Improving life expectancy in people with serious mental illness: Should we place more emphasis on primary prevention?

Ilyas, Athif; Chesney, Edward; Patel, Rashmi

doi:10.1192/bjp.bp.117.203240

Cited by 58 publications

(44 citation statements)

References 46 publications

(47 reference statements)

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“…Hence, interventions such as those employed in this study may provide a response to the repeated calls for lifestyle interventions, psychological strategies, and education programs for the promotion of mental health and primary prevention strategies of common mental health disorders. [5,[8][9][10][11] Targeting mental health promotion and prevention through interventions such as that used in the present study may provide a protective 'buffer' for individuals. For example, enhanced positive emotion may increase an individual's ability to cope when faced with adversity, [14] and hence increase their resilience.…”

Section: Discussionmentioning

confidence: 96%

“…[5][6][7] This has led to repeated calls to address mental health on a population-level using a more integrative approach that includes non-pharmacological strategies such as lifestyle interventions, mental health promotion, education programs and psychological therapies. [5,[7][8][9][10][11][12] Further, in a recent article in BMC Public Health, [13] a call was made to encourage a greater focus on primary prevention initiatives to reduce the burden of mental health disorders. Mental health promotion and prevention initiatives may enhance the mental health of healthy populations and serve as a protective buffer against mental illness.…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness of an online multimodal intervention for mental health promotion: A randomised controlled trial

Przybylko

Morton

Kent

et al. 2019

Preprint

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Introduction There is an urgent need for efficacious interventions to combat the global mental health crisis, and mental health promotion and primary preventive approaches are paramount. Objective This study examined whether an online multimodal intervention that incorporates evidence-based strategies from the disciplines of Lifestyle Medicine and Positive Psychology improved measures of mental health and emotional wellness. Methods 425 adults (68.8% females, aged 46.5 ± 15.6) from Australia and New Zealand were randomised to an intervention or control group. The intervention group participated in a ten-week online multimodal intervention. Measures of mental health and emotional wellness were taken at baseline (Week 1), post-intervention (Week 12), and 12 weeks post-intervention (Week 24). The control group completed the same assessments. Results The intervention group experienced significant improvements from Week 1 to 12 in: mental health (10%, p<0.001, d=0.50) and vitality (22%, p<0.001, d=0.54) subscales of the Short Form Survey (SF-36); depression (-42%, p<0.001, d=0.48), anxiety (-38%, p<0.001, d=0.39) and stress (-31%, p<0.001, d=0.52) subscales of the Depression, Anxiety and Stress Scale (DASS-21); and life satisfaction (8%, p<0.001, d=0.48) as measured by the Satisfaction With Life Scale (SWLS).The control group experienced significant improvements only in the mental health (3%, p=0.028, d=0.16) subscale of the SF-36, and the stress subscale (-9%, p=0.038, d=0.15) of the DASS-21. The changes in the intervention group were significantly greater (p<0.001) than the control group for all measures. Improvements in the outcome measures were generally sustained for the intervention group at 12 weeks post-intervention. Conclusion The online multimodal intervention improved measures of mental health and emotional wellness suggesting that such interventions may be useful for mental health promotion and prevention.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

The effectiveness of an online multimodal intervention for mental health promotion: A randomised controlled trial

Przybylko

Morton

Kent

et al. 2019

Preprint

View full text Add to dashboard Cite

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“…Life expectancy in patients with schizophrenia is 15-20 years less than the general population. [1][2][3][4][5][6][7][8][9] A dominant cause of morbidity and mortality in these patients is cardiovascular disease. Some studies involving patients with schizophrenia show that over two-thirds die of coronary heart disease, compared with approximately one half in the general population.…”

Section: Introductionmentioning

confidence: 99%

Metabolic screening in primary care for patients with schizophrenia or schizoaffective disorder and taking antipsychotic medication

Keenan

Chepulis

et al. 2020

J Prim Health Care

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INTRODUCTIONLife expectancy in patients with schizophrenia is 15–20 years less than the general population. A dominant cause of morbidity and mortality in these patients is cardiovascular disease. Adverse consequences of modifiable cardiovascular risk factors can be reduced by regular monitoring of metabolic outcomes and intervention if required. AIMTo evaluate the metabolic screening in primary care for patients with schizoaffective disorders managed in primary care. To show the usefulness of combining simple practice audits in evaluating such areas of clinical practice. METHODSAn audit was undertaken in eight general practices in the Waikato and Bay of Plenty regions of New Zealand. Specifically, the monitoring of patients with schizophrenia or schizoaffective disorder whose antipsychotic medication was prescribed by primary care doctors was audited. Patient monitoring was compared to the guideline recommendation of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) and the Best Practice Advisory Centre (BPAC). RESULTSIn total, 117 patients were included in the audit and none were fully monitored, as recommended by the RANZCP guidelines. Although two-thirds of patients had been evaluated for glycosylated haemoglobin (HbA1c), lipids, blood pressure, complete blood count and weight, <10% of patients had had prolactin, waist circumference or electrocardiogram measurements recorded. The proportion of patients having a HbA1c measured was also significantly higher in younger patients and patients who were non-Māori or enrolled with an urban practice (all P<0.05). When using the simplified BPAC guidelines, half of all patients were correctly monitored. DISCUSSIONThese findings show there is room for improvement in the monitoring of patients receiving antipsychotic medication in primary care. This may indicate the need for clear guidance and general practitioner education around the monitoring requirements of these patients. Alternatively, a more simplified monitoring protocol may need to be developed. This audit has also shown that there is value in several practices completing the same audit and providing a larger cohort of patients for pooled data analysis.

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“…Mental health promotion and prevention initiatives may enhance the mental health of healthy populations and serve as a protective buffer against mental illness. [14] Over the past few decades, numerous evidence-based strategies for improving mental health and emotional wellness have emerged in the literature underpinning the disciplines of "Lifestyle Medicine" and "Positive Psychology". [15][16][17][18] Lifestyle Medicine has historically focused on the prevention, management and reversal of chronic diseases through the promotion of exercise, a healthy diet, and sleep, [16,[19][20][21][22][23][24][25][26] however, there is growing evidence that these lifestyle practices also have positive benefits on mental health.…”

Section: Introductionmentioning

confidence: 99%

“…[5,[8][9][10][11] Targeting mental health promotion and prevention through interventions such as that used in the present study may provide a protective 'buffer' for individuals. For example, enhanced positive emotion may increase an individual's ability to cope when faced with adversity,[14] and hence increase their resilience. The broaden-and-build theory asserts that the experiences of positive emotions may strengthen an individual's personal, social and psychological resources, sparking upward spirals in their emotional wellbeing [54].…”

mentioning

confidence: 99%

The effectiveness of an online multimodal intervention for mental health promotion: A randomised controlled trial

Przybylko

Morton

Kent

et al. 2020

Preprint

View full text Add to dashboard Cite

Introduction: There is an urgent need for efficacious interventions to combat the global mental health crisis, and mental health promotion and primary preventive approaches are paramount. Objective: This study examined whether an online multimodal intervention that incorporates evidence-based strategies from the disciplines of Lifestyle Medicine and Positive Psychology improved measures of mental health and emotional wellness. Methods: 425 adults (68.8% females, aged 46.5 ± 15.6) from Australia and New Zealand were randomised to an intervention or control group. The intervention group participated in a ten-week online multimodal intervention. Measures of mental health and emotional wellness were taken at baseline (Week 1), post-intervention (Week 12), and 12 weeks post-intervention (Week 24). The control group completed the same assessments. Results: The intervention group experienced significant improvements from Week 1 to 12 in: mental health (10%, p < 0.001, d = 0.50) and vitality (22%, p < 0.001, d = 0.54) subscales of the Short Form Survey (SF-36); depression (-42%, p < 0.001, d = 0.48), anxiety (-38%, p < 0.001, d = 0.39) and stress (-31%, p < 0.001, d = 0.52) subscales of the Depression, Anxiety and Stress Scale (DASS-21); and life satisfaction (8%, p < 0.001, d = 0.48) as measured by the Satisfaction With Life Scale (SWLS).The control group experienced significant improvements only in the mental health (3%, p = 0.028, d = 0.16) subscale of the SF-36, and the stress subscale (-9%, p = 0.038, d = 0.15) of the DASS-21. The changes in the intervention group were significantly greater (p < 0.001) than the control group for all measures. Improvements in the outcome measures were generally sustained for the intervention group at 12 weeks post-intervention. Conclusion: The online multimodal intervention improved measures of mental health and emotional wellness suggesting that such interventions may be useful for mental health promotion and prevention. Trial registration: The Australian New Zealand Clinical Trials Registry ACTRN12619000993190. Registered on 12 July 2019 (Retrospectively registered). The ANZCTRN is part of the WHO Primary Registries.

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Improving life expectancy in people with serious mental illness: Should we place more emphasis on primary prevention?

Cited by 58 publications

References 46 publications

The effectiveness of an online multimodal intervention for mental health promotion: A randomised controlled trial

The effectiveness of an online multimodal intervention for mental health promotion: A randomised controlled trial

Metabolic screening in primary care for patients with schizophrenia or schizoaffective disorder and taking antipsychotic medication

The effectiveness of an online multimodal intervention for mental health promotion: A randomised controlled trial

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