Nonpharmacological Interventions for the Treatment of Cardiometabolic Risk Factors in People With Schizophrenia—A Systematic Review

Tumiel, Ewa; Wichniak, Adam; Jarema, Marek; Lew–Starowicz, Michał

doi:10.3389/fpsyt.2019.00566

Cited by 24 publications

(17 citation statements)

References 48 publications

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“…Individual lifestyle counseling and psychoeducation interventions focused on promoting a healthy lifestyle should be considered as first-line strategies for the prevention and management of physical comorbidities in patients with primary psychosis 203,[216][217][218] . Patients should be advised to engage in at least 30 min of moderate-intensity physical activity for a minimum of five days per week 215 .…”

Section: Physical Comorbiditiesmentioning

confidence: 99%

The clinical characterization of the patient with primary psychosis aimed at personalization of management

et al. 2021

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The current management of patients with primary psychosis worldwide is often remarkably stereotyped. In almost all cases an antipsychotic medication is prescribed, with second‐generation antipsychotics usually preferred to first‐generation ones. Cognitive behavioral therapy is rarely used in the vast majority of countries, although there is evidence to support its efficacy. Psychosocial interventions are often provided, especially in chronic cases, but those applied are frequently not validated by research. Evidence‐based family interventions and supported employment programs are seldom implemented in ordinary practice. Although the notion that patients with primary psychosis are at increased risk for cardiovascular diseases and diabetes mellitus is widely shared, it is not frequent that appropriate measures be implemented to address this problem. The view that the management of the patient with primary psychosis should be personalized is endorsed by the vast majority of clinicians, but this personalization is lacking or inadequate in most clinical contexts. Although many mental health services would declare themselves “recovery‐oriented”, it is not common that a focus on empowerment, identity, meaning and resilience is ensured in ordinary practice. The present paper aims to address this situation. It describes systematically the salient domains that should be considered in the characterization of the individual patient with primary psychosis aimed at personalization of management. These include positive and negative symptom dimensions, other psychopathological components, onset and course, neurocognition and social cognition, neurodevelopmental indicators; social functioning, quality of life and unmet needs; clinical staging, antecedent and concomitant psychiatric conditions, physical comorbidities, family history, history of obstetric complications, early and recent environmental exposures, protective factors and resilience, and internalized stigma. For each domain, simple assessment instruments are identified that could be considered for use in clinical practice and included in standardized decision tools. A management of primary psychosis is encouraged which takes into account all the available treatment modalities whose efficacy is supported by research evidence, selects and modulates them in the individual patient on the basis of the clinical characterization, addresses the patient’s needs in terms of employment, housing, self‐care, social relationships and education, and offers a focus on identity, meaning and resilience.

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Section: Physical Comorbiditiesmentioning

confidence: 99%

The clinical characterization of the patient with primary psychosis aimed at personalization of management

et al. 2021

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“…The second generation drugs, however, have been linked to their own serious side-effects as well. These most commonly include cardiometabolic side-effects, which significantly increase the risk of developing cardiometabolic disorders such as Type 2 diabetes mellitus (DM) and cardiovascular disease (11)(12)(13)(14)(15)(16)(17)(18)(19). Typically, Type 2 DM is preceded by the onset of the metabolic syndrome, which is characterized by weight gain, hypertension, hyperlipidemia, hyperglycemia, glucose intolerance, and insulin resistance (20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Differential Effects of Acute Treatment With Antipsychotic Drugs on Peripheral Catecholamines

Boyda

Tse

et al. 2020

Front. Psychiatry

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Antipsychotic drugs represent the most effective treatment for chronic psychotic disorders. The newer second generation drugs offer the advantage of fewer neurological side-effects compared to prior drugs, but many cause serious metabolic side-effects. The underlying physiology of these side-effects is not well-understood, but evidence exists to indicate that the sympathetic nervous system may play an important role. In order to examine this possibility further, we treated separate groups of adult female rats acutely with either the first generation antipsychotic drug haloperidol (0.1 or 1 mg/kg) or the second generation drugs risperidone (0.25 or 2.5 mg/kg), clozapine (2 or 20 mg/kg), olanzapine (3 or 15 mg/kg) or vehicle by intraperitoneal injection. Blood samples were collected prior to drug and then 30, 60, 120, and 180 mins after treatment. Plasma samples were assayed by HPLC-ED for levels of norepinephrine, epinephrine, and dopamine. Results confirmed that all antipsychotics increased peripheral catecholamines, although this was drug and dose dependent. For norepinephrine, haloperidol caused the smallest maximum increase (+158%], followed by risperidone (+793%), olanzapine (+952%) and clozapine (+1,684%). A similar pattern was observed for increases in epinephrine levels by haloperidol (+143%], olanzapine (+529%), risperidone (+617%) then clozapine (+806%). Dopamine levels increased moderately with olanzapine [+174%], risperidone [+271%], and clozapine [+430%]. Interestingly, levels of the catecholamines did not correlate strongly with each other prior to treatment at baseline, but were increasingly correlated after treatment as time proceeded. The results demonstrate antipsychotics can potently regulate peripheral catecholamines, in a manner consistent with their metabolic liability.

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“…Though physical activity has been found to have positive physical and mental health benefits for people with severe mental illness (SMI), 1 exercise interventions are seldom offered as a treatment option in mental health care 2 . Given that the estimated mortality gap for people with SMI is between 11 years 3 and 30 years 4 with a 20% reduction in life expectancy, 5,6 it is of public health importance to identify how to increase uptake and implementation of physical activity interventions among this population group.…”

Section: Introductionmentioning

confidence: 99%

An exercise intervention for people with serious mental illness: Findings from a qualitative data analysis using participatory theme elicitation

Yap

McCartan

Davidson

et al. 2020

Health Expectations

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Nonpharmacological Interventions for the Treatment of Cardiometabolic Risk Factors in People With Schizophrenia—A Systematic Review

Cited by 24 publications

References 48 publications

The clinical characterization of the patient with primary psychosis aimed at personalization of management

The clinical characterization of the patient with primary psychosis aimed at personalization of management

Differential Effects of Acute Treatment With Antipsychotic Drugs on Peripheral Catecholamines

An exercise intervention for people with serious mental illness: Findings from a qualitative data analysis using participatory theme elicitation

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