M14. Therapeutic Lifestyle Changes (TLC) for Adults With Serious Mental Illness

Abstract

International Congress on Schizophrenia Research S216Posters (Monday) and legal difficulties (arrests) (PE= 17.39, SE = 7.64, P = .03) predicted greater increase in cholesterol levels. ROC analysis identified randomization to olanzapine as the most discriminative predictor of >4 kg weight gain. Background: The delivery of mental health care is shifting to one that is patient-centered and recovery-oriented, with the goal of increasing quality of life. These pilot studies test an adjunctive, holistic, behavioral approach to treating serious mental illness (SMI) and medication-associated weight gain; investigators hypothesized that engagement in a greater number of therapeutic lifestyle changes (TLCs) leads to improvement in quality of life, reduction of psychiatric symptoms, and weight loss. Methods: Pilot Study 1 took place within the year-long multi-modal behavioral weight management intervention "Management of Antipsychotic Medication Associated Obesity-2." Veterans received nutrition classes and counseling weekly for 2 months and monthly thereafter up to 12 months. Dietitians surveyed 55 Veterans at each of these meetings on their engagement with 8 TLCs: exercise, nutrition, stress management, relaxation, relationships, service to others, religious and spiritual involvement, and recreation. Data on the number of TLCs practiced by these Veterans was analyzed in relation to weight change as well as measures of quality of life. Pilot Study 2 involved 19 Veterans with SMI, who attended 4 classes about TLCs, received individual counseling over 9 weeks, and maintained journals to track TLC practice. Results: Using mixed-effect linear models with random intercepts by participant, analyses of Study 1 data showed increased total TLC activity was associated with greater weight loss over time; the estimated relationship after controlling for individual differences is −.81 (ie, for every increase in TLC by one activity we can expect a reduction in weight by 0.8 pounds [F(1,435) = 11.8, P < .01]). Increased TLC activity was also associated with higher ratings of quality of life (t(41) = 2.32, P = .03) on the Biopsychosocial-spiritual Scale. In Study 2, TLC practice increased significantly over 9 weeks, and was significantly associated with improvements in quality of life on the World Health Organization Quality of Life Scale-Brief (physical health domain [F(1,21) = 4.9, P = .04], psychological health domain [F(1,19) = 4.4, P = .05], environmental health domain Conclusion