Improved psychosocial functioning and quality of life in inpatients with severe mental illness receiving a multidisciplinary lifestyle enhancing treatment. The MULTI study II

Abstract

Patients hospitalised with severe mental illness (SMI) have poor physical health. Recently, a multidisciplinary lifestyle enhancing treatment for inpatients with SMI (MULTI) was implemented after which improvements of physical health were observed in the longer term. As part of a comprehensive evaluation of MULTI, we aimed to additionally analyse changes in perceived psychosocial functioning and quality of life after 18 months of MULTI compared to treatment as usual (TAU). Furthermore, we explored whether increased physical activity mediated significant changes. In this observational study, we collected data on psychosocial functioning (HoNOS) and quality of life (EQ-5D and WHOQoL-Bref) within our cohort of inpatients with SMI. This was supplemented by repeated physical activity measurement (ActiGraph GT3X+). Data were analysed using linear multilevel regression, adjusting for baseline values of outcome and differences between groups. Patients receiving MULTI (n = 65) showed significantly improved functioning on sum score and subscales for impairment and social functioning compared to TAU (n = 47). Quality of life improved within MULTI but did not differ significantly from TAU. Changes in total activity did not mediate improvements in psychosocial functioning, suggesting that multiple components of MULTI contribute to these improvements. In addition to previously observed improvement of physical health, MULTI showed to be a feasible treatment to sustainably improve psychosocial functioning compared to TAU and increase the quality of life in inpatients with SMI.