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以氯氮平治疗的精神分裂症患者为研究对象的护士主导的生活方式干预。

Nurse-led lifestyle intervention in a cohort of schizophrenia patients treated with clozapine.

机构信息

Neurosciences Institute, Hospital Clinic of Barcelona, Barcelona, Spain; Jaume I University, Castellón, Spain.

University of Coimbra, Portugal.

出版信息

Arch Psychiatr Nurs. 2023 Oct;46:51-57. doi: 10.1016/j.apnu.2023.06.008. Epub 2023 Jul 4.

Abstract

Patients diagnosed with schizophrenia are characterized by early mortality compared to the general population. The main cause of this premature death reflects medical complications linked to metabolic syndrome (MetS). The use of antipsychotics such as clozapine is associated with weight gain and metabolic disturbances in certain predisposed individuals. Non-pharmacological interventions for weight control have become a key element for secondary prevention in the health of patients diagnosed with schizophrenia. Here, we aim to evaluate the physical health effects of a nurse-led non-pharmacological intervention program in patients with a diagnosis of schizophrenia treated with clozapine. Thirty-one outpatients from the outpatient clinical facility of Hospital Clinic in Barcelona, Spain diagnosed with schizophrenia and other psychotic disorders receiving clozapine treatment were enrolled in a prospective interventional study, comprising an 8-week group program of therapeutic education in a healthy lifestyle. MetS factors, physical activity, diet, and lifestyle were evaluated at baseline, post-intervention (8 weeks), and 3 months after the program. Weight, body mass index, high-density lipoprotein cholesterol, and diet patterns displayed significant differences post-intervention and after 3 months, while only waist, hip perimeter, and lifestyle improved post-intervention. Our results suggest the effectiveness of the lifestyle intervention in patients under clozapine treatment despite its long-time differential effect. Strategies to prevent weight gain and metabolic decline will help prevent premature cardiometabolic disease in this vulnerable population.

摘要

与普通人群相比,被诊断患有精神分裂症的患者具有早期死亡率的特点。这种过早死亡的主要原因反映了与代谢综合征(MetS)相关的医疗并发症。某些易患人群使用氯氮平之类的抗精神病药会导致体重增加和代谢紊乱。针对体重控制的非药物干预措施已成为精神分裂症患者健康二级预防的关键要素。在这里,我们旨在评估护士主导的非药物干预计划对接受氯氮平治疗的精神分裂症患者的身体健康的影响。西班牙巴塞罗那 Clinic 医院门诊临床设施的 31 名被诊断患有精神分裂症和其他精神病性障碍并接受氯氮平治疗的门诊患者被纳入了一项前瞻性干预研究,该研究包括为期 8 周的健康生活方式治疗教育小组计划。在基线、干预后(8 周)和计划后 3 个月评估了 MetS 因素、身体活动、饮食和生活方式。体重、体重指数、高密度脂蛋白胆固醇和饮食模式在干预后和 3 个月后均显示出显著差异,而仅腰围和臀围以及生活方式在干预后得到改善。我们的结果表明,尽管氯氮平治疗的长期差异效应,但生活方式干预对患者有效。预防体重增加和代谢下降的策略将有助于预防这一脆弱人群的过早心血管代谢疾病。

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