Abstract
AimsThe aim of this study was to estimate the effects of lifestyle interventions on bodyweight and other cardiometabolic risk factors in people with psychotic disorders. Additionally, the long-term effects on body weight and the effects on depressive symptoms were examined.Material and MethodsWe searched four databases for randomized controlled trials (RCTs) that compared lifestyle interventions to control conditions in patients with psychotic disorders. Lifestyle interventions were aimed at weight loss or weight gain prevention, and the study outcomes included bodyweight or metabolic parameters.ResultsThe search resulted in 25 RCTs -only 4 were considered high quality- showing an overall effect of lifestyle interventions on bodyweight (effect size (ES) = −0.63, p<0.0001). Lifestyle interventions were effective in both weight loss (ES = −0.52, p<0.0001) and weight-gain-prevention (ES = −0.84, p = 0.0002). There were significant long-term effects, two to six months post-intervention, for both weight-gain-prevention interventions (ES = −0.85, p = 0.0002) and weight loss studies (ES = −0.46, p = 0.02). Up to ten studies reported on cardiometabolic risk factors and showed that lifestyle interventions led to significant improvements in waist circumference, triglycerides, fasting glucose and insulin. No significant effects were found for blood pressure and cholesterol levels. Four studies reported on depressive symptoms and showed a significant effect (ES = −0.95, p = 0.05).ConclusionLifestyle interventions are effective in treating and preventing obesity, and in reducing cardiometabolic risk factors. However, the quality of the studies leaves much to be desired.
Highlights
IntroductionPsychosis is the psychiatric term for a state of mind in which a person suffers from delusions (false beliefs that hinder a persons’ ability to function) or hallucinations (false sensory perceptions) that are not accompanied by insight [1]
Psychosis is the psychiatric term for a state of mind in which a person suffers from delusions or hallucinations that are not accompanied by insight [1]
None of the available meta-analyses reported on the effects of lifestyle interventions on depressive symptoms, it has been widely recognized that patients with psychotic disorders often suffer from comorbid depressive symptoms [27,28,29], and that increased physical activity in these patients has been associated with lower levels of depression [30]
Summary
Psychosis is the psychiatric term for a state of mind in which a person suffers from delusions (false beliefs that hinder a persons’ ability to function) or hallucinations (false sensory perceptions) that are not accompanied by insight [1]. Only two of the available metaanalyses included the effects of lifestyle interventions on cardiometabolic risk [16, 17] The authors of these studies did not report results on all relevant metabolic outcomes that were available, even though these are important factors with regard to comorbidities and mortality in this patient group. None of the available meta-analyses reported on the effects of lifestyle interventions on depressive symptoms, it has been widely recognized that patients with psychotic disorders often suffer from comorbid depressive symptoms [27,28,29], and that increased physical activity in these patients has been associated with lower levels of depression [30]
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