IntroductionDiet and physical activity interventions are effective in psychiatric outpatients that suffer from obesity, namely those treated with antipsychotic drugs. However, there is less evidence related to these interventions in hospitalised acute patients.AimTo evaluate the effect of a diet and physical activity program on weight and BMI variation in acute psychiatric patients during hospitalisation.MethodsMatched case-control study from January to September 2016. Inclusion criteria: patients with at least 15 days of hospitalisation in an acute psychiatry ward, evaluated by a nutritionist in the admission and medical discharge. The intervention consisted in a diet and physical activity program, with total restriction to visitors to bring food to the patients. Statistical analysis was done with T-student and multiple linear regression taking into account the effect of age, sex, daily dose of antipsychotics, and days of hospitalisation.ResultsSixty-six patients were studied (34 cases and 32 controls). Groups were statistically similar concerning the average of age, daily dose of antipsychotics, days of hospitalisation and sex. The differences of weight gain during hospitalisation were 0.088 kg (cases) versus 1484 kg (controls), P < 0.05. And the differences of the increased BMI during the hospitalisation were 0.041 kg/m2 (cases) versus 0.509 kg/m2 (controls), P < 0.05.ConclusionsObesity presents challenging health problems for individuals with severe mental illness that require inpatient treatment. This study provides evidence that individuals with acute mental illness can benefit from weight control interventions during their hospitalisation, in special a total restriction to visitors to bring food to the patients.
Chronic pain affects the whole person, not just physically, but also psychologically, spiritually and emotionally. Several studies have found a relationship between chronic pain and depression. Nurses play a key role in the treatment of these conditions. Which nursing interventions are referenced in the literature for the relief of pain and depression? were some of the research questions. Our purpose was to identify the nursing interventions referenced in the literature for the relief of chronic pain and depression. An electronic research of articles was performed in the following databases: CINHAL Complete, CINHAL Plus and MEDLINE (via EBSCOhost). Selection criteria: experimental or quasi-experimental studies published between 1st January, 2007 and 31st December, 2014; Participants older than 18 years with chronic pain and depression; Nursing interventions; Results in relieving pain and depression. 17 experimental and quasi-experimental studies were included in the final sample, all with a high level of evidence. Cognitive-behavioural therapy and education were the most frequently referenced interventions, with significant results in the relief of chronic pain and depression. Exercise and relaxation also showed an important contribution to the achievement of positive results in these conditions. Conclusions: There is evidence that the combination of intervention such as cognitive behavioural therapy, education and, eventually, exercise and relaxation, may have a positive contribution in reducing chronic pain and depression. The implementation of these interventions should be encompassed within a complex, multimodal treatment plan and it should be individualized, tailored to the specific characteristics of each individual.
BackgroundInsomnia is a highly prevalent complaint, largely associated with mental disease. Clinical evidence classifies insomnia in 2 subtypes: with sleep misperception (WSM) and without sleep misperception (wSM). That presents distinctive pathophysiologic pathways and different public health implications.ObjectivesDescribe the main differences between primary insomnia WSM and wSM regarding:– clinical features;– diagnosis;– management;– implications.MethodsWe conducted a systematic review. PubMed, Embase and PsycInfo were searched from 2000–2016. The reference lists of systematic reviews, narrative synthesis and some important articles were included. Following the inclusion criteria, we selected 25 studies from 59 articles.ResultsThe prevalence of sleep-state misperception in primary insomniacs (total sleep time > 6.5 h and sleep efficiency > 85%) is around 26%. Insomniacs with normal sleep duration showed a profile of high depression and anxiety and low ego strength, whereas insomniacs with short sleep duration showed a profile of a medical disorder.Cortical hyperarousal is higher in insomniacs and could be related to an alteration in sleep protection mechanisms. The sleep architecture was relatively normal for the WSM comparing with the group wSM. Risk of cardiometabolic, neurocognitive morbidity and mortality, and responses to treatment are different between these two insomnia phenotypes. Patients with short sleep duration may respond better to biological treatments, whereas insomnia with normal sleep duration may respond primarily to psychological therapies.ConclusionsThe clinical characteristics of patients with sleep-state misperception differed from those without this condition. Available research related to these conditions is expanding rapidly, but many questions remain unanswered.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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