Outcome of a psychosocial health promotion intervention aimed at improving physical health and reducing alcohol use in patients with schizophrenia and psychotic disorders (MINT)

Abstract

Background: Life expectancy is reduced by 19 years in men and 17 in women with psychosis in Sweden, largely due to cardiovascular disease.Aim: Assess whether a psychosocial health promotion intervention improves cardiometabolic risk factors, quality of life, and severity of illness in patients with psychotic disorders more than treatment as usual.Methods: A pragmatic intervention trial testing a manual-based multi-component health promotion intervention targeting patients with psychosis. The Swedish intervention was adapted from IMPaCT therapy, a health-promotion program based on motivational interviewing and cognitive behavioral therapy, designed to be incorporated into routine care.The intervention group consisted of 119 patients and a control group of 570 patients from specialized psychosis departments. Outcome variables were assessed 6 months before intervention during the run-in period, again at the start of intervention, and 12 months after the intervention began. The control group received treatment as usual.Results: The intervention had no significant effect on any of the outcome variables. However, BMI, waist circumference, systolic BP, heart rate, HbA1c, general health, and Clinical Global Impressions Scale score improved significantly during the run-in period before the start of the active intervention (observer effect). The multi-component design meant that treatment effects could only be calculated for the intervention as a whole.Conclusion: The results of the intervention are similar to those of the U.K. IMPaCT study, in which the modular health-promotion intervention had little effect on cardiovascular risk indicators. However, in the current study, the run-in period had a positive effect on cardiometabolic risk factors.

Effectiveness of Short-Term Lifestyle Modification on Reducing Body- Weight-Related Parameters in Persons with Severe Mental Illness: A Randomized Controlled Trial

“…Similarly, a few studies also reported that lifestyle intervention was not only effective in reducing body weight but also improved the QOL, general health, and psychological well-being of persons with SMI. 28,31,33,[37][38][39][40] Our findings reflect those reported in such literature.…”

Identification and management of cardiometabolic risk in subjects with schizophrenia spectrum disorders: A Delphi expert consensus study

“…Although the primary prevention of cardiovascular risk factors in the general population has increased in the last decades [28], more needs to be done in people with schizophrenia-spectrum disorders [30]. As a matter of fact, only a few trials aimed at promoting healthy lifestyles and prevent CVD risk started in the last years in people with schizophrenia-spectrum disorders [31,32]. As a reflection of the difficulties in implementation of preventive measures in these patients, a population-based register study demonstrated that the mortality from all causes and from diseases of the circulatory system declined faster for the general population than for patients with severe mental disorders [33].…”

Monitoring the Effectiveness of Treatment in Women with Schizophrenia: New Specialized Cooperative Approaches

“…Health promotion interventions have been found to be effective in reducing the risk of mortality. Westman and collaborators carried out an intervention trial testing the efficacy of a health promotion intervention targeting 570 patients with psychosis [ 94 ]. Body mass index, waist circumference, heart rate, and general health improved during the run-in period, suggesting a positive effect on cardiometabolic risk factors.…”