Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-10T07:45:42.523Z Has data issue: false hasContentIssue false
  • English
  • Français

A well-being programme in severe mental illness. reducing risk for physical ill-health: A post-programme service evaluation at 2 years

Published online by Cambridge University Press:  31 August 2007

Shubulade Smith ,
David Yeomans ,
Chris J.P. Bushe ,
Cecilia Eriksson ,
Tom Harrison ,
Robert Holmes ,
Laurence Mynors-Wallis ,
Helen Oatway  and
Gary Sullivan
Shubulade Smith*
Affiliation:
PO Box 23, institute of Psychiatry, Decrespigny Park, Camberwell, London, SE5 8AF, UK
David Yeomans
Affiliation:
Leeds Mental Health Teaching NHS Trust, Clarence House, 11 Clarence Road, Horsforth, Leeds, LS18 4LB, UK
Chris J.P. Bushe
Affiliation:
Eli Lilly and Company Ltd, Basingstoke, UK, Lilly House, Priestley Road, Basingstoke, RG24 9NL, UK
Cecilia Eriksson
Affiliation:
PO Box 23, institute of Psychiatry, Decrespigny Park, Camberwell, London, SE5 8AF, UK
Tom Harrison
Affiliation:
Scarborough House, 35 Auckland Road, Sparkbrook, Birmingham, B11 1RH, UK
Robert Holmes
Affiliation:
Caludon Centre, Clifford Bridge Rd, Coventry, CV2 2TE, UK
Laurence Mynors-Wallis
Affiliation:
Alderney Hospital, Ringwood Road, Poole, BH12 4NB, UK
Helen Oatway
Affiliation:
Tees and Northeast Yorkshire Mental Health Trust, Teesbay Unit, St.Lukes Hospital, Martan Road, Middlesbrough, TS4 3AF, UK
Gary Sullivan
Affiliation:
School of Care Sciences, University of Glamorgan, Pontypridd, Wales, UK
*
∗Corresponding author. Tel.: +44 020 7848 0694; fax: +44 020 7848 0921. E-mail address: s.smith@iop.kcl.ac.uk (S. Smith).
Get access

Abstract

introduction

Cardiovascular disease is more prevalent in patients with severe mental illness (SMI) than in the general population.

Method

Seven geographically diverse centres were assigned a nurse to monitor the physical health of SMI patients in secondary care over a 2-year period in the “Well-being Support Programme” (WSP). A physical health screen was performed and patients were given individual weight and lifestyle advice including smoking cessation to reduce cardiovascular risk.

Results

Nine hundred and sixty-six outpatients with SMI >2 years were enrolled. The completion rate at 2 years was 80%. Significant improvements were observed in levels of physical activity (p < 0.0001), smoking (p < 0.05) and diet (p < 0.0001). There were no changes in mean BMI although 42% lost weight over 2 years. Self-esteem improved significantly. Low self-esteem decreased from 43% at baseline to 15% at 2 years (p < 0.0001). At the end of the programme significant cardiovascular risk factors remained, 46% of subjects smoked, 26% had hypertension and 81% had BMI >25.

Conclusion

Physical health problems are common in SMI subjects. Many patients completed 2 years follow up suggesting that this format of programme is an acceptable option for SMI patients. Cardiovascular risk factors were significantly improved. interventions such as the Well-being Support Programme should be made widely available to people with SMI.

Keywords

Severe mental illnessCardiovascular risk factorsObesityWeight managementWell-being support programme
Type
Original article
Information
European Psychiatry , Volume 22 , Issue 7 , October 2007 , pp. 413 - 418
Copyright
Copyright © Elsevier Masson SAS 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Brar, J.S., Ganguli, R., Pandina, G., Turkoz, I., Berry, S., Mahmoud, R.Effects of behavioral therapy on weight loss in overweight and obese patients with schizophrenia or schizoaffective disorder. J Clin Psychiatry 2005;66:205–212.CrossRefGoogle ScholarPubMed
Brown, S., inskip, H., Barraclough, B.Causes of the excess mortality of schizophrenia. Br J Psychiatry 2000;177:212–217.CrossRefGoogle ScholarPubMed
Bushe, C., Haley, C., McNamara, D., Fleming-McCrossan, M., Devitt, P. Weight management by group interventions. The longer term outcomes at 20 months in an Irish cohort of patients with serious mental illness. Poster presented at 25th Biennial Congress of the Collegium internationale Neuro-Psychopharmacologicum 9–13 July, Chicago, IL; 2006.Google Scholar
Bushe, C., Holt, R.Prevalence of diabetes and impaired glucose tolerance in patients with schizophrenia. Br J Psychiatry 2004;47(Suppl):S67–S71.Google ScholarPubMed
Day, J.C., Wood, G., Dewey, M., Bentall, D.P.A self-rating scale for measuring neuroleptic side-effects. Validation in a group of schizophrenic patients. Br J Psychiatry 1995;166:650–653.CrossRefGoogle Scholar
Department of Health. Public Health White Paper. Choosing health. Making healthier choices easier. Chapter 6, Section 43, 2003. Available at: http://www.doh.gov.uk/PublicationsandStatistics.Google Scholar
Enger, C., Weatherby, L., Reynolds, R.F., Glasser, D.B., Walker, A.M.Serious cardiovascular events and mortality among patients with schizophrenia. J Nerv Ment Dis 2004;192:19–27.CrossRefGoogle ScholarPubMed
Evans, S., Newton, R., Higgins, S.Nutritional intervention to prevent weight gain in patients commenced on olanzapine: a randomised controlled trial. Aust NZ J Psychiatry 2005;39:479–486.Google Scholar
Faulkner, G., Cohn, T., Remington, G.interventions to reduce weight gain in schizophrenia. Cochrane Database Syst Rev 2007;1. CD005148.Google Scholar
Gasquet, I., Haro, J.M., Novick, D., Edgell, E.T., Kennedy, L., Lepine, J.P.et al.Pharmacological treatment and other predictors of treatment outcomes in previously untreated patients with schizophrenia: results from the European Schizophrenia Outpatient Health Outcomes (SOHO) study. int Clin Psychopharmacol 2005;20:199–205.Google ScholarPubMed
Goff, D.C., Sullivan, L.M., McEvoy, J.P., Meyer, J.M., Nasrallah, H.A., Daumit, G.L.et al.A comparison of ten-year cardiac risk estimates in schizophrenia patients from the CATIE study and matched controls. Schizophr Res 2005;80(1):45–53.CrossRefGoogle ScholarPubMed
Haddad, P.Weight change with atypical antipsychotics in the treatment of schizophrenia. J Psychopharmacol 2005;19(6 Suppl):16–27.CrossRefGoogle ScholarPubMed
Holt, R.I., Bushe, C., Citrome, L.Diabetes and schizophrenia 2005: are we any closer to understanding the link?. J Psychopharmacol 2005;19(6 Suppl):56–65.Google ScholarPubMed
Kalarchian, M., Marcus, M., Levine, M., Haas, G., Greeno, C., Weissfield, L.et al.Behavioural treatment of obesity in patients taking antipsychotic medications. J Clin Psychiatry 2005;66:1058–1063.CrossRefGoogle ScholarPubMed
Katzmarzyk, P.T., Church, T.S., Janssen, I., Ross, R., Blair, S.N.Metabolic syndrome, obesity and mortality: impact of cardiorespiratory fitness. Diabetes Care 2005;28:391–397.Google ScholarPubMed
LaMonte, M.J., Barlow, C.E., Jurca, R., Kampert, J.B., Church, T.S., Blair, S.N.Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome: a prospective study of men and women. J Appl Physiol 2005;99:1205–1213.Google Scholar
Lawrence, D.M., Holman, C.D., Jablensky, A.V., Hobbs, M.S.Death rate from ischaemic heart disease in Western Australian psychiatric patients 1980–1998. Br J Psychiatry 2003;182:31–36.Google ScholarPubMed
Lee, S., Kuk, J.L., Katzmarzyk, P.T., Blair, S.N., Church, T.S., Ross, R.Cardiorespiratory fitness attenuates metabolic risk independent of abdominal subcutaneous and visceral fat in men. Diabetes Care 2005;28:895–901.CrossRefGoogle ScholarPubMed
Marder, S.R., Essock, S.M., Miller, A.L., Buchanan, R.W., Casey, D.E., Davis, J.M.et al.Physical health monitoring of patients with schizophrenia. Am J Psychiatry 2004;161(8):1334–1349.CrossRefGoogle ScholarPubMed
McCreadie, R., Macdonald, E., Blacklock, C., Tilak Singh, D., Wiles, D.et al.Dietary intake of schizophrenic patients in Nithsdale, Scotland: case-control study. Br Med J 1998;317:784–785.Google ScholarPubMed
McCreadie, R.G.Scottish Schizophrenia Lifestyle Group Diet, smoking and cardiovascular risk in people with schizophrenia: descriptive study. Br J Psychiatry 2003;183:534–539.Google ScholarPubMed
McEvoy, J., Meyer, M., Goff, D., Nasrallah, H., Davis, S., Sullivan, L.et al.Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results from the Clinical antipsychotic Trials of intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophr Res 2005;80:19–32.CrossRefGoogle ScholarPubMed
Menza, M., Vreeland, B., Minsky, S., Gara, M., Radler, D.R., Sakowitz, M.Managing atypical antipsychotic-associated weight gain: 12-month data on a multimodal weight control program. J Clin Psychiatry 2004;65:471–477.CrossRefGoogle ScholarPubMed
Ohlsen, R., Peacock, G., Smith, S.Developing a service to monitor and improve physical health in people with serious mental illness. J Psychiatric Mental Health Nursing 2005;12:614–619.CrossRefGoogle ScholarPubMed
Omnibus Survey of UK General Practitioners conducted 10–11 March, 2005. TNS Healthcare, cited in Running on Empty Report, http://www.rethink.org/news+campaigns/pressreleases/running-on-empty.htm.Google Scholar
Pendlebury, J., Bushe, C., Wildgust, H., Holt, R.Long term maintenance of weight loss in patients with severe mental illness through a behavioural programme in UK. Acta Psychiatr Scand 2007;115:286–294.CrossRefGoogle ScholarPubMed
Ryan, M.C., Collins, P., Thakore, J.H.Impaired fasting glucose tolerance in first-episode, drug-naive patients with schizophrenia. Am J Psychiatry 2003;160:284–289.Google ScholarPubMed
Ryan, M.C., Flanagan, S., Kinsella, U., Keeling, F., Thakore, J.H.The effects of atypical antipsychotics on visceral fat distribution in first episode, drug-naive patients with schizophrenia. Life Sci 2004;74:1999–2008 (Erratum in Life Sci 2004;75:2851).CrossRefGoogle ScholarPubMed
Strassnig, M., Brar, J.S., Ganguli, R.Nutritional assessment of patients with schizophrenia: a preliminary study. Schizophr Bull 2003;29:393–397.Google ScholarPubMed
Thakore, J.H., Mann, J.N., Vlahos, I., Martin, A., Reznek, R.increased visceral fat distribution in drug-naive and drug-free patients with schizophrenia. int J Obes Relat Metab Disord 2002;26:137–141.CrossRefGoogle ScholarPubMed
Wannamethee, S.G., Shaper, A.G., Lennon, L., Morris, R.W.Metabolic syndrome vs Framingham Risk Score for prediction of coronary heart disease, stroke, and type 2 diabetes mellitus. Arch intern Med 2005;165:2644–2650.CrossRefGoogle ScholarPubMed
Yusuf, S., Hawken, S., Ounpuu, S., Bautista, L., Franzosi, M.G., Commerford, P.Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet 2005;366:1640–1649.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.