Intervenções não farmacológicas para manejo do ganho de peso em pacientes com esquizofrenia em uso de antipsicóticos

Abstract

ResumoIntrodução: Pacientes com esquizofrenia têm maior prevalência de obesidade em comparação à população geral. Esse fato está relacionado a uma alimentação inadequada, ao sedentarismo e ao uso de antipsicóticos. O aumento da obesidade associa-se a diversos distúrbios metabólicos, como o diabetes melito. As intervenções para prevenção e controle do ganho de peso são necessárias nessa população, em especial as intervenções não farmacológicas. Objetivo: Revisar os estudos sobre intervenções não farmacológicas para prevenção e controle do ganho de peso em pacientes com esquizofrenia. Métodos: Foram encontrados oito estudos controlados e quatro não controlados sobre intervenções não farmacológicas. Foi feita uma revisão sobre a metodologia e os fatores positivos e limitações dos estudos. Conclusões: As intervenções não farmacológicas parecem ter um efeito importante em termos de prevenção e controle do ganho de peso e, portanto, devem ser incentivadas e adaptadas à realidade dos pacientes e serviços de saúde. Arq Bras Endocrinol Metab. 2009;53(4):391-8. DescritoresGanho de peso; esquizofrenia; antipsicóticos; atividade física; nutrição AbstRAct Introduction: Schizophrenic patients have a higher prevalence of obesity than the general population. There are several factors implicated in weight gain, including poor dietary conditions, sedentary lifestyle and antipsychotic drugs use. Obesity is also associated with metabolic disturbances such as diabetes mellitus. Weight gain interventions are necessary in this population, especially non-pharmacological interventions. Objective: To review the non-pharmacological interventions for weight gain management in patients with schizophrenia. Methods: Eight clinical trials and four open-label studies using these interventions were found. The methodology, strength and limitations of the studies were reviewed. Conclusions: Non-pharmacological interventions seem to have an important effect on weight gain prevention and control, and should be encouraged and adapted to patients and in mental health institution's reality. Arq Bras

A 6-month randomized controlled trial to test the efficacy of a lifestyle intervention for weight gain management in schizophrenia

“…These lifestyles strategies for weight-gain management have been proven to be effective in clinical trials and include regular check-ups, lifestyle and medication counseling, medication assessments, behavioral control programs, and pharmacological intervention [10,15]. Most interventions used pharmacological adjuncts or cognitive behavioral interventions for reducing weight gain in patients with schizophrenia [10] though very few studies used lifestyle modifications for patients with schizophrenia [16].…”

Schizoaffective Disorder and Depression. A case study of a patient from Ceará, Brazil

“…Weight gain is another factor contributing to lowering patient's self-stem in general and in depression. Sedenctarism, unbalanced diet and the use of certain anti-psychotic drugs acts sinergically towards weight gain and are very common in schizophrenic patients [14] . According to Atuxx et al (2009) drug therapy can contribute to weight loss, however, an multimodal approach to weight control, with contextualized flexibility, may produce better results [14].…”

The effectiveness of a non-pharmacological intervention for weight gain management in severe mental disorders: results from a national multicentric study

“…1,4 Although weight gain is an important clinical issue in the treatment of severe mental disorders, intervention studies in this context are scarce. [5][6][7] At present, there is limited evidence for the effectiveness and safety of current pharmacological interventions…”