Department of Health Sciences, Faculty of Science & Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands.
Department of Clinical, Neuro- and Developmental Psychology & Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands.
BMC Psychiatry. 2022 Apr 13;22(1):261. doi: 10.1186/s12888-022-03854-x.
Lifestyle interventions for severe mental illness (SMI) are known to have small to modest effect on physical health outcomes. Little attention has been given to patient-reported outcomes (PROs).
To systematically review the use of PROs and their measures, and quantify the effects of lifestyle interventions in patients with SMI on these PROs.
Five electronic databases were searched (PubMed/Medline, Embase, PsycINFO, CINAHL, and Web of Science) from inception until 12 November 2020 (PROSPERO: CRD42020212135). Randomised controlled trials (RCTs) evaluating the efficacy of lifestyle interventions focusing on healthy diet, physical activity, or both for patients with SMI were included. Outcomes of interest were PROs.
A total of 11.267 unique records were identified from the database search, 66 full-text articles were assessed, and 36 RCTs were included, of which 21 were suitable for meta-analyses. In total, 5.907 participants were included across studies. Lifestyle interventions had no significant effect on quality of life (g = 0.13; 95% CI = - 0.02 to 0.27), with high heterogeneity (I = 68.7%). We found a small effect on depression severity (g = 0.30, 95% CI = 0.00 to 0.58, I = 65.2%) and a moderate effect on anxiety severity (g = 0.56, 95% CI = 0.16 to 0.95, I = 0%).
This meta-analysis quantifies the effects of lifestyle interventions on PROs. Lifestyle interventions have no significant effect on quality of life, yet they could improve mental health outcomes such as depression and anxiety symptoms. Further use of patient-reported outcome measures in lifestyle research is recommended to fully capture the impact of lifestyle interventions.
针对严重精神疾病 (SMI) 的生活方式干预措施已被证实对身体健康结果具有较小到适度的影响。然而，患者报告的结果 (PRO) 却很少受到关注。
系统地回顾 PRO 的使用及其测量方法，并定量评估生活方式干预措施对 SMI 患者这些 PRO 的影响。
从建库起至 2020 年 11 月 12 日，我们对 5 个电子数据库（PubMed/Medline、Embase、PsycINFO、CINAHL 和 Web of Science）进行了检索（PROSPERO：CRD42020212135）。纳入评估针对 SMI 患者的健康饮食、身体活动或两者结合的生活方式干预措施的疗效的随机对照试验 (RCT)。我们感兴趣的结局是 PRO。
从数据库检索中确定了 11267 条独特的记录，评估了 66 篇全文文章，纳入了 36 项 RCT，其中 21 项适合进行荟萃分析。共有 5907 名参与者参与了研究。生活方式干预措施对生活质量没有显著影响（g=0.13；95%CI=-0.02 至 0.27），存在高度异质性（I=68.7%）。我们发现，生活方式干预措施对抑郁严重程度有较小的影响（g=0.30，95%CI=0.00 至 0.58，I=65.2%），对焦虑严重程度有中等程度的影响（g=0.56，95%CI=0.16 至 0.95，I=0%）。
本荟萃分析量化了生活方式干预措施对 PRO 的影响。生活方式干预措施对生活质量没有显著影响，但可以改善抑郁和焦虑等心理健康结局。建议在生活方式研究中进一步使用患者报告的结局测量方法，以全面捕捉生活方式干预措施的影响。
