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Table 1 Characteristics of randomised controlled trials of lifestyle interventions for weight gain in psychosis

From: Health promotion lifestyle interventions for weight management in psychosis: a systematic review and meta-analysis of randomised controlled trials

Study (year)

Sample size

Participants/ setting

Diagnosis

Antipsychotic medication

Primary outcomes

Intervention

Control

Duration*

Followup**

Álvarez Jiménez et al. (2006) [15]

(a) 28

Outpatients

Schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, brief reactive psychosis, or psychosis not otherwise specified (NOS)

Olanzapine, risperidone, haloperidol

- Body weight

10 to 14 individual sessions (weight check, agenda setting, review of self monitoring records, homework assignments) provided by clinical psychologists

Usual care +  nonstructured information about weight gain and encouragement to limit food intake and/or increase physical activity

12

0

(b) 33

- BMI change

- Percentage of patients whose weight increased by more than 7 % of the initial weight

Brar et al. (2005) [13]

(a) 35

Outpatients or stable long-term inpatients

Schizophrenia (38), Schizoaffective disorder (33)

Risperidone

Body weight change

20 group-based behavioural treatment sessions for weight loss (manual driven didactic programme)

Usual care

14

0

(b) 37

Concomitant medications: sedative-hypnotics, antidepressants

Brown & Smith (2009) [29]

(a) 15

Outpatients

Schizophrenia (11), bipolar disorder (5), depression (9), borderline personality disorder (3)

Weight gain drugs (not specified)

Body weight change

5 semistructured health promotion sessions using an operational manual based on motivational interviewing, education, diary keeping, and facilitation of access to mainstream facilities, facilitated by mental health key workers

Usual care

N/A

0

(b) 11

Evans et al. (2005) [14]

(a) 29

Outpatients

Schizophrenia (16), Schizoaffective disorder (11), schizophreniform psychosis (10), bipolar disorder (8), depression (5)

Olanzapine

- Body weight

6 individual nutritional education sessions conducted by an accredited practicing dietician

Passive nutritional education from the booklet “Food for the mind”

12

12

(b) 22

- BMI change

- Waist circumference change

Forsberg et al. (2008) [27]

(a) 27

Supported housing facilities

Schizophrenia (23), bipolar disorder (3), other psychotic disorders (7), other psychiatric diagnoses (8)

Antipsychotic medication

- Weight

Programme for healthy living: 2 sessions weekly focusing on the cooking of good nourishing food and on physical activity (indoor and outdoor activities) lead by a circle leader (no training in mental health field and no own experience of working with person with psychiatric disabilities but has a personal interest in healthy food and experience as a fitness instructor)

“aesthetic study circle” (learn and practice artistic techniques)

52

0

(b) 19

- Waist

- BMI

- Physiological values

Khazaal et al. (2007) [20]

(a) 31

Outpatients

Schizophrenia and schizoaffective disorders (73.8 %), bipolar disorder (8.2 %), schizotypal disorder (6.6 %), other (11.5 %)

Olanzapine, risperidone, clozapine, quetiapine, amisulpride, classical antipsychotics

- Body weight

12 2-hour group sessions weekly (motivational interview), tasting sessions, psychoeducation on links between weight gain and antipsychotics, food intake moderation prescribed, provided by two psychologists

Brief Nutritional Education (one informative 2 hour group session)

12

3

(b) 30

- BMI

- Eating and weight-related cognitions (MAC-R)

- Binge eating simptomatology (SCID-IV)

Kwon et al. (2006) [16]

(a) 33

Outpatients

Schizophrenia or schizoaffective disorder

Olanzapine

- Body weight

Diet and exercise management programme based on cognitive and behavioural therapy, nutritional education, diary and exercise lead respectively by a dietician and an exercise coordinator

Usual care +  recommendations as to physical activity and eating

12

0

(b) 15

- BMI

Littrell et al. (2003)

(a) 35

Outpatients

Schizophrenia (54), schizoaffective disorder (16)

Olanzapine

- Body weight

16 1-hour psychoeducation classes using the "Solutions of wellness" modules ("Nutrition, wellness and living a healthy lifestyle", "Fitness and exercise") held by a clinician

Usual care +  olanzapine

16

8

(b) 35

Concomitant medications: lithium, valproate, SSRI

- BMI

Mauri et al. (2008) [28]

(a) 21

Outpatients

Bipolar I disorder (41), bipolar II disorder (2), depressive disorder with psychotic symptoms (1)

Olanzapine

- Body weight

dietary group programme for weight control: 30-minutes psychoeducational meetings + diet

N/A

12

0

(b) 27

- BMI

McKibbin et al. (2006) [17]

(a) 32

Board-and-care and community clubhouse

Schizophrenia (48), schizoaffective disorder (9)

Antipsychotics

- Body weight

24 weekly, 90 min sessions addressing diabetes education, nutrition, and lifestyle exercise conducted by healthcare providers, dieticians, and diabetes educators

Usual care +  3 brochures from American Diabetes Association

24

0

(b) 32

- BMI

- Waist circumference change

Milano et al. (2007) [26]

(a) 22

Outpatients

Schizophrenia or manic episodes in bipolar disease

Olanzapine

- Body weight change

Psychoeducational programme with information on correct alimentary practices and personal health; diet (reduction of 500 kcal/ die); programme on physical exercise (3/wk, 30-60 min)

Regular diet, no physical activity

8

0

(b) 14

- BMI

Weber & Wyne (2006) [19]

(a) 8

Outpatients

Schizophrenia or schizoaffective disorder

One oral atypical antipsychotic

- Body weight

1-hour group session based on cognitive- behavioural strategies to promote risk reduction (with food and activity diary) provided by a trained psychiatric nurse practitioner supervised weekly

Usual care

16

16

(b) 9

- BMI

- Waist-hip ratio

- Blood glucose level

Wu et al. (2007) [21]

(a) 28

Hospitalized patients

Schizophrenia

Clozapine

- Body weight

Dietary control by a registered dietician. 1-hour physical activity sessions 3 times a week

N/A

24

0

(b) 28

- BMI

- Body fat

     

- Waist-hip ratio

    
  1. (a) experimental group.
  2. (b) control group.
  3. *number of weeks.
  4. **follow-up assessment, number of weeks after the end of intervention.