Lifestyle Interventions for Adults With Serious Mental Illness: A Systematic Literature Review

Abstract

Objective The promotion of healthy lifestyles among persons with serious mental illness is an integral part of their recovery. The aims of this systematic literature review were to rate the methodological quality of lifestyle intervention outcome studies for persons with serious mental illness, summarize intervention strategies, examine physical health outcomes, and evaluate the inclusion of racial and ethnic minority groups in these studies. Methods Electronic bibliographic database searches were performed to locate studies conducted in the United States. Articles written in English and published in peer-reviewed journals between 1980 and 2009 were included. The authors used a standardized instrument to rate studies' methodological quality. Results Twenty-three articles were reviewed. Based on studies' methodological quality, three levels of evidence were found: single-group reports, quasi-experimental studies, and randomized controlled trials. Most interventions used behavioral techniques to improve dietary habits and increase physical activity. Twelve studies reported significant improvements in either weight loss or metabolic syndrome risk factors associated with receiving a lifestyle intervention. Persons from racial and ethnic minority groups were underrepresented, especially Hispanics and Asian Americans. Only one study included non–English-speaking participants. Conclusions Lifestyle interventions adapted to persons with serious mental illness show promise in reducing weight loss and some risk factors for metabolic syndrome. The under-representation of persons from racial or ethnic minority groups in this literature limits its generalizability. Implications for research and practice are discussed.

Telephone-Delivered Physical Activity Intervention for Individuals With Serious Mental Illness

“…A recent systematic literature review of lifestyle interventions for adults with SMI indicated that physical activity (PA) and healthy eating have potential benefit in addressing obesity among individuals with SMI (Cabassa, Ezell, & Lewis-Fernandez, 2010). Specifically, the importance of PA should be emphasized because (1) many forms of PA, such as walking, have been reported to improve physical health (e.g., decreased body fat, improved metabolic risk profiles, and improved physical fitness; Bravata et al, 2007;Daumit et al, 2005; I. M. Lee & Skerrett, 2001) and (2) it can be integrated into peoples' daily lives (Callaghan, 2004;Strassnig, Brar, & Ganguli, 2005).…”

Role of Leisure in Recovery From Mental Illness

“…As a key contributor to recovery, the pursuit of active living (Cabassa, Ezell, & Lewis-Fernández, 2010;Richardson, Faulkner, 148 Y. Iwasaki et al McDevitt, et al, 2005) has been discussed in relation to counteracting inactive, sedentary lifestyles, and obesity among people with mental illness that present substantial health risks including diabetes and heart disease (Brown, Leith, Dickerson, et al, 2010;Galletly & Murray, 2009;Wheeler, Harrison, Mohini, et al, 2010). However, it is plausible that recovery, in addition to health promotion, may also be strengthened in persons with serious mental illness if efforts to promote active living include enjoyable, expressive, and meaningful leisure experiences (Fullagar, 2008, pp.…”

Perceived social support for diet and exercise among persons with serious mental illness enrolled in a healthy lifestyle intervention.

“…Reviews of research on lifestyle intervention studies for adults with serious mental illness have found that programs show significant, but modest, effects on weight loss and reducing risk factors for metabolic syndrome (Cabassa, Ezell, & Lewis-Fernández, 2010; Faulkner, Soundy, & Lloyd, 2003). For example, few studies have reported an average weight loss of 5% or more of body weight (Verhaeghe, De Maeseneer, Maes, Van Heeringen, & Annemans, 2011), the minimum amount of weight loss considered necessary to reduce risk of serious health problems (Faulkner et al, 2003).…”