Effect of lifestyle modification on schizophrenia patients on antipsychotics

Abstract

Background Schizophrenia affects physical health, represented in the form of change in behavior, such as decrease in physical activity, tendency to isolation, and changes in eating behavior, including increase intake of food (junk food and fat) and increase in consumption of sugar. Patients with schizophrenia tent to increase consumption of cigarettes and caffeine. All of these contribute toward having a bad effect on physical health, as they increased the risk of occurrence of comorbid diseases, such as hypertension, diabetes mellitus, and metabolic syndrome (MetS). Although there is treatment for schizophrenia, it has serious adverse effects, including sleepiness and slowness, weight gain, interference with sex life, and increased chance of developing diabetes and hypertension.Patients and methods A total of 36 patients underwent programmed lifestyle modification, which include pharmacological intervention and lifestyle interventions, including psychoeducational, dietary, and exercise programs. The psychoeducational program focused on the roles of eating and activity in weight management. Dietary program included individualized well-balanced diet plan for each patient by a clinical nutritionist in the hospital according to patient’s measurements, physical health, and acceptance. Exercise program included aerobic exercise intervention and stretching-toning control program, which was planned by the physical trainer of the hospital in the playground. Assessment is done at the beginning of the study and monthly through 3-month duration. We used Positive and Negative Syndrome Scale to assess and follow-up symptoms of schizophrenia, GASS for follow-up of adverse effects of antipsychotics, and Health Promoting Lifestyle Profile Scale II to detect the effect of lifestyle modification.Results The mean age of the studied group of patients was 34.5±5.87 years, with 56.41% of them being male. Overall, 25% of patients were found to have MetS at the beginning of the study, and after 3 months of commitment to the program of lifestyle modification, they decreased to 16.67%. There was a significant difference between the studied participants regarding metabolic parameters throughout the 3 months. There was significant improvement in all other dimensions of Positive and Negative Syndrome Scale and significant improvement in total GASS scale after the second months of commitment of lifestyle modification, with significant improvement in all dimension except for cardiovascular and screening for diabetes.Conclusion Schizophrenia and antipsychotics have an effect on lifestyle of the patients, leading to more exposure of them to medical comorbidities such as hypertension, diabetes mellitus, and MetS, and it also effects the sedentary life, diet, and smoking. This can be avoided by applying a lifestyle modification program that targets to improve quality of life, symptoms of schizophrenia, and decreased number of relapses by increasing adherence to treatment.