Suggesting a Medical-Psychiatric Cohort for ACT Treatment

Kanofsky, J. Daniel; Bronovitski, Dimitri; Woesner, Mary E.

doi:10.1176/appi.ps.68905

2017

DOI: 10.1176/appi.ps.68905

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Suggesting a Medical-Psychiatric Cohort for ACT Treatment

J. Daniel Kanofsky

Dimitri Bronovitski

Mary E. Woesner

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2022

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“…If there are savings, this would suggest that an ACT model intervention-such as that used with the CHANGE group-is underutilized and may be clinically and fiscally valuable for some medical-psychiatric cohorts. [37][38][39][40][41][42]…”

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confidence: 99%

Lifestyle Coaching May Be an Effective Treatment for Schizophrenia

Kanofsky

Shankar

Wylie‐Rosett

2022

American Journal of Lifestyle Medicine

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This commentary critiques the Danish CHANGE trial, which evaluated 3 levels of outpatient intervention intensity, in a group of outpatients with obesity and schizophrenia. Neither adding care coordination with weekly nurse contacts alone nor combining this treatment with assertive community lifestyle coaching as compared to treatment as usual improved outcomes, which included cardiovascular disease risk calculation, cardiorespiratory fitness, weight, and self-reported behaviors such as smoking, physical activity, and diet. The CHANGE trial investigators appear strongly averse to recommending the development and implementation of lifestyle medicine programs as a major component when treating outpatients with severe mental disorders. The potential dismissal of lifestyle medicine as a component of treatment for severe mental disorders is problematic. Valuable lessons can be learned from more thoroughly analyzing secondary outcomes such as medical and psychiatric hospitalization rates and total health care cost. The CHANGE trial data analysis needs to be expanded beyond the focus on changes in weight and serum cholesterol. Insulin resistance and high refined carbohydrate intake may be major factors in determining both the medical and psychiatric clinical course of schizophrenia. Assertive community lifestyle coaching is a novel treatment modality. Evidence strongly suggests assertive community lifestyle coaching substantially decreases both psychiatric and medical hospitalization rates.

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mentioning

confidence: 99%

Lifestyle Coaching May Be an Effective Treatment for Schizophrenia

Kanofsky

Shankar

Wylie‐Rosett

2022

American Journal of Lifestyle Medicine

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Suggesting a Medical-Psychiatric Cohort for ACT Treatment

Cited by 1 publication

References 3 publications

Lifestyle Coaching May Be an Effective Treatment for Schizophrenia

Lifestyle Coaching May Be an Effective Treatment for Schizophrenia

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