Schizophrenia Program, Department of Psychiatry, Universidade Federal de São Paulo, Brazil.
Braz J Psychiatry. 2011 Jun;33(2):117-21. doi: 10.1590/s1516-44462011000200005.
To evaluate the effectiveness of a non-pharmacological intervention for weight gain management in severe mental disorders.
An open, multicentre interventional study was conducted in 93 mental health services. Patients concerned with weight gain were included in this study and received a 12-week 1-hour group intervention focused on nutrition counseling, lifestyle, physical activity and self-esteem. Weight, waist circumference and blood pressure were measured before and after the intervention.
1,071 patients were enrolled in the study, and 73.9% completed the 12-week intervention. Significant weight loss (Mean difference: 0.41, CI 95%: 0.18 to 0.64, p = 0.001) and a significant BMI reduction (Mean difference: 0.13, CI 95%: 0.04 to 0.22, p = 0.006) were observed. During the intervention 37 (4.4%) patients lost > 7% of their initial weight, 780 (92.5%) maintained their weight, and 26 (3.1%) of the patients had a meaningful weight gain (> 7%). There was a significant increase in the proportion of patients undertaking physical activity after the intervention (70.8%, p < 0.001).
In this 3-month open study we found a small weight and waist reduction, and increased physical activity practice, suggesting a trend towards anthropometric profile improvement. However, further randomized-controlled trials are necessary to evaluate the efficacy and clinical relevance of this psychosocial intervention for weight gain.
评估针对严重精神障碍患者体重增加管理的非药物干预措施的有效性。
在 93 家精神卫生服务机构开展了一项开放、多中心的干预性研究。本研究纳入了关注体重增加的患者，并为其提供了为期 12 周、每周 1 小时的团体干预，重点是营养咨询、生活方式、身体活动和自尊。在干预前后测量体重、腰围和血压。
研究共纳入 1071 例患者，73.9%完成了 12 周的干预。体重显著下降（平均差值：0.41，95%CI：0.18 至 0.64，p = 0.001），体重指数显著降低（平均差值：0.13，95%CI：0.04 至 0.22，p = 0.006）。在干预过程中，有 37 例（4.4%）患者体重减轻超过初始体重的 7%，780 例（92.5%）患者维持体重，26 例（3.1%）患者体重明显增加（>7%）。干预后，进行身体活动的患者比例显著增加（70.8%，p < 0.001）。
在这项为期 3 个月的开放研究中，我们发现体重和腰围略有减少，身体活动增加，表明人体测量特征有改善的趋势。然而，需要进一步的随机对照试验来评估这种心理社会干预对体重增加的疗效和临床相关性。
