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Mazoruk S, Meyrick J, Taousi Z, Huxley A. The effectiveness of health behavior change interventions in managing physical health in people with a psychotic illness: A systematic review. Perspect Psychiatr Care 2020; 56:121-140. [PMID: 31131451 DOI: 10.1111/ppc.12391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 04/02/2019] [Accepted: 04/14/2019] [Indexed: 11/28/2022] Open
Abstract
PURPOSE People living with psychotic illness disproportionately experience more comorbidities and have a markedly shorter life expectancy compared to the general population. This review evaluates the effectiveness of health behavior change interventions in improving health outcomes in this group. DESIGN AND METHODS All studies included objective physical health measures or health behaviors as the main outcome measures and experimental design with baseline and follow-up quantitative data. Only studies of moderate and strong quality were included. Narrative synthesis was undertaken. FINDINGS Included studies utilized a range of methodological designs and outcome measures. The majority reported significant intervention effect on most outcome measures. PRACTICE IMPLICATIONS Health behavior change interventions can be effective in improving health outcomes in people with psychotic illness, with the potential benefit of improved psychiatric outcomes.
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Affiliation(s)
- Sabina Mazoruk
- Department of Health and Social Sciences, University of the West of England, Bristol, UK
| | - Jane Meyrick
- Department of Health and Social Sciences, University of the West of England, Bristol, UK
| | - Zohra Taousi
- Department of Community Psychiatry, Hertfordshire Partnership University NHS Foundation Trust, St Albans, Hertfordshire, UK
| | - Adam Huxley
- Change Grow Live, Department of Psychology, Hatfield, Hertfordshire, UK
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Fraser SJ, Brown WJ, Whiteford HA, Burton NW. Impact of nurse-led behavioural counselling to improve metabolic health and physical activity among adults with mental illness. Int J Ment Health Nurs 2018; 27:619-630. [PMID: 28466504 DOI: 10.1111/inm.12343] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 01/27/2023]
Abstract
The life expectancy of adults with mental illness is significantly less than that of the general population, and this is largely due to poor physical health. Behavioural counselling can improve physical health indicators among people with non-communicable disease. This repeated-measures, single-group intervention trial evaluated the effects of a 19-week behavioural counselling programme on metabolic health indicators and physical activity levels of outpatient adults with mental illness. Sixteen participants completed the intervention that comprised individual face-to-face counselling sessions with a registered nurse every 3 weeks, and progress reviews with a medical practitioner every 6 weeks. Assessment included self-report and objective measurement of physical activity, and measures of blood pressure and anthropometry. Statistically-significant changes were demonstrated between baseline and post intervention for participants' waist circumference (P = 0.035) and waist-to-height ratio (P = 0.037). Non-significant improvements were demonstrated in weight and physical activity. The findings indicated that adults with mental illness can engage in a nurse-led behavioural counselling intervention, with improvements in some metabolic health measures after 19 weeks. It is recommended that behavioural counselling programmes for adults with mental illness be sustained over time and have an 'open door' policy to allow for attendance interruptions, such as hospitalization.
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Affiliation(s)
- Sarah J Fraser
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Harvey A Whiteford
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Nicola W Burton
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Bressington D, Chien WT, Mui J, Lam KKC, Mahfoud Z, White J, Gray R. Chinese Health Improvement Profile for people with severe mental illness: A cluster-randomized, controlled trial. Int J Ment Health Nurs 2018; 27:841-855. [PMID: 28786197 DOI: 10.1111/inm.12373] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2017] [Indexed: 12/12/2022]
Abstract
The aim of the present study was to establish the feasibility of conducting a full-scale trial and to estimate the preliminary effect of a Chinese Health Improvement Profile (CHIP) intervention on self-reported physical well-being of people with severe mental illness (SMI). The study used a parallel-group, open-label, cluster-randomized, controlled trial (RCT) design. Twelve community psychiatric nurses (CPN) and their corresponding 137 patients with SMI were randomized into the CHIP or treatment-as-usual (TAU) groups. After training, the CPN completed the CHIP at baseline and 12 months, and the findings were used to devise an individualized care plan to promote health behaviour change. Patients were assessed at baseline and 6 and 12 months after starting the intervention. There was an observed positive trend of improvement on the physical component subscale of SF12v2 in the CHIP group compared to the TAU group after 12 months, but the difference did not reach statistical significance (P = 0.138). The mental component subscale showed a similar positive trend (P = 0.077). CHIP participants were more satisfied with their physical health care than TAU patients (P = 0.009), and the CPN were positive about the usefulness/acceptability of the intervention. There were significant within-group improvements in the total numbers of physical health risks, as indicated by the CHIP items (P = 0.005). The findings suggest that it is feasible to conduct a full-scale RCT of the CHIP in future. The CHIP is an intervention that can be used within routine CPN practice, and could result in small-modest improvements in the physical well-being of people with SMI.
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Affiliation(s)
- Daniel Bressington
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Wai Tong Chien
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Jolene Mui
- Castle Peak and Siu Lam Hospitals, Hong Kong, Hong Kong
| | - Kar Kei Claire Lam
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Ziyad Mahfoud
- Department of Health Policy and Research, Weill Cornell Medicine, Ar-Rayyan, Qatar
| | | | - Richard Gray
- College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
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Hjorth P, Juel A, Hansen MV, Madsen NJ, Viuff AG, Munk-Jørgensen P. Reducing the Risk of Cardiovascular Diseases in Non-selected Outpatients With Schizophrenia: A 30-Month Program Conducted in a Real-life Setting. Arch Psychiatr Nurs 2017; 31:602-609. [PMID: 29179828 DOI: 10.1016/j.apnu.2017.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 07/19/2017] [Accepted: 08/18/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The most common cause of premature death in people with schizophrenia is cardiovascular disease, partially explained by an unhealthy lifestyle, smoking, poor diet and sedentary behavior. We aimed to reduce cardiovascular risk factors. METHOD Naturalistic follow-up study with 54 long-term-treated non-selected outpatients with schizophrenia. The 30-month program consisted of individual guidance, group sessions and normal treatment and care offered in our clinic. RESULTS On average, the participating women reduced their waist circumference by 11.4cm (P=0.037), whereas the participating men increased their waist circumference by 3.3cm (P=0.590). Patients' consumption of fast food was reduced from 1.2 to 0.8 times/week (P=0.016), just as their consumption of soft drinks was reduced from 0.7 to 0.1l/day (P=0.006). Their consumption of coffee increased from 1.6 to 2.5 cups/day (P=0.086). The time women spent on light physical activity increased from 134 to 469min/week (P=0.055). The number of daily cigarettes smoked was reduced by 25.7% for all smokers. CONCLUSIONS Our program showed that it is possible for women but not for men to reduce their risk factors for developing cardiovascular disease. The program is manageable in most outpatient clinics and can be performed by nursing staff interested in physical health with support from and in cooperation with medical doctors, psychiatrist and leaders/managers.
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Affiliation(s)
- Peter Hjorth
- Mental Health Center, Psychiatric Hospital, Randers, Denmark.
| | - Anette Juel
- Aarhus University Hospital, Risskov, Denmark
| | | | | | - Anne Grethe Viuff
- Regional Psychiatric Services West, Central Denmark Region, Herning, Denmark
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Ameliorating antipsychotic-induced weight gain by betahistine: Mechanisms and clinical implications. Pharmacol Res 2016; 106:51-63. [DOI: 10.1016/j.phrs.2016.02.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 02/08/2016] [Accepted: 02/11/2016] [Indexed: 01/08/2023]
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McGinty EE, Baller J, Azrin ST, Juliano-Bult D, Daumit GL. Interventions to Address Medical Conditions and Health-Risk Behaviors Among Persons With Serious Mental Illness: A Comprehensive Review. Schizophr Bull 2016; 42. [PMID: 26221050 PMCID: PMC4681556 DOI: 10.1093/schbul/sbv101] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
People with serious mental illness (SMI) have mortality rates 2 to 3 times higher than the overall US population, largely due to cardiovascular disease. The prevalence of cardiovascular risk factors such as obesity and diabetes mellitus and other conditions, such as HIV/AIDS, is heightened in this group. Based on the recommendations of a National Institute of Mental Health stakeholder meeting, we conducted a comprehensive review examining the strength of the evidence surrounding interventions to address major medical conditions and health-risk behaviors among persons with SMI. Peer-reviewed studies were identified using 4 major research databases. Randomized controlled trials and observational studies testing interventions to address medical conditions and risk behaviors among persons with schizophrenia and bipolar disorder between January 2000 and June 2014 were included. Information was abstracted from each study by 2 trained reviewers, who also rated study quality using a standard tool. Following individual study review, the quality of the evidence (high, medium, low) and the effectiveness of various interventions were synthesized. 108 studies were included. The majority of studies examined interventions to address overweight/obesity (n = 80). The strength of the evidence was high for 4 interventions: metformin and behavioral interventions had beneficial effects on weight loss; and bupropion and varenicline reduced tobacco smoking. The strength of the evidence was low for most other interventions reviewed. Future studies should test long-term interventions to cardiovascular risk factors and health-risk behaviors. In addition, future research should study implementation strategies to effectively translate efficacious interventions into real-world settings.
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Affiliation(s)
- Emma E. McGinty
- Departments of Health Policy and Management and Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;,*To whom correspondence should be addressed; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 359, Baltimore, MD 21205, US; tel: 410-614-4018, e-mail:
| | - Julia Baller
- Departments of Health Policy and Management and Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | | | - Gail L. Daumit
- Division of General Internal Medicine, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD
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Mitchell AJ, De Hert M. Promotion of physical health in persons with schizophrenia: can we prevent cardiometabolic problems before they begin? Acta Psychiatr Scand 2015; 132:83-5. [PMID: 26177260 DOI: 10.1111/acps.12466] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- A J Mitchell
- Invited Guest EditorsPsycho-oncology, Leicestershire Partnership NHS trust, University of Leicester, Leicester, UK.
| | - M De Hert
- University Psychiatric Centre, KU Leuven, Leuven, Belgium.,Department of Neurosciences, KU Leuven, Leuven, Belgium
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Loh SY, Abdullah A, Abu Bakar AK, Thambu M, Nik Jaafar NR. Structured Walking and Chronic Institutionalized Schizophrenia Inmates: A pilot RCT Study on Quality of Life. Glob J Health Sci 2015; 8:238-48. [PMID: 26234968 PMCID: PMC4804032 DOI: 10.5539/gjhs.v8n1p238] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 04/19/2015] [Accepted: 05/17/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Lifestyle moderate-intensity physical activity can lower the risk of over twenty chronic health conditions, whilst inactivity reduces daily functioning and physical health of individuals living with schizophrenia. This study conducted in 2014 examines the effect of structured walking participation on QOL, psychosocial functioning and symptoms in Hospital Permai, one of the largest psychiatry institution in Asia METHOD Chronic patients with schizophrenia (n=104) who met inclusion criteria were randomised to either a 3-month structured walking intervention or a treatment-as-usual arm. The Positive and Negative Syndrome Scale (PANSS), global functioning (PSP) and QOL (SF-36) were measured at baseline and after the 3-month interval. RESULTS At 3 month follow-up, there were significant within group differences in QOL (SF-36), psychiatric symptoms (PANSS), and personal and social performance (PSP). There were statistically significant increase in the median SF-36 scores, with increases shown in physical functioning (p<.001), physical role limitations (p<.05), social functioning (p<.01) in the intervention group compared to treatment-as-usual group. Statistically significant reduction of median PANSS score of the intervention group were noted in positive (p<0.001) and negative (p<0.01) symptom, and general psychopathology (p<0.01) scales. Statistically significant increase in the median PSP score (p<0.01) was found in the intervention group compared with the treatment-as-usual group. Between-group differences at post intervention (favouring Intervention) were significant for PANSS positive and SF36 Physical CONCLUSION In long stayed chronic inmates, a simple but consistent, organized walking intervention has the potential to bring improvement in functioning, reduction in psychiatric symptoms and quality of Life. The emphasis of rehabilitation should target at lifestyle redesign intervention.
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Young SL, Taylor M, Lawrie SM. "First do no harm." A systematic review of the prevalence and management of antipsychotic adverse effects. J Psychopharmacol 2015; 29:353-62. [PMID: 25516373 DOI: 10.1177/0269881114562090] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS We aim to identify the prevalence and management strategies of nine clinically important categories of antipsychotic adverse effects, namely: extrapyramidal symptoms; sedation; weight gain; type II diabetes; hyperprolactinaemia; metabolic syndrome, dyslipidaemia; sexual dysfunction; and cardiovascular effects. BACKGROUND Antipsychotic drugs are widely prescribed for schizophrenia and other mental disorders. The adverse effects of antipsychotics are common, with a potential negative impact on adherence and engagement. Despite this, the scientific study of the prevalence or management of adverse antipsychotic effects is a neglected area. METHOD A systematic review was undertaken using pre-defined search criteria and three databases, with hand searching of citations and references. Inclusion was agreed on by two independent researchers after review of abstracts or full text. Quality analysis of included studies was conducted using pre-agreed criteria. RESULTS In total, 53 studies met inclusion criteria, revealing the following: (1) antipsychotic polypharmacy was associated with increased frequency of adverse effects, and (2) a longer duration of treatment is associated with greater severity (e.g. higher BMI); (3) clozapine was more strongly associated with metabolic disturbance than other antipsychotics in three studies and olanzapine was associated with the most weight gain in three studies; (4) hyperprolactinaemia was more common in women than men, but 50% men noted sexual dysfunction versus 25-50% in women; (5) despite clinical guideline recommendations there is a low rate of baseline testing for lipids and glucose; and (6) seven studies described adverse effect management strategies, but only two examined their efficacy - one found a significant reduction in weight with non-pharmacological group therapy and the other found a significant reduction in dyslipidaemia with statins. CONCLUSIONS Antipsychotic adverse effects are diverse and frequently experienced, but are not often systematically assessed. There is a need for further scientific study concerning the management of these side effects.
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Nover C, Jackson SS. Primary care-based educational interventions to decrease risk factors for metabolic syndrome for adults with major psychotic and/or affective disorders: a systematic review. Syst Rev 2013; 2:116. [PMID: 24369749 PMCID: PMC3877871 DOI: 10.1186/2046-4053-2-116] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 12/05/2013] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Individuals with major psychotic and/or affective disorders are at increased risk for developing metabolic syndrome due to lifestyle- and treatment-related factors. Numerous pharmacological and non-pharmacological interventions have been tested in inpatient and outpatient mental health settings to decrease these risk factors. This review focuses on primary care-based non-pharmacological (educational or behavioral) interventions to decrease metabolic syndrome risk factors in adults with major psychotic and/or affective disorders. METHODS The authors conducted database searches of PsychINFO, MEDLINE and the Cochrane Database of Systematic Reviews, as well as manual searches and gray literature searches to identify included studies. RESULTS The authors were unable to identify any studies meeting a priori inclusion criteria because there were no primary care-based studies. CONCLUSIONS This review was unable to demonstrate effectiveness of educational interventions in primary care. Interventions to decrease metabolic syndrome risk have been demonstrated to be effective in mental health and other outpatient settings. The prevalence of mental illness in primary care settings warrants similar interventions to improve health outcomes for this population.
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Affiliation(s)
- Cynthia Nover
- College of Social & Behavioral Sciences and Social Work, Eastern Washington University, 208 Senior Hall, Cheney, WA 99004, USA.
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Ahrendt AD, Kattelmann KK, Rector TS, Maddox DA. The Effectiveness of Telemedicine for Weight Management in the MOVE!
Program. J Rural Health 2013; 30:113-9. [DOI: 10.1111/jrh.12049] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- April D. Ahrendt
- Department of Clinical Nutrition; Sioux Falls VA Health Care System; Sioux Falls South Dakota
| | - Kendra K. Kattelmann
- Department of Nutritional Sciences; South Dakota State University; Brookings South Dakota
| | - Thomas S. Rector
- Center for Chronic Disease Outcomes Research; Minneapolis VA Medical Center; Minneapolis Minnesota
- Department of Medicine; University of Minnesota; Minneapolis Minnesota
| | - David A. Maddox
- Internal Medicine; University of South Dakota Sanford School of Medicine; Sioux Falls South Dakota
- Basic Research; Avera Research Institute; Sioux Falls South Dakota
- Research and Development; Sioux Falls VA Health Care System; Sioux Falls South Dakota
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Attux C, Martini LC, Elkis H, Tamai S, Freirias A, Camargo MDGM, Mateus MD, Mari JDJ, Reis AF, Bressan RA. A 6-month randomized controlled trial to test the efficacy of a lifestyle intervention for weight gain management in schizophrenia. BMC Psychiatry 2013; 13:60. [PMID: 23418863 PMCID: PMC3599931 DOI: 10.1186/1471-244x-13-60] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 02/13/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Patients with schizophrenia have lower longevity than the general population as a consequence of a combination of risk factors connected to the disease, lifestyle and the use of medications, which are related to weight gain. METHODS A multicentric, randomized, controlled-trial was conducted to test the efficacy of a 12-week group Lifestyle Wellness Program (LWP). The program consists of a one-hour weekly session to discuss topics like dietary choices, lifestyle, physical activity and self-esteem with patients and their relatives. Patients were randomized into two groups: standard care (SC) and standard care plus intervention (LWP). Primary outcome was defined as the weight and body mass index (BMI). RESULTS 160 patients participated in the study (81 in the intervention group and 79 in the SC group). On an intent to treat analysis, after three months the patients in the intervention group presented a decrease of 0.48 kg (CI 95% -0.65 to 1.13) while the standard care group showed an increase of 0.48 kg (CI 95% 0.13 to 0.83; p=0.055). At six-month follow-up, there was a significant weight decrease of -1.15 kg, (CI 95% -2.11 to 0.19) in the intervention group compared to a weight increase in the standard care group (+0.5 kg, CI 95% -0.42-1.42, p=0.017). CONCLUSION In conclusion, this was a multicentric randomized clinical trial with a lifestyle intervention for individuals with schizophrenia, where the intervention group maintained weight and presented a tendency to decrease weight after 6 months. It is reasonable to suppose that lifestyle interventions may be important long-term strategies to avoid the tendency of these individuals to increase weight.
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Affiliation(s)
- Cecília Attux
- Department of Psychiatry, Universidade Federal de São Paulo, Rua Machado Bitencourt, 222, Vila Clementino, CEP 04044-000, São Paulo, (SP), Brazil.
| | - Larissa C Martini
- Department of Psychiatry, Universidade Federal de São Paulo. Rua Machado Bitencourt, 222, Vila Clementino, CEP 04044-000, São Paulo, (SP), Brazil
| | - Hélio Elkis
- Department and Institute of Psychiatry, University of São Paulo Medical School. Rua Dr. Ovídio Pires de Campos, 785 – Cerqueira César, CEP 05403010, São Paulo, (SP), Brazil
| | - Sérgio Tamai
- CAISM (Centro de Atenção Integrada à Saúde Mental) from Irmandade Santa Casa de Misericórdia de São Paulo, Rua Major Maragliano, 287, Vila Mariana, CEP 04017030, São Paulo, (SP), Brazil
| | - Andréa Freirias
- CAISM (Centro de Atenção Integrada à Saúde Mental) from Irmandade Santa Casa de Misericórdia de São Paulo, Rua Major Maragliano, 287, Vila Mariana, CEP 04017030, São Paulo, (SP), Brazil
| | - Maria das Graças Miquelutti Camargo
- Department and Institute of Psychiatry, University of São Paulo Medical School. Rua Dr. Ovídio Pires de Campos, 785 – Cerqueira César, CEP 05403010, São Paulo, (SP), Brazil
| | - Mário Dinis Mateus
- Department of Psychiatry, Universidade Federal de São Paulo. Rua Machado Bitencourt, 222, Vila Clementino, CEP 04044-000, São Paulo, (SP), Brazil
| | - Jair de Jesus Mari
- Department of Psychiatry, Universidade Federal de São Paulo. Rua Machado Bitencourt, 222, Vila Clementino, CEP 04044-000, São Paulo, (SP), Brazil
| | - André F Reis
- Division of Endocrinology, Department of Medicine, Universidade Federal de São Paulo (UNIFESP). Rua Pedro de Toledo, 910, Vila Clementino, CEP 04039-002, São Paulo, (SP), Brazil
| | - Rodrigo A Bressan
- Department of Psychiatry, Universidade Federal de São Paulo. Rua Machado Bitencourt, 222, Vila Clementino, CEP 04044-000, São Paulo, (SP), Brazil
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Benseñor IM, Brunoni AR, Pilan LA, Goulart AC, Busatto GF, Lotufo PA, Scazufca M, Menezes PR. Cardiovascular risk factors in patients with first-episode psychosis in São Paulo, Brazil. Gen Hosp Psychiatry 2012; 34:268-75. [PMID: 22305369 DOI: 10.1016/j.genhosppsych.2011.12.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Revised: 11/24/2011] [Accepted: 12/15/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The objective was to evaluate the cardiovascular profile of first-episode psychosis patients in São Paulo, Brazil, an issue that has not been sufficiently explored in low-/middle-income countries. METHOD A cross-sectional study was performed 1 to 3 years after an initial, larger survey that assessed first-episode psychosis in São Paulo. We evaluated cardiovascular risk factors and lifestyle habits using standard clinical examination and laboratory evaluation. RESULTS Of 151 contacted patients, 82 agreed to participate (mean age=35 years; 54% female). The following diagnoses were found: 20.7% were obese, 29.3% had hypertension, 39.0% had dyslipidemia, 19.5% had metabolic syndrome, and 1.2% had a >20% 10-year risk of coronary heart disease based on Framingham score. Also, 72% were sedentary, 25.6% were current smokers, and 7.3% reported a heavy alcohol intake. CONCLUSION Compared to other samples, ours presented a distinct profile of higher rates of hypertension and diabetes (possibly due to dietary habits) and lower rates of smoking and alcohol intake (possibly due to higher dependence on social support). Indirect comparison vs. healthy, age-matched Brazilians revealed that our sample had higher frequencies of hypertension, diabetes and metabolic syndrome. Therefore, we confirmed a high cardiovascular risk in first-episode psychosis in Brazil. Transcultural studies are needed to investigate to which extent lifestyle contributes to such increased risk.
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Affiliation(s)
- Isabela M Benseñor
- Hospital das Clínicas, University of Sao Paulo, Sao Paulo 05403-000, Brazil.
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