Deenik J, Tenback D E, Tak E C P M, Hendriksen I J M, van Harten P N
Tijdschr Psychiatr. 2020;62(7):564-574.
An unhealthy lifestyle plays an important role in the substantially reduced life-expectancy of inpatients with severe mental illness (SMI). However, there is a lack of evidence on the long-term effectiveness and implementation of lifestyle improvements in inpatient mental healthcare.
AIM: Increasing knowledge and understanding of (the implementation of) lifestyle changes in inpatients with SMI in longer-term clinical care.
METHOD: Cross-sectional research followed by an observational study to evaluate a multidisciplinary lifestyle enhancing treatment (MULTI) for both changes in health-related outcomes after 18 months compared to treatment as usual (TAU), and the implementation barriers and facilitators.
RESULTS: Patients were very sedentary and less physically active compared to people without SMI. After 18 months, MULTI showed significant improvements in total physical activity, cardiometabolic risk factors, psychosocial functioning and mediation use, compared to TAU. Physical health did not improve in TAU. The implementation of MULTI was hampered by organisational factors and facilitated by positive attitudes of healthcare professionals and patients towards MULTI and their own role in it.
CONCLUSION: Using a multidisciplinary integrated approach, it is possible to improve the lifestyle, and thus the health status, of SMI inpatients, within the current context of routine mental healthcare.
不健康的生活方式在严重精神疾病（SMI）住院患者预期寿命大幅缩短中起着重要作用。然而，关于住院精神卫生保健中改善生活方式的长期有效性和实施情况，缺乏证据。
在长期临床护理中，增加对SMI住院患者生活方式改变（的实施）的认识和理解。
采用横断面研究，随后进行观察性研究，以评估多学科生活方式强化治疗（MULTI）与常规治疗（TAU）相比，18个月后健康相关结局的变化，以及实施障碍和促进因素。
与无SMI的人相比，患者久坐不动，身体活动较少。18个月后，与TAU相比，MULTI在总体身体活动、心脏代谢危险因素、心理社会功能和药物使用方面有显著改善。TAU组的身体健康状况没有改善。MULTI的实施受到组织因素的阻碍，而医疗保健专业人员和患者对MULTI及其自身在其中的作用的积极态度则促进了其实施。
在当前常规精神卫生保健背景下，采用多学科综合方法可以改善SMI住院患者的生活方式，从而改善其健康状况。
