Evaluation of Weight Gain and Metabolic Parameters among Adolescent Psychiatric Inpatients: Role of Health Promotion and Life Style Intervention Programs

Abstract

Objective: The purpose of the current preliminary study was to estimate the nature and occurrence of metabolic abnormalities among adolescent inpatients receiving psychiatric treatment and to pilot a health promotion and life style intervention program. Method: A total of 107 adolescents admitted over a 12-month period were evaluated for physical, clinical and metabolic parameters in two inpatient psychiatric units in Sydney, Australia, where a health promotion and life style intervention program was provided under the leadership of a Sports Psychologist. Results: 46% of subjects were found to be "at risk for adverse health outcome" with one or more metabolic abnormalities and 4.6% qualified for a diagnosis of Metabolic Syndrome meeting 3 or more of the modified criteria for Metabolic Syndrome in young people. 13% of the sample was overweight with abnormal Body Mass Index (BMI). While two thirds recognized the importance of staying physically active, only a quarter were maintaining adequate level of physical activity. Regarding quality of life, only 30 to 40% reported good life and health satisfaction. Conclusion: Our findings suggest that metabolic abnormalities are not uncommon among young psychiatric patients and that they are often missed. Regular monitoring for the presence of metabolic abnormalities and clinical risk factors should be part of the comprehensive management with special focus on preventative programs.

Evaluation of the physical health of adolescent in-patients in generic and secure services: retrospective case-note review

“…[11][12][13][30][31][32] Previous research also shows that metabolic abnormalities are common in adolescents receiving mental healthcare, but often go unnoticed and untreated. 6,10,13,21 Individuals admitted to generic and secure mental health wards have a wide range of difficulties and non-specific mental health needs, and may or may not be prescribed psychotropic medication. It is therefore important to develop clear guidelines and policies that focus on adolescents in mental healthcare, regardless of their diagnosis or physical health status.…”

Physical health interventions on adolescent mental health inpatient units: A systematic review and call to action

“…For example, many have high BMI values on admission, which rapidly increase with duration of stay (Carney, Imran, Law, Folstad, & Parker, 2019). They also display pre-cursors to developing metabolic disorders and preventable physical health conditions, such as dysregulated blood metabolites and hyperprolactinemia (Carney et al, 2016;Carney et al, 2019;Cordes et al, 2017;Eapen et al, 2012;Vancampfort et al, 2017). This affords the opportunity to intervene to prevent the development of comorbid conditions.…”

“…This affords the opportunity to intervene to prevent the development of comorbid conditions. Adolescents with mental health conditions are also less likely to receive high-quality physical health care across both inpatient and community mental health services than the general population (Carney et al, 2016;Carney, Bradshaw, & Yung, 2018;Cordes et al, 2017;Eapen et al, 2012;Vancampfort et al, 2017). Previous evaluations have shown young people who are prescribed antipsychotic medication do not receive physical health monitoring according to NICE guidelines (Gnanavel & Hussain, 2018;Pasha, Saeed, & Drewek, 2015).…”

Bridging the gap from evidence to policy and practice: Reducing the progression to metabolic syndrome for children and adolescents on antipsychotic medication

“…It is recommended that a healthy lifestyle instruction or intervention program is offered at each clinic visit (Correll, 2008). Health promotion as well as intensive lifestyle and behavioral programs (Alvarez-Jimenez et al, 2008b; Brar et al, 2005; Curtis et al, 2011; Curtis et al, 2012; Kwon et al, 2006) should be made available for all patients, routinely including youth-friendly intervention strategies incorporating dietary counseling, exercise programs and information on healthy living to prevent weight gain occurring, and to assist those who have gained excess weight to lose it and remain at healthy levels (Eapen, 2012; Eapen et al, 2012).…”