Primary care-based educational interventions to decrease risk factors for metabolic syndrome for adults with major psychotic and/or affective disorders: a systematic review

Cynthia Nover,Sarah S Jackson

doi:10.1186/2046-4053-2-116

Abstract

BackgroundIndividuals with major psychotic and/or affective disorders are at increased risk for developing metabolic syndrome due to lifestyle- and treatment-related factors. Numerous pharmacological and non-pharmacological interventions have been tested in inpatient and outpatient mental health settings to decrease these risk factors. This review focuses on primary care-based non-pharmacological (educational or behavioral) interventions to decrease metabolic syndrome risk factors in adults with major psychotic and/or affective disorders.MethodsThe authors conducted database searches of PsychINFO, MEDLINE and the Cochrane Database of Systematic Reviews, as well as manual searches and gray literature searches to identify included studies.ResultsThe authors were unable to identify any studies meeting a priori inclusion criteria because there were no primary care-based studies.ConclusionsThis review was unable to demonstrate effectiveness of educational interventions in primary care. Interventions to decrease metabolic syndrome risk have been demonstrated to be effective in mental health and other outpatient settings. The prevalence of mental illness in primary care settings warrants similar interventions to improve health outcomes for this population.

Highlights

Individuals with major psychotic and/or affective disorders are at increased risk for developing metabolic syndrome due to lifestyle- and treatment-related factors
Comorbidity of mental illness and chronic physical illness Individuals with major psychotic and/or affective disorders experience higher rates of comorbid physical health problems compared with the general population
This review focuses on non-pharmacological, educationbased interventions to address metabolic syndrome risk factors in patients with major psychotic or affective/ mood disorders who are treated in the primary care setting

Summary

Introduction

Individuals with major psychotic and/or affective disorders are at increased risk for developing metabolic syndrome due to lifestyle- and treatment-related factors. Comorbidity of mental illness and chronic physical illness Individuals with major psychotic and/or affective disorders (for example, schizophrenia, bipolar disorder or major depressive disorder) experience higher rates of comorbid physical health problems compared with the general population. Causes of comorbidity in this population are thought to include psychiatric medication and lifestyle factors, such as diet and tobacco consumption. Individuals with major psychotic disorders, especially schizophrenic disorders, consume tobacco at higher rates than the general population [1,11,12,13], which partially explains the increased risk of cardiovascular disease in this population. Sedentary lifestyle and unhealthy food consumption patterns, including higher daily intake of calories and cholesterol, are common among individuals with major psychotic and/or affective disorders [11,14]

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