Physical health interventions for patients who have experienced a first episode of psychosis: a narrative review

Abstract

Objectives: Service users with severe psychiatric illnesses, such as schizophrenia, major depressive disorder and bipolar disorder, are more likely to suffer from ill health. There is evidence that lifestyle interventions, for example, exercise, dietary advice and smoking cessation programmes for service users with severe mental illness can be of health benefit. This review was carried out to identify the literature pertaining to physical health interventions for service users who have experienced a first-episode psychosis (FEP), to examine the nature of the interventions which were carried out and to assess these interventions in terms of feasibility and efficacy. Methods: A narrative review was conducted in August 2019 by searching ‘Pubmed’ and ‘Embase’ electronic databases. Studies investigating the effect a physical health intervention had on service users who had experienced a FEP were included in the review. Results: Fifteen studies met inclusion criteria: 12 quantitative studies and 3 qualitative. Exercise, dietary advice, smoking cessation and motivational coaching were some of the physical health interventions utilised in the identified studies. Positive effects were seen in terms of physical health markers wherever they were investigated, particularly when the intervention was delivered early. The impact on psychiatric symptoms and longer-term impacts on health were less frequently assessed. Conclusions: Physical health interventions have a positive impact on service users who have experienced a FEP. More research is warranted in this area in Ireland. These studies should include controls, have longer follow-up periods and should assess the impact on psychiatric health.

Enhancing functional recovery for young people recovering from first episode psychosis via sport-based life skills training: outcomes of a feasibility and pilot study

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A single-blind, randomised controlled trial of a physical health nurse intervention to prevent weight gain and metabolic complications in first-episode psychosis: the Physical Health Assistance in Early Psychosis (PHAstER) study

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Addressing physical health in mental illness: the urgent need to translate evidence-based interventions into routine clinical practice

“…At this point, there is sufficient evidence supporting specific interventions that are detailed in resources such as the recent Lancet Commission: 'A blueprint for protecting physical health in people with mental illness' (Firth et al 2019) and also the 'Maudsley Practice guidelines for Physical Health Conditions in Psychiatry' (Taylor and Pillinger, 2020). The review on interventions to improve the physical health of people with a first episode of psychosis (FEP) by Fouhy et al (2020) in this themed issue also highlights the limited, but effective interventions for this population (Fouhy et al 2020).…”