regarding efficacy for mental health, the available evidence to date does support their potential to change behaviour across various domains.
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Affiliation(s)
- Chelsea Sawyer
- Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
| | - Grace McKeon
- School of Population Health, University of New South Wales, Randwick, NSW 2052, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Randwick, NSW 2052, Australia
| | - Lamiece Hassan
- Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
| | - Henry Onyweaka
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General/Mclean Hospital, Boston, MA, USA
| | - Luis Martinez Agulleiro
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Daniel Guinart
- Hospital del Mar Research Institute, Institut de Salut Mental, Hospital del Mar, Barcelona, Spain
- Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Spain
- Department of Psychiatry, the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA
| | - John Torous
- Department of Psychiatry, Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Zucker School of Medicine at Northwell/Hofstra, New York, NY, USA
- Department of Psychiatry, Beth Israel Deaconess Hospital, Boston, MA, USA
| | - Joseph Firth
- Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
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Teasdale SB, Tripodi E, Harman A, Plain J, Burrows TL. Exploring the role of dietitians in mental health services and the perceived barriers and enablers to service delivery: A cross-sectional study. J Hum Nutr Diet 2023; 36:1771-1781. [PMID: 37438941 PMCID: PMC10946798 DOI: 10.1111/jhn.13203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 06/14/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Mental health is a rapidly evolving area of practice for dietitians. The role of dietitians in supporting the physical health of consumers experiencing mental illness is becoming more widely recognised given the importance of lifestyle interventions for physical health. The present study aimed to explore the dietitian role in mental health services as well as identify barriers and enablers to service delivery. METHODS This was a cross-sectional survey of dietitians currently employed in any capacity in public and private mental health services. An online survey comprised of questions pertaining to four domains, including demographics, role and service provision, experience and supervision, barriers/challenges and drivers/enablers was completed and included closed and open-ended responses. RESULTS In total, 48 responses were included. The mean ± SD age of respondents was 36.1 ± 10.9 years (range 23-67 years) with the majority working in inpatient settings. The top three tasks respondents reported conducting were individual consultations (n = 47; 98%), group programs (n = 23; 48%) and multidisciplinary team meetings. Barriers included a lack of awareness from others regarding a dietitian's role in mental health, and a lack of specific tools for nutrition screening. More training, resources and increased evidence base to guide practice would enable better service provision. CONCLUSIONS The present study provides insights regarding the possible drivers and barriers to effective service provision for dietitians working in mental health services focusing on the local contexts of respondents. The findings highlight the importance and value of working collaboratively within a multidisciplinary team.
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Affiliation(s)
- Scott B. Teasdale
- Mindgardens Neuroscience NetworkKensingtonNSWAustralia
- Discipline of Psychiatry and Mental Health, Faculty of MedicineUniversity of New South WalesKensingtonNSWAustralia
| | - Elise Tripodi
- Justice Health and Forensic Mental Health NetworkMalabarNSWAustralia
| | - Alexandra Harman
- Department of Nutrition and DieteticsIllawarra Shoalhaven Local Health DistrictWollongongNSWAustralia
| | | | - Tracy L. Burrows
- School of Health Sciences, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNSWAustralia
- Food and Nutrition ProgramHunter Medical Research InstituteNew LambtonNSWAustralia
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Simjanoski M, de Azevedo Cardoso T, Frey BN, Minuzzi L, De Boni RB, Balanzá-Martínez V, Kapczinski F. Lifestyle in bipolar disorder: A cross-sectional study. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023; 16:244-250. [PMID: 37839960 DOI: 10.1016/j.rpsm.2023.04.001] [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: 12/09/2022] [Revised: 04/14/2023] [Accepted: 04/27/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Modifiable lifestyle behaviors are important factors for improving mental health, yet there has been a lack of research studying lifestyle as a multidimensional construct in bipolar disorder (BD). The aim of this cross-sectional study was to compare the lifestyle patterns of individuals with BD in a current mood episode with healthy controls (HCs) using the Short Multidimensional Inventory Lifestyle Evaluation (SMILE). MATERIALS AND METHODS The sample consisted of 46 individuals with BD currently experiencing a depressive or manic episode and 50 HC, assessed using the MINI International Neuropsychiatric Interview, Montgomery-Åsberg Depression Rating Scale (MADRS), and the Young Mania Rating Scale (YMRS). The SMILE scale assesses lifestyle across seven domains: diet and nutrition, substance abuse, physical activity, stress management, restorative sleep, social support, and environmental exposures. Between-groups comparisons were performed based on the presence of a psychiatric diagnosis and the type of BD episode. RESULTS We found significant differences in the total SMILE score (r=0.75, p<0.001) and in scores from each domain of the scale between BD and HC (p<0.05), where individuals with BD in a depressive or manic episode with or without mixed features reported worse lifestyle across all domains. Differences between individuals with BD in different mood episodes across domains on the SMILE scale were non-significant. CONCLUSION Findings from this study highlight the presence of unhealthy lifestyle patterns in people with BD regardless of the polarity of their mood episode. Implementation of multidimensional lifestyle assessments is an essential step toward detecting the clustering of unhealthy lifestyle patterns in BD.
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Affiliation(s)
- Mario Simjanoski
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada.
| | - Taiane de Azevedo Cardoso
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada
| | - Benicio N Frey
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Women's Health Concerns Clinic and Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, Canada
| | - Luciano Minuzzi
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Women's Health Concerns Clinic and Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, Canada
| | - Raquel B De Boni
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), 4365 Manguinhos, Rio de Janeiro, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Av. de Blasco Ibáñez, 13, Valencia, Spain
| | - Flavio Kapczinski
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Paulo Gama, 110, Porto Alegre, Brazil
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Tzeng WC, Feng HP. Dietary Management in Individuals With Serious Mental Illness and Comorbid Diabetes: A Focused Ethnography Study. J Nurs Res 2023; 31:e292. [PMID: 37522625 DOI: 10.1097/jnr.0000000000000571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Patients with serious mental illness (SMI) are more likely to have Type 2 diabetes mellitus (T2DM). However, studies that discuss the eating habits of patients with both T2DM and SMI are lacking. PURPOSE This study was designed to explore the beliefs and experiences of Taiwanese patients with SMI who also have T2DM. METHODS Fieldwork for this study included 2 years of participant observation and individual interviews with 13 patients with SMI. Data from transcripts of observational field notes and interviews were transcribed verbatim and analyzed. RESULTS The participants described their experiences and concerns regarding dietary management during the period after receiving their T2DM diagnosis. The results of the data analysis were distinguished into three categories, including (a) increased difficulty in life, (b) positive view of dietary control, and (c) inability to abide by dietary restrictions. CONCLUSIONS The findings suggest that healthcare professionals should work to better understand the challenges faced by patients with SMI and T2DM in implementing changes and resisting the temptation to eat unhealthy food and provide suggestions tailored to their cultural background, lifestyle, and eating characteristics.
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Affiliation(s)
- Wen-Chii Tzeng
- PhD, RN, Professor, School of Nursing, National Defense Medical Center, Taipei City, Taiwan, ROC
| | - Hsin-Pei Feng
- PhD, RN, Assistant Professor, School of Nursing, National Defense Medical Center, Taipei City, Taiwan, ROC
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Giménez-Palomo A, Gomes-da-Costa S, Borràs R, Pons-Cabrera MT, Doncel-Moriano A, Arbelo N, Leyes P, Forga M, Mateu-Salat M, Pereira-Fernandes PM, Benabarre A, Pacchiarotti I, Vieta E. Effects of malnutrition on length of stay in patients hospitalized in an acute psychiatric ward. Acta Psychiatr Scand 2023; 148:316-326. [PMID: 37539719 DOI: 10.1111/acps.13598] [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: 04/05/2023] [Revised: 07/11/2023] [Accepted: 07/15/2023] [Indexed: 08/05/2023]
Abstract
INTRODUCTION Psychiatric patients are considered at risk for malnutrition due to pharmacological treatments, lifestyle habits and the mental illness by itself. Even though metabolic risk factors have been related to worse outcomes in certain conditions, the evidence regarding the nutritional status and its impact on the length of stay in psychiatric inpatients is scarce. This study aims to characterize the nutritional status in acute psychiatric patients, to correlate it with the length of stay, and to find specific potential indicators of malnutrition. METHODS Adult patients admitted to the Hospital Clínic of Barcelona acute psychiatric ward throughout a 1-year period were included in this cross-sectional study. Sociodemographic and clinical variables were registered, including length of stay and the nutritional status measured with the CONUT score. RESULTS Malnutrition was observed in 42.5% of patients. Plasmatic transferrin saturation, protein and iron levels were inversely correlated with length of stay, having low iron levels an association with longer hospitalizations. The length of stay was not influenced by diagnosis or treatment. Negative correlations with the nutritional status were found in: BMI, cholesterol, triglycerides, albumin, total proteins, prealbumin, iron, lymphocytes and zinc levels, and transferrin saturation. The multivariate analysis showed a significant association for cholesterol and zinc levels, lymphocyte count, and BMI. CONCLUSIONS Our results suggest that nutritional status might influence the course of psychiatric admissions. Cholesterol and zinc levels, lymphocyte count, and BMI might be factors strongly associated with malnutrition. This consideration might allow the identification of profiles in which lifestyle interventions could be implemented.
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Affiliation(s)
- Anna Giménez-Palomo
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Institute of Neurosciences (UBNeuro), Barcelona, Spain
| | - Susana Gomes-da-Costa
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Institute of Neurosciences (UBNeuro), Barcelona, Spain
| | - Roger Borràs
- Cardiovascular Institute, Hospital Clínic of Barcelona, IDIBAPS, Autonomous University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - M T Pons-Cabrera
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Institute of Neurosciences (UBNeuro), Barcelona, Spain
| | - Antonio Doncel-Moriano
- Institute of Neurosciences (UBNeuro), Barcelona, Spain
- Neurology Service, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Néstor Arbelo
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Institute of Neurosciences (UBNeuro), Barcelona, Spain
| | - Pere Leyes
- Endocrinology Service, Institute of Digestive and Metabolic Diseases, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Maria Forga
- Endocrinology Service, Institute of Digestive and Metabolic Diseases, Hospital Clínic of Barcelona, Barcelona, Spain
| | | | | | - Antonio Benabarre
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Institute of Neurosciences (UBNeuro), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Isabella Pacchiarotti
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Institute of Neurosciences (UBNeuro), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Institute of Neurosciences (UBNeuro), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
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Esh N, Michael S, Paetzholdt J, Samaras K. Bridging public and private health services to best meet the cardiometabolic needs of people with severe mental illness: a retrospective cohort study. Australas Psychiatry 2023; 31:678-684. [PMID: 37491945 DOI: 10.1177/10398562231190781] [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: 07/27/2023]
Abstract
OBJECTIVE Cardiovascular disease is the leading cause of premature mortality in people with severe mental illness (SMI). Despite this, there lacks consensus regarding the most appropriate platform to monitor and treat cardiometabolic risk factors in this cohort. The current study aims to evaluate the effectiveness of tailored cardiometabolic healthcare in a private, GP-led clinic for people with SMI. METHOD A total of 63 adults with SMI were referred to a private GP-led cardiometabolic clinic from a neighbouring inner-city mental health service, where they received individualised cardiometabolic healthcare free-of-charge between 2014 and 2020. Paired t test was used to measure change in cardiometabolic data over the course of treatment. Chi-squared and Fisher's Exact tests were used to examine differences in demographic data and client engagement. RESULTS Over a mean period of 9 months, there was a significant mean reduction of weight (2.1 kg), BMI (0.72 kg/m2) and waist circumference (6 cm). Engagement over a longer period was associated with stable accommodation and improved cardiometabolic outcomes. CONCLUSIONS Targeted referral for individualised cardiometabolic interventions can lead to clinically significant improvement in cardiometabolic outcomes, providing a cause for therapeutic optimism when approaching physical health in people with SMI.
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Affiliation(s)
- Nicole Esh
- NorthWestern Mental Health, Melbourne Health, Parkville, VIC, Australia
| | - Sarah Michael
- St Vincent's Health Network Sydney, Darlinghurst, NSW, Australia; and Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Jonathan Paetzholdt
- The Australian Centre for Metabolic Health, St Vincent's Clinic, Darlinghurst, NSW, Australia
| | - Katherine Samaras
- St Vincent's Health Network Sydney, Darlinghurst, NSW, Australia; The Australian Centre for Metabolic Health, St Vincent's Clinic, Darlinghurst, NSW, Australia; and Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
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Andersen MF, Roed K, Riis A, Rafn BS, Ebdrup BH, Midtgaard J. Perspectives of professional experts in relation to the development of community-based exercise for young adults with schizophrenia: a qualitative study. BMJ Open Sport Exerc Med 2023; 9:e001658. [PMID: 37780132 PMCID: PMC10533806 DOI: 10.1136/bmjsem-2023-001658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 10/03/2023] Open
Abstract
Physical activity is a key modifiable factor in protecting physical and mental health in people with severe mental illness including schizophrenia. Therefore, early promotion of physical activity is recommended and programmes supporting long-term maintenance of physically active behaviour are warranted. This study aimed to explore the perspectives of professional experts in relation to the development of a sustainable community-based exercise programme tailored to young adults with schizophrenia and intended to promote change and adoption of physical activity. We conducted 9 semistructured interviews with 11 clinical and professional experts. Qualitative content analysis, as described by Graneheim and Lundman, was applied to analyse data. We identified four categories: (1) living a physical active life with schizophrenia, (2) exercise as promotor of personal recovery, (3) prescribing safe and relevant exercise and (4) instructors' qualifications and formation. When developing sustainable community-based exercise programmes tailored to young adults with schizophrenia, developers should ensure instructors' qualifications and provide an exercise protocol. In addition, developers should consider providing an inclusive and recovery-oriented exercise environment.
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Affiliation(s)
- Martin Færch Andersen
- Centre for Applied Research in Mental Health Care, Psychiatric Center Glostrup, Glostrup, Denmark
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
| | - Kickan Roed
- Centre for Applied Research in Mental Health Care, Psychiatric Center Glostrup, Glostrup, Denmark
| | - Allan Riis
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
- Center for General Practice, Aalborg University, Aalborg, Denmark
| | - Bolette Skjødt Rafn
- Centre for Applied Research in Mental Health Care, Psychiatric Center Glostrup, Glostrup, Denmark
- Department of Oncology, Rigshospitalet Department of Oncology, Copenhagen, Denmark
| | - Bjørn Hylsebeck Ebdrup
- Center for Neuropsychiatric Schizophrenia Research, Psychiatric Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Julie Midtgaard
- Centre for Applied Research in Mental Health Care, Psychiatric Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Hoogervorst MM, van Meijel B, Bruin EKD, Beekman A, Boonstra N, Adriaanse M. The nurse-led GILL eHealth intervention for improving physical health and lifestyle behaviours in clients with severe mental illness: design of a cluster-randomised controlled trial. BMC Psychiatry 2023; 23:672. [PMID: 37715156 PMCID: PMC10504705 DOI: 10.1186/s12888-023-05024-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/13/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Clients with severe mental illness (SMI) have overall poor physical health. SMI reduces life expectancy by 5-17 years, primarily due to physical comorbidity linked to cardiometabolic risks that are mainly driven by unhealthy lifestyle behaviours. To improve physical health in clients with SMI, key elements are systematic somatic screening and lifestyle promotion. The nurse-led GILL eHealth was developed for somatic screening and the implementation of lifestyle activities in clients with SMI. Aims of this study are to evaluate the effectiveness of the GILL eHealth intervention in clients with SMI compared to usual care, and to evaluate the implementation process, and the experiences of clients and healthcare providers with GILL eHealth. METHODS The GILL study encompasses a cluster-randomised controlled trial in approximately 20 mental health care facilities in the Netherlands. The randomisation takes place at the team level, assigning clients to the eHealth intervention or the usual care group. The GILL eHealth intervention consists of two complementary modules for somatic screening and lifestyle promotion, resulting in personalised somatic treatment and lifestyle plans. Trained mental health nurses and nurse practitioners will implement the intervention within the multidisciplinary treatment context, and will guide and support the participants in promoting their physical health, including cardiometabolic risk management. Usual care includes treatment as currently delivered, with national guidelines as frame of reference. We aim to include 258 clients with SMI and a BMI of 27 or higher. Primary outcome is the metabolic syndrome severity score. Secondary outcomes are physical health measurements and participants' reports on physical activity, perceived lifestyle behaviours, quality of life, recovery, psychosocial functioning, and health-related self-efficacy. Measurements will be completed at baseline and at 6 and 12 months. A qualitative process evaluation will be conducted alongside, to evaluate the process of implementation and the experiences of clients and healthcare professionals with GILL eHealth. DISCUSSION The GILL eHealth intervention is expected to be more effective than usual care in improving physical health and lifestyle behaviours among clients with SMI. It will also provide important information on implementation of GILL eHealth in mental health care. If proven effective, GILL eHealth offers a clinically useful tool to improve physical health and lifestyle behaviours. TRIAL REGISTRATION Clinical trial registration NCT05533749, registration date: 8 September 2022.
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Affiliation(s)
- Meike M Hoogervorst
- Department of Psychiatry, Amsterdam UMC and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Berno van Meijel
- Department of Psychiatry, Amsterdam UMC and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Health, Sports and Welfare, Inholland University of Applied Sciences, Amsterdam, The Netherlands
- Parnassia Psychiatric Institute, Parnassia Academy, The Hague, The Netherlands
| | - Esther Krijnen-de Bruin
- Department of Health, Sports and Welfare, Inholland University of Applied Sciences, Amsterdam, The Netherlands
| | - Aartjan Beekman
- Department of Psychiatry, Amsterdam UMC and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Nynke Boonstra
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- NHL Stenden, University of Applied Sciences, Leeuwarden, The Netherlands
- KieN VIP Mental Health Care Services, Leeuwarden, The Netherlands
| | - Marcel Adriaanse
- Department of Health Sciences, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Eder J, Simon MS, Glocker C, Musil R. [Weight gain and treatment with psychotropic drugs : Background and management]. DER NERVENARZT 2023; 94:859-869. [PMID: 37672085 DOI: 10.1007/s00115-023-01534-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/21/2023] [Indexed: 09/07/2023]
Abstract
Psychotropic drug-induced weight gain (PIWG) is a well-known and frequent side effect which is relevant for the prognosis of patients. Individual medications have varying risks for the occurrence of PIWG, and at the same time there are individual risk factors on the part of patients, such as age, gender, metabolic and genetic factors. As the metabolic changes in the context of PIWG result in increased mortality in the long term, it is important to prevent PIWG by appropriate prevention and to intervene in a targeted manner if PIWG has already occurred. Appropriate monitoring is therefore essential. This article provides an overview of underlying mechanisms, risk constellations and possible countermeasures.
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Affiliation(s)
- J Eder
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität (LMU) München, Nußbaumstraße 7, 80336, München, Deutschland
| | - M S Simon
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität (LMU) München, Nußbaumstraße 7, 80336, München, Deutschland
| | - C Glocker
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität (LMU) München, Nußbaumstraße 7, 80336, München, Deutschland.
| | - R Musil
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität (LMU) München, Nußbaumstraße 7, 80336, München, Deutschland
- Oberberg Fachklinik Bad Tölz, Bad Tölz, Deutschland
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Cheung A, Dutta P, Kovic Y, Stojcevski M, Fan X. Food4Thought: a Medical Trainee-Led, Remotely Delivered Nutrition Outreach Program for Individuals with Serious Mental Illness. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023; 47:406-410. [PMID: 36447069 PMCID: PMC9708131 DOI: 10.1007/s40596-022-01732-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/10/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Amy Cheung
- UMass Chan Medical School, Worcester, MA, USA
| | - Pooja Dutta
- UMass Chan Medical School, Worcester, MA, USA
| | - Yumi Kovic
- University of Florida College of Medicine, Gainesville, FL, USA
| | | | - Xiaoduo Fan
- UMass Chan Medical School, Worcester, MA, USA.
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Li Y, Luo R, Wang D, Zhang X. Association between Empathy and Clinical Symptoms among Overweight and Non-Overweight Chinese Chronic Schizophrenia Patients. Brain Sci 2023; 13:1075. [PMID: 37509007 PMCID: PMC10377734 DOI: 10.3390/brainsci13071075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Patients with schizophrenia are afflicted by severe clinical symptoms and serious cognitive dysfunction. The aim of this study is to investigate the potential relationships between clinical symptoms and empathy and their variations between overweight and non-overweight schizophrenia patients. To address this problem, a group of 776 inpatients diagnosed with chronic schizophrenia (504 overweight patients and 272 non-overweight patients) was recruited. The Positive and Negative Syndrome Scale (PANSS) and its five-factor model were employed to assess clinical symptoms, while empathy levels were measured using the Interpersonal Reactivity Index (IRI). The overweight patients had lower education levels but higher positive symptoms than the non-overweight patients (all p < 0.05). In addition, the overweight patients performed significantly better with respect to empathy (FDR-corrected p < 0.05). Additional multiple regression analyses indicated significant associations between the total score of the IRI and PANSS negative symptoms, gender, and family history of psychiatric disorders among the overweight group; among non-overweight patients, there was a significant correlation between suicide and the total score of the IRI. This study provides evidence suggesting that chronic schizophrenia patients who are overweight may have distinct clinical characteristics, particularly with respect to their empathy, compared with non-overweight patients. Moreover, different variables are associated with empathy in different groups.
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Affiliation(s)
- Yuchen Li
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
| | - Ruichenxi Luo
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
| | - Dongmei Wang
- Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Xiangyang Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
- Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100101, China
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Głodek M, Skibinska M, Suwalska A. Diet and physical activity and metabolic disorders in patients with schizophrenia and bipolar affective disorder in the Polish population. PeerJ 2023; 11:e15617. [PMID: 37456885 PMCID: PMC10348314 DOI: 10.7717/peerj.15617] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/01/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction There are numerous reports of a higher prevalence of metabolic disorders in patients with schizophrenia and bipolar disorder (BD), yet its connections to diet and physical activity remain not fully explained. This article aimed to evaluate diet, physical activity and selected biochemical and anthropometric parameters associated with metabolism in patients with schizophrenia and BD and to analyse the relationships between these variables in the subjects. Materials and Methods A total of 126 adults participated in the study: 47 patients with schizophrenia, 54 patients with BD and 25 patients in mental illness remission (reference group). Data were collected on the underlying illness and concomitant illnesses, and the severity of symptoms of the current episode was assessed using the following scales: PANSS, MADRS and YMRS. An assessment of the subjects' diet (KomPAN questionnaire) and their physical activity (International Physical Activity Questionnaire) was carried out. Anthropometric and blood pressure measurements were taken and BMI and WHR were calculated. Serum concentrations of fasting glucose, TSH, total cholesterol, LDL and HDL fractions, triglycerides and leptin, ghrelin and resistin were determined. For statistical analysis, the significance level was set at 0.05. For multiple comparisons one way ANOVA or Kruskal Wallis were used with post hoc Tukey and Dunn tests, respectively. To determine correlation of variables, Pearson's linear correlation coefficient or Spearman's rank correlation coefficient were used. Results A total of 50.8% of the subjects had at least one metabolic disorder-most commonly excessive body weight (66.7%) and abdominal obesity (64.3%). Patients did not differ significantly in terms of physical activity, but they did differ in mean time spent sitting-with this being significantly longer for all groups than in the general population. The subjects differed in diet: patients with BD consumed less unhealthy foods than patients with schizophrenia. The highest correlations between physical activity, diet and variables defining metabolic disorders were found in patients with BD. Only in patients with schizophrenia were there significant correlations between the course of the disease and physical activity. Discussion The results suggest the existence of associations between diet, physical activity, and metabolic disorders in both BD and schizophrenia patients. They also suggest a tendency among those patients to spend long periods of time sitting.
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Affiliation(s)
- Magdalena Głodek
- Department of Mental Health, Chair of Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
- Department of Adult Psychiatry, Chair of Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | - Maria Skibinska
- Department of Genetics in Psychiatry, Chair of Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | - Aleksandra Suwalska
- Department of Mental Health, Chair of Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
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KAYA S, UZDİL Z, SHIVAPPA N, HEBERT JR, SÖKÜLMEZ KAYA P, TERZİ M. Dietary Inflammatory Index score and its association with body mass index, body fat percentage, body fat mass, and lipid profile in patients with multiple sclerosis. Turk J Med Sci 2023; 53:1155-1165. [PMID: 38813018 PMCID: PMC10763805 DOI: 10.55730/1300-0144.5681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/26/2023] [Accepted: 06/21/2023] [Indexed: 05/31/2024] Open
Abstract
Background/aim Multiple sclerosis (MS) may cause modifications in body composition, particularly for body fat associated with obesity and some biochemical parameters such as lipid profiles. We investigated whether there is a link between the inflammatory contents of diets and body composition and lipid profiles in patients with MS. Materials and methods This was a cross-sectional study that included 85 MS patients. The study data of the patients were collected in the Neurology Clinic of Ondokuz Mayıs University's Health Practice and Research Center. The data included demographic characteristics; anthropometric measurements such as body weight, height, body mass index, waist circumference, hip circumference, body fat mass, body fat-free mass, and waist-hip ratio; and biochemical parameters such as high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol, triglyceride, and total cholesterol. Results The body fat percentages of the patients were higher among those with proinflammatory diets (p < 0.05). Body fat percentage had a positive and very weak correlation with the Dietary Inflammatory Index (DII) score (rho = 0.206 and rho = 0.217, respectively; p < 0.05). HDL-c levels were higher in the group with high DII scores and there was a positive and weak correlation between HDL-c and DII scores (rho = 0.307, p < 0.05). Crude and adjusted linear regression models showed that the effect of HDL-c on DII scores was significant (p < 0.05). Conclusion We showed that DII scores, associated with the inflammatory potential of the diet and proinflammatory diets, may be associated with adiposity in MS patients and can be used from a clinical point of view for assessment.
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Affiliation(s)
- Seda KAYA
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara,
Turkiye
| | - Zeynep UZDİL
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun,
Turkiye
| | - Nitin SHIVAPPA
- Department of Epidemiology and Biostatistics and the Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina,
USA
- Connecting Health Innovations, LLC, Columbia, South Carolina,
USA
| | - James R. HEBERT
- Department of Epidemiology and Biostatistics and the Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina,
USA
- Connecting Health Innovations, LLC, Columbia, South Carolina,
USA
| | - Pınar SÖKÜLMEZ KAYA
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun,
Turkiye
| | - Murat TERZİ
- Department of Neurology, Faculty of Medicine, Ondokuz Mayıs University, Samsun,
Turkiye
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Rohde C, Köhler-Forsberg O, Nierenberg AA, Østergaard SD. Pharmacological treatment of bipolar disorder and risk of diabetes mellitus: A nationwide study of 30,451 patients. Bipolar Disord 2023; 25:323-334. [PMID: 36751986 DOI: 10.1111/bdi.13308] [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: 02/09/2023]
Abstract
OBJECTIVE While treatment with antipsychotics and antiepileptics have been associated with an increased risk of diabetes mellitus (DM), lithium may have the opposite effect via inhibition of glycogen synthase kinase-3. The aim of this study was to investigate whether treatment of bipolar disorder with lithium, antipsychotics, or antiepileptics is associated with the risk of DM in a real-world clinical setting. METHODS Using nationwide registers, we identified all patients diagnosed with bipolar disorder in Danish Psychiatric Services from January 1, 1996, to January 1, 2019 (N = 30,451). The risk of developing DM was operationalized via hospital diagnoses and redeemed prescriptions for glucose-lowering drugs. For lithium, antipsychotics, valproate, and lamotrigine, we calculated hazard rate ratios (HRR) for developing DM via adjusted Cox proportional hazards models. Potential cumulative dose-response-like associations were examined using the log-rank test. RESULTS During follow-up (245,181 person-years), 2107 (6.9%) patients developed DM. Compared with non-users of the respective drugs, we found no clinically or statistically significant difference in the risk of developing DM among patients receiving lithium (n = 11,690; incidence rate of DM/1000 person-years (IR) = 8.87, 95% CI: 8.02-9.90; HRR = 0.94, 95% CI: 0.84-1.06) or lamotrigine (n = 11,785; IR = 7.58, 95% CI: 6.69-8.59; HRR = 0.89, 95% CI: 0.77-1.02), respectively. Conversely, for patients receiving valproate (n = 5171; IR = 12.68, 95% CI: 10.87-14.80; HRR = 1.34, 95% CI: 1.14-1.58) and antipsychotics (n = 22,719; IR = 12.00, 95% CI: 11.14-12.94; HRR = 1.65, 95% CI: 1.45-1.88), respectively, there was increased risk of developing DM. For antipsychotics, we observed a clear cumulative dose-response-like association with the risk of DM. CONCLUSIONS Treatment with valproate and antipsychotics-but not with lithium and lamotrigine-was associated with increased risk of DM in a real-world cohort of patients with bipolar disorder.
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Affiliation(s)
- Christopher Rohde
- Department of Affective Disorders, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ole Köhler-Forsberg
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
| | - Andrew A Nierenberg
- Department of Affective Disorders, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Søren Dinesen Østergaard
- Department of Affective Disorders, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Nadalin S, Zatković L, Peitl V, Karlović D, Vidrih B, Puljić A, Pavlić SD, Buretić-Tomljanović A. Association between PLA2 gene polymorphisms and treatment response to antipsychotic medications: A study of antipsychotic-naïve first-episode psychosis patients and nonadherent chronic psychosis patients. Prostaglandins Leukot Essent Fatty Acids 2023; 194:102578. [PMID: 37290257 DOI: 10.1016/j.plefa.2023.102578] [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: 02/13/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 06/10/2023]
Abstract
Here we investigated whether antipsychotic treatment was influenced by three polymorphisms: rs10798059 (BanI) in the phospholipase A2 (PLA2)G4A gene, rs4375 in PLA2G6, and rs1549637 in PLA2G4C. A total of 186 antipsychotic-naïve first-episode psychosis patients or nonadherent chronic psychosis individuals (99 males and 87 females) were genotyped by polymerase chain reaction analysis/restriction fragment length polymorphism. At baseline, and after 8 weeks of treatment with various antipsychotic medications, we assessed patients' Positive and Negative Syndrome Scale (PANSS) scores, PANSS factors, and metabolic syndrome-related parameters (fasting plasma lipid and glucose levels, and body mass index). We found that PLA2G4A polymorphism influenced changes in PANSS psychopathology, and PLA2G6 polymorphism influenced changes in PANSS psychopathology and metabolic parameters. PLA2G4C polymorphism did not show any impact on PANSS psychopathology or metabolic parameters. The polymorphisms' effect sizes were estimated as moderate to strong, with contributions ranging from around 6.2-15.7%. Furthermore, the polymorphisms' effects manifested in a gender-specific manner.
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Affiliation(s)
- Sergej Nadalin
- Department of Psychiatry, General Hospital "Dr. Josip Benčević", Slavonski Brod, Croatia; School of Medicine, Catholic University of Croatia, Zagreb, Croatia.
| | - Lena Zatković
- Hospital pharmacy, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Vjekoslav Peitl
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Dalibor Karlović
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Branka Vidrih
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Antonia Puljić
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Sanja Dević Pavlić
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Alena Buretić-Tomljanović
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
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Mötteli S, Provaznikova B, Vetter S, Jäger M, Seifritz E, Hotzy F. Examining Nutrition Knowledge, Skills, and Eating Behaviours in People with Severe Mental Illness: A Cross-Sectional Comparison among Psychiatric Inpatients, Outpatients, and Healthy Adults. Nutrients 2023; 15:2136. [PMID: 37432259 DOI: 10.3390/nu15092136] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 07/12/2023] Open
Abstract
Compared to the general population, people with severe mental illness (SMI) have an increased risk of weight gain and metabolic syndrome, but also of malnutrition, in part due to unhealthy lifestyle behaviours. The aim of this cross-sectional study was to identify barriers to healthy eating, including nutrition knowledge and skills in people with SMI. For this purpose, we compared the means of anthropometric data such as body mass index, waist-to-hip ratio, and interview data on nutrition knowledge and skills, health-related variables, eating behaviours, personality, motivation, and attitudes in 65 inpatients and 67 outpatients of the Psychiatric Hospital of the University of Zurich and 64 healthy adults using ANOVA and chi-squared tests. The results showed that patients with SMI had worse nutritional status and lifestyle compared to the healthy controls, including disordered (e.g., night eating) and unhealthy (e.g., high intake of sugary foods) eating habits. However, levels of nutrition knowledge, cooking and food skills, and motivation to eat healthily were not significantly lower in the psychiatric patients than in the healthy adults and were not associated with weight change. Based on our findings, nutritional support for people with SMI is urgently needed and should include not only educational but also behavioural and long-term approaches.
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Affiliation(s)
- Sonja Mötteli
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, 8032 Zürich, Switzerland
- University Hospital of Psychiatry and Psychotherapy, University of Bern, 3012 Bern, Switzerland
| | - Barbora Provaznikova
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, 8032 Zürich, Switzerland
| | - Stefan Vetter
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, 8032 Zürich, Switzerland
| | - Matthias Jäger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, 8032 Zürich, Switzerland
- Psychiatrie Baselland, 4410 Liestal, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, 8032 Zürich, Switzerland
| | - Florian Hotzy
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, 8032 Zürich, Switzerland
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Warner A, Holland C, Lobban F, Tyler E, Harvey D, Newens C, Palmier-Claus J. Physical health comorbidities in older adults with bipolar disorder: A systematic review. J Affect Disord 2023; 326:232-242. [PMID: 36709829 DOI: 10.1016/j.jad.2023.01.083] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 01/19/2023] [Accepted: 01/21/2023] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To ascertain the prevalence and predictors of physical health comorbidities in older adults with bipolar disorder. METHODS The authors conducted a systematic review and narrative synthesis of peer-reviewed journal articles reporting on physical health comorbidities in older adults (aged ≥50) with a diagnosis of bipolar disorder. The Mixed Methods Appraisal Tool (MMAT) assessed study quality. RESULTS 23 papers reporting on 19 studies met the inclusion criteria. The literature on diabetes, obesity and renal disease was inconclusive. There was some tentative evidence to higher rates of cardiovascular disease and some forms of cancer in older adults with bipolar disorder in comparison to the general population, but this requires further investigation. We identified no studies looking at oral health. LIMITATIONS The quality ratings of the identified research were generally low. Very few studies included a comparison sample from the general population or controlled for key covariates in their analysis. CONCLUSION Existing literature provides tentative evidence that some physical health comorbidities are elevated in older adults with bipolar disorder. Clinicians should consider interventions that improve the physical health of this group, alongside the chronic mental health difficulties they experience.
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Affiliation(s)
- Aaron Warner
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster, UK; Centre for Ageing Research, Division of Health Research, Lancaster, UK.
| | - Carol Holland
- Centre for Ageing Research, Division of Health Research, Lancaster, UK
| | - Fiona Lobban
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster, UK; Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK
| | - Elizabeth Tyler
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
| | - Daisy Harvey
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster, UK
| | - Connie Newens
- Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK
| | - Jasper Palmier-Claus
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster, UK; Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK
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Lee C, Waite F, Piernas C, Aveyard P. Development and initial evaluation of a behavioural intervention to support weight management for people with serious mental illness: an uncontrolled feasibility and acceptability study. BMC Psychiatry 2023; 23:130. [PMID: 36859248 PMCID: PMC9979581 DOI: 10.1186/s12888-023-04517-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/02/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND The rates of obesity and associated health problems are higher in people with serious mental illness (SMI), such as schizophrenia and bipolar disorder, than the general population. A primary care referral to a behavioural weight management programme can be an effective intervention, but people with SMI have reported barriers to engaging with them and bespoke options are rarely provided in routine practice. It is possible that adjunct support addressing these specific barriers could help. Here we report the development, feasibility and acceptability of an intervention to improve uptake and engagement with a mainstream weight management programme for people with SMI. METHODS We worked with people with a lived-experience of SMI and used the person-based approach to develop the 'Weight cHange for people with sErious mEntal iLlness' (WHEEL) intervention. It comprised a referral to a mainstream weight management programme (WW®) to be attended once a week, in-person or online, for 12-weeks. The adjunct support comprised a one-off, online consultation called Meet Your Mentor and weekly, telephone or email Mentor Check Ins for 12-weeks. We assessed the feasibility of WHEEL through the number of programme and adjunct support sessions that the participants attended. We analysed the acceptability of WHEEL using a thematic analysis of qualitative interviews conducted at baseline and at 12-week follow-up. Our exploratory outcome of clinical effectiveness was self-reported weight at baseline and at end-of-programme. RESULTS Twenty participants were assessed for eligibility and 17 enrolled. All 17 participants attended Meet Your Mentor and one was lost to follow-up (94% retention). Nine out of 16 attended ≥50% of the weekly programme sessions and 12/16 attended ≥50% of the weekly check-ins. Participants reported in the interviews that the adjunct support helped to establish and maintain a therapeutic alliance. While some participants valued the in-person sessions, others reported that they preferred the online sessions because it removed a fear of social situations, which was a barrier for some participants. The mean change in self-reported weight was - 4·1 kg (SD: 3·2) at 12-weeks. CONCLUSIONS A mainstream weight management programme augmented with brief and targeted education and low-intensity check-ins generated sufficient engagement and acceptability to warrant a future trial.
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Affiliation(s)
- Charlotte Lee
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK. .,Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK.
| | - Felicity Waite
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Headington, Oxford, Oxfordshire, OX3 7JX, UK.,Oxford Health NHS Foundation Trust, Warneford Lane, Headington, Oxford, Oxfordshire, OX3 7JX, UK
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK.,Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
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Martland R, Teasdale S, Murray RM, Gardner-Sood P, Smith S, Ismail K, Atakan Z, Greenwood K, Stubbs B, Gaughran F. Dietary intake, physical activity and sedentary behaviour patterns in a sample with established psychosis and associations with mental health symptomatology. Psychol Med 2023; 53:1565-1575. [PMID: 34420532 PMCID: PMC10009388 DOI: 10.1017/s0033291721003147] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND People with psychosis experience cardiometabolic comorbidities, including metabolic syndrome, coronary heart disease and diabetes. These physical comorbidities have been linked to diet, inactivity and the effects of the illness itself, including disorganisation, impairments in global function and amotivation associated with negative symptoms of schizophrenia or co-morbid depression. METHODS We aimed to describe the dietary intake, physical activity (PA) and sedentary behaviour patterns of a sample of patients with established psychosis participating in the Improving Physical Health and Reducing Substance Use in Severe Mental Illness (IMPaCT) randomised controlled trial, and to explore the relationship between these lifestyle factors and mental health symptomatology. RESULTS A majority of participants had poor dietary quality, low in fruit and vegetables and high in discretionary foods. Only 29.3% completed ⩾150 min of moderate and/or vigorous activity per week and 72.2% spent ⩾6 h per day sitting. Cross-sectional associations between negative symptoms, global function, and PA and sedentary behaviour were observed. Additionally, those with more negative symptoms receiving IMPaCT therapy had fewer positive changes in PA from baseline to 12-month follow-up than those with fewer negative symptoms at baseline. CONCLUSION These results highlight the need for the development of multidisciplinary lifestyle and exercise interventions to target eating habits, PA and sedentary behaviour, and the need for further research on how to adapt lifestyle interventions to baseline mental status. Negative symptoms in particular may reduce patient's responses to lifestyle interventions.
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Affiliation(s)
- Rebecca Martland
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Scott Teasdale
- School of Psychiatry, University of New South Wales Sydney, High St, Kensington 2033, Australia
| | - Robin M. Murray
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK
| | - Poonam Gardner-Sood
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Shubulade Smith
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK
| | - Khalida Ismail
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Zerrin Atakan
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Kathryn Greenwood
- Sussex Partnership NHS Foundation Trust and School of Psychology, University of Sussex, Brighton, UK
| | - Brendon Stubbs
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK
| | - Fiona Gaughran
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK
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50
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Byrne P. Premature mortality of people with severe mental illness: a renewed focus for a new era. Ir J Psychol Med 2023; 40:74-83. [PMID: 35357297 DOI: 10.1017/ipm.2022.3] [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] [Indexed: 11/05/2022]
Abstract
This perspective article applies public health principles to improve the physical health of selected populations with mental disorders. Two preventable adverse outcomes, poorer physical health and premature mortality, are described across mental disorders. Evidence of the lifetime effects of adverse childhood experiences and inequalities is presented: these are the 'causes of the causes'. Seven drivers of physical disorders are illustrated that drive preventable deaths and as doctors, psychiatrists must lead from the front to reverse rising mortality. Evidence supports universal and selective interventions and even the most difficult challenges such as weight gain and opioid misuse are an opportunity for psychiatry to engage with individual patients and their organisations, public health colleagues, health systems and beyond. Interventions complement and do not replace existing clinical practices that reduce self-harm and prevent suicide. Mental health teams already do most of the work in this arena, and the case is made to refocus on physical health with task sharing. The top 10 recommendations within a personalised medicine framework are listed in this paper as a starting point.
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Affiliation(s)
- Peter Byrne
- Department of Psychological Medicine, Royal London Hospital, London, UK
- Public Mental Health Implementation Centre, Royal College of Psychiatrists, London, UK
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