Efficacy of lifestyle interventions in physical health management of patients with severe mental illness

Abstract

Awareness of the importance of maintaining physical health for patients with severe mental illnesses has recently been on the increase. Although there are several elements contributing to poor physical health among these patients as compared with the general population, risk factors for cardiovascular disease such as smoking, diabetes mellitus, hypertension, dyslipidemia, metabolic syndrome, and obesity are of particular significance due to their relationship with mortality and morbidity. These patients present higher vulnerability to cardiovascular risk factors based on several issues, such as genetic predisposition to certain pathologies, poor eating habits and sedentary lifestyles, high proportions of smokers and drug abusers, less access to regular health care services, and potential adverse events during pharmacological treatment. Nevertheless, there is ample scientific evidence supporting the benefits of lifestyle interventions based on diet and exercise designed to minimize and reduce the negative impact of these risk factors on the physical health of patients with severe mental illnesses.

Peer Navigators and Integrated Care to Address Ethnic Health Disparities of People with Serious Mental Illness

“…Research implicates some biological pathways. For example, genetically some people with psychiatric conditions are predisposed toward some physical health conditions (e.g., diabetes) (Chacón, Mora, Gervás-Ríos, & Gilaberte, 2011; Fagiolini & Goracci, 2009). Alternatively, long term use of psychotropic medication seems to be associated with cardiovascular illness (Hansen, Maciejewski, Yu-Isenberg, & Farley, 2012) and a metabolic syndrome that heightens risk of heart disease, diabetes, and cerebrovascular accidents (Smith et al, 2008).…”

Prevalence and correlates of diabetes mellitus and dyslipidaemia in a long-stay inpatient schizophrenia population in Singapore

“…There is strong evidence that shows the effectiveness of lifestyle interventions through diet and exercise for managing risk factors of CVDs in patients with severe mental illness. (53) As earlier mentioned, smoking is strictly prohibited in our wards. Inpatients' weight and physical illnesses (e.g.…”

Physical Health Inequities in People with Severe Mental Illness: Identifying Initiatives for Practice Change

“…These include metabolic disturbances (Haupt, 2006;Wu et al, 2008), increased appetite leading to increased food intake (Harrison, 2004;Rowell, Long, Chance, & Dolley, 2012), and the sedating effects of antipsychotic medication which is reported to affect coordination and decrease motivation to engage in physical activity (Chacon, Mora, Gervas-Rios, & Gilabarte, 2011). Morrison et al (2012) suggest that the efficacy of antipsychotic medication is overestimated, and that the physical health of people with SMI needs to be considered when treatment decisions are made.…”

“…To this end, MHNs need to expand their role to include health promotion and the facilitation of engagement in programs that will assist people with SMI to manage these modifiable risks, potentially minimising the risk of developing chronic physical disease (Chacon et al, 2011;Park, Usher, & Foster, 2011).…”