Allison David B, Newcomer John W, Dunn Andrea L, Blumenthal James A, Fabricatore Anthony N, Daumit Gail L, Cope Mark B, Riley William T, Vreeland Betty, Hibbeln Joseph R, Alpert Jonathan E
University of Alabama at Birmingham, Birmingham, Alabama, USA.
Am J Prev Med. 2009 Apr;36(4):341-50. doi: 10.1016/j.amepre.2008.11.020.
The National Institute of Mental Health convened a meeting in October 2005 to review the literature on obesity, nutrition, and physical activity among those with mental disorders. The findings of this meeting and subsequent update of the literature review are summarized here. Levels of obesity are higher in those with schizophrenia and depression, as is mortality from obesity-related conditions such as coronary heart disease. Medication side effects, particularly the metabolic side effects of antipsychotic medications, contribute to the high levels of obesity in those with schizophrenia, but increased obesity and visceral adiposity have been found in some but not all samples of drug-naïve patients as well. Many of the weight-management strategies used in the general population may be applicable to those with mental disorders, but little is known about the effects of these strategies on this patient population or how these strategies may need to be adapted for the unique needs of those with mental disorders. The minimal research on weight-management programs for those with mental disorders indicates that meaningful changes in dietary intake and physical activity are possible. Physical activity is an important component of any weight-management program, particularly for those with depression, for which a substantial body of research indicates both mental and physical health benefits. Obesity among those with mental disorders has not received adequate research attention, and empirically-based interventions to address the increasing prevalence of obesity and risk of cardiovascular and metabolic diseases in this population are lacking.
美国国立精神卫生研究所于2005年10月召开了一次会议，以回顾有关精神障碍患者的肥胖、营养和身体活动方面的文献。本文总结了此次会议的结果以及后续文献综述的更新内容。精神分裂症和抑郁症患者的肥胖水平较高，与肥胖相关疾病（如冠心病）的死亡率也较高。药物副作用，尤其是抗精神病药物的代谢副作用，导致精神分裂症患者肥胖水平较高，但在一些（并非全部）未服用药物的患者样本中也发现肥胖和内脏脂肪增多的情况。一般人群中使用的许多体重管理策略可能适用于精神障碍患者，但对于这些策略对该患者群体的影响以及如何根据精神障碍患者的独特需求进行调整，我们知之甚少。针对精神障碍患者体重管理项目的研究极少，这表明在饮食摄入和身体活动方面实现有意义的改变是可能的。身体活动是任何体重管理项目的重要组成部分，尤其是对于抑郁症患者，大量研究表明身体活动对身心健康均有益处。精神障碍患者的肥胖问题尚未得到足够的研究关注，且缺乏基于实证的干预措施来应对该人群中日益增加的肥胖患病率以及心血管和代谢疾病风险。
