Bushe Chris J, McNamara Dermot, Haley Cliff, McCrossan Mary Fleming, Devitt Pat
Eli Lilly and Company Ltd, Adelaide Road, Dublin, Ireland.
BMC Psychiatry. 2008 Sep 15;8:76. doi: 10.1186/1471-244X-8-76.
Weight gain is commonly observed during psychotropic treatments for chronic forms of severe mental illness and is most rapid during the early treatment phases. All formats of behavioural weight intervention programmes have suggested that weight gain can be prevented or reversed in some patients. There is no data on these programmes in acutely unwell inpatients whom may be the major beneficiaries.
A modular behavioural intervention programme (Solutions for Wellness) used in SMI outpatients since 2002 in Ireland has been adapted for inpatient use. Preliminary data is reported from 5 centres in Ireland.
In 47 inpatients the mean weight change was +0.26 kg (SD 2.02) with a median change of 0 kg. Mean follow-up was 23.7 (SD 21.6) days, and median 14 days (range 6-98 days). There was no difference in mean weight change in those patients involved for > 35 days compared with < 35 days (+0.26 kg; 0.25 kg; p = 0.5). Weight loss or maintenance was seen in 70% of patients.
These preliminary data are supportive of the concept that acutely unwell inpatients with SMI may engage with a behavioural weight programme. Weight change observed contrasts with the significant weight gain often seen in most subjects. Further clinical trials are warranted.
在对慢性重度精神疾病进行精神药物治疗期间,体重增加是常见现象,且在治疗早期最为迅速。所有形式的行为体重干预计划都表明,部分患者的体重增加可以预防或逆转。对于可能是主要受益人群的急性病住院患者,尚无关于这些计划的数据。
自2002年起在爱尔兰用于重度精神疾病门诊患者的模块化行为干预计划(健康解决方案)已被改编用于住院患者。报告了来自爱尔兰5个中心的初步数据。
47名住院患者的平均体重变化为+0.26千克(标准差2.02),中位数变化为0千克。平均随访时间为23.7天(标准差21.6),中位数为14天(范围6 - 98天)。参与时间超过35天的患者与参与时间少于35天的患者相比,平均体重变化无差异(+0.26千克;0.25千克;p = 0.5)。70%的患者体重减轻或维持不变。
这些初步数据支持这样的概念,即患有重度精神疾病的急性病住院患者可能参与行为体重计划。观察到的体重变化与大多数受试者常见的显著体重增加形成对比。有必要进行进一步的临床试验。