Physical activity, dietary habits and Coronary Heart Disease risk factor knowledge amongst people with severe mental illness

Department of Mental Health Sciences, (Hampstead Campus), Royal Free and University College Medical School, London, UK.
Social Psychiatry and Psychiatric Epidemiology (Impact Factor: 2.54). 11/2007; 42(10):787-93. DOI: 10.1007/s00127-007-0247-3
Source: PubMed


Evidence regarding Coronary Heart Disease (CHD) related lifestyle in people with severe mental illnesses (SMI) such as schizophrenia is sparse. We aimed to quantify adverse CHD knowledge, diet and exercise in a representative primary care sample, and to determine whether socio-economic deprivation explained any findings.
We compared CHD lifestyle and CHD knowledge in 74 people with SMI and 148 without from seven general practices. We measured CHD knowledge, dietary fibre, fats and exercise using validated instruments and adjusted for socio-economic status.
Fewer people with SMI had higher CHD knowledge: OR 0.49 (95% CI: 0.27-0.88), higher total exercise scores 0.49 (0.27-0.86), higher fibre 0.46 (0.26-0.82) or lower saturated fat diets 0.53 (0.30-0.94). These results were stable irrespective of antipsychotic medication, socio-economic status or type of statistical analysis.
High fat, low fibre diets, lack of exercise and smoking are the likely causes of the majority of CHD in this high-risk group, irrespective of medication and socio-economic deprivation. This lifestyle and particularly the lower CHD knowledge provides a theoretical focus for more comprehensive preventative CHD interventions in SMI.


Available from: Michael B King, Jan 14, 2014
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    • "There is conclusive evidence that the burden of weight gain is even higher in individuals with mental disorders (MD) than in the general population [6, 7]. Important factors contributing to the high prevalence of overweight and obesity in people with MD are side effects of especially second generation antipsychotic drugs [8], a lack of regular physical activity (PA) and unhealthy eating behaviour [9]. "
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    ABSTRACT: Background There is a higher prevalence of obesity in individuals with mental disorders compared to the general population. The results of several studies suggested that weight reduction in this population is possible following psycho-educational and/or behavioural weight management interventions. Evidence of the effectiveness alone is however inadequate for policy making. The aim of the current study was to evaluate the cost-effectiveness of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders. Methods A Markov decision-analytic model using a public payer perspective was applied, projecting the one-year results of a 10-week intervention over a time horizon of 20 years, assuming a repeated yearly implementation of the programme. Scenario analysis was applied evaluating the effects on the results of alternative modelling assumptions. One-way sensitivity analysis was performed to assess the effects on the results of varying key input parameters. Results An incremental cost-effectiveness ratio of 27,096€/quality-adjusted life years (QALY) in men, and 40,139€/QALY in women was found in the base case. Scenario analysis assuming an increase in health-related quality of life as a result of the body mass index decrease resulted in much better cost-effectiveness in both men (3,357€/QALY) and women (3,766€/QALY). The uncertainty associated with the intervention effect had the greatest impact on the model. Conclusions As far as is known to the authors, this is the first health economic evaluation of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders. Such research is important as it provides payers and governments with better insights how to spend the available resources in the most efficient way. Further research examining the cost-effectiveness of health promotion targeting physical activity and healthy eating in individuals with mental disorders is required.
    BMC Public Health 08/2014; 14(1):856. DOI:10.1186/1471-2458-14-856 · 2.26 Impact Factor
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    • "It is well established that individuals with MD are at a greater risk of being overweight or obese than the general population [2,3]. Important reasons for this high prevalence consist of the use of SGAs [9], lower PA levels [10,11] and unhealthy eating habits [15,17]. It is therefore promising that growing attention is being given to the importance of health promotion interventions targeting PA and healthy eating in this population. "
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    ABSTRACT: The existing literature on weight management interventions targeting physical activity and healthy eating in mental health care appears to provide only limited evidence. The aim of the study was to examine the effectiveness of a 10-week health promotion intervention, followed by a 6-month follow-up period in individuals with mental disorders living in sheltered housing in the Flanders region (Belgium). The study had a cluster preference randomized controlled design. Twenty-five sheltered housing organizations agreed to participate (16 in the intervention group, nine in the control group). In the intervention group, 225 individuals agreed to participate, while in the control group 99 individuals entered into the study. The main outcomes were changes in body weight, Body Mass Index, waist circumference and fat mass. Secondary outcomes consisted of changes in physical activity levels, eating habits, health-related quality of life and psychiatric symptom severity. A significant difference was found between the intervention group and the control group regarding body weight (-0.35 vs. +0.22 kg; p=0.04), Body Mass Index (-0.12 vs. +0.08 kg/m2; p=0.04), waist circumference (-0.29 vs. + 0.55 cm; p<0.01), and fat mass (-0.99 vs. -0.12%; p<0.01). The decrease in these outcomes in the intervention group disappeared during the follow up period, except for fat mass. Within the intervention group, a larger decrease in the primary outcomes was found in the participants who completed the intervention. No significant differences between the two groups in changes in the secondary outcomes were found, except for the pedometer-determined steps/day. In the intervention group, the mean number of daily steps increased, while it decreased in the control group. The study demonstrated that small significant improvements in the primary outcomes are possible in individuals with mental disorders. Integration of health promotion activities targeting physical activity and healthy eating into daily care are, however, necessary to maintain the promising results.Trial registrationThis study is registered at NCT 01336946.
    BMC Public Health 07/2013; 13(1):657. DOI:10.1186/1471-2458-13-657 · 2.26 Impact Factor
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    • "Interestingly, rates of violence are lower among people with schizophrenia than in the general population, although there is a dispute about the rate of violence toward others. Rates of marriage are also lower, and their lifespan is usually shorter due to the danger of suicide, treatment and hospitalization complications, a lower socioeconomic level, and greater physical morbidity (Osborn et al. 2007; 2010). Schizophrenia causes impairment at the intrapersonal and interpersonal levels, as well as in familial, social, and professional functioning (Elizur et al. 2003). "
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    ABSTRACT: This study examines the differences between individuals diagnosed with schizophrenia and nonpatient controls people in terms of levels of differentiation of self and family differentiation. Data were collected from 134 participants—67 with schizophrenia and 67 nonpatient controls—each of whom completed the Differentiation of Self Inventory–Revised (DSI–R) and the Family Differentiation Scale (DIFS). Participants with schizophrenia were found to have higher levels of emotional reactivity, emotional cutoff and fusion with others, as well as lower levels of I-position, and they reported lower levels of family differentiation. The findings lend support to Bowen's theoretical conceptions concerning the relationship between differentiation and schizophrenia.
    Deviant Behavior 04/2013; 34(4). DOI:10.1080/01639625.2012.726176 · 0.55 Impact Factor
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