Dept of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Academic Primary Health Care Centre, Region Stockholm, Sweden.
Division of Psychiatry, Dept of Clinical Sciences, Lund University, Lund, Sweden; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
Schizophr Res. 2019 Jun;208:138-144. doi: 10.1016/j.schres.2019.03.026. Epub 2019 Apr 9.
Life expectancy is reduced by 19 years in men and 17 in women with psychosis in Sweden, largely due to cardiovascular disease.
Assess whether a psychosocial health promotion intervention improves cardiometabolic risk factors, quality of life, and severity of illness in patients with psychotic disorders more than treatment as usual.
A pragmatic intervention trial testing a manual-based multi-component health promotion intervention targeting patients with psychosis. The Swedish intervention was adapted from IMPaCT therapy, a health-promotion program based on motivational interviewing and cognitive behavioral therapy, designed to be incorporated into routine care. The intervention group consisted of 119 patients and the control group of 570 patients from specialized psychosis departments. Outcome variables were assessed 6 months before intervention during the run-in period, again at the start of intervention, and 12 months after the intervention began. The control group received treatment as usual.
The intervention had no significant effect on any of the outcome variables. However, BMI, waist circumference, systolic BP, heart rate, HbA1c, general health, and Clinical Global Impressions Scale score improved significantly during the run-in period before the start of the active intervention (observer effect). The multi-component design meant that treatment effects could only be calculated for the intervention as a whole.
The results of the intervention are similar to those of the U.K. IMPaCT study, in which the modular health-promotion intervention had little effect on cardiovascular risk indicators. However, in the current study, the run-in period had a positive effect on cardiometabolic risk factors.
在瑞典，患有精神病的男性预期寿命缩短 19 年，女性缩短 17 年，这主要归因于心血管疾病。
评估心理社会健康促进干预是否比常规治疗更能改善精神病患者的心血管代谢风险因素、生活质量和疾病严重程度。
一项实用的干预试验，测试了一种针对精神病患者的基于手册的多组件健康促进干预。瑞典的干预措施改编自 IMPaCT 治疗，这是一种基于动机访谈和认知行为疗法的健康促进计划，旨在纳入常规护理。干预组包括 119 名患者，对照组包括来自专门的精神病科的 570 名患者。在干预开始前的 6 个月进行评估，在干预开始时再次评估，并在干预开始 12 个月后进行评估。对照组接受常规治疗。
干预对任何结果变量都没有显著影响。然而，BMI、腰围、收缩压、心率、HbA1c、总体健康和临床总体印象量表评分在开始积极干预前的运行期显著改善（观察效应）。多组件设计意味着只能对整个干预进行治疗效果计算。
干预的结果与英国的 IMPaCT 研究相似，其中模块化的健康促进干预对心血管风险指标几乎没有影响。然而，在当前研究中，运行期对心血管代谢风险因素有积极影响。
