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Physical health interventions for patients who have experienced a first episode of psychosis: a narrative review

Published online by Cambridge University Press:  28 September 2020

Fergal Fouhy ,
Walter Cullen  and
Karen O’Connor
Fergal Fouhy*
Affiliation:
Cork University Hospital, Cork, Ireland
Walter Cullen
Affiliation:
UCD School of Medicine, Dublin, Ireland
Karen O’Connor
Affiliation:
South Lee Mental Health Service, Cork, Ireland
*
*Address for correspondence: Fergal Fouhy, Cork University Hospital, Cork, MunsterT12 YE02, Ireland. (Email: [email protected])
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Abstract

Objectives:

Service users with severe psychiatric illnesses, such as schizophrenia, major depressive disorder and bipolar disorder, are more likely to suffer from ill health. There is evidence that lifestyle interventions, for example, exercise, dietary advice and smoking cessation programmes for service users with severe mental illness can be of health benefit. This review was carried out to identify the literature pertaining to physical health interventions for service users who have experienced a first-episode psychosis (FEP), to examine the nature of the interventions which were carried out and to assess these interventions in terms of feasibility and efficacy.

Methods:

A narrative review was conducted in August 2019 by searching ‘Pubmed’ and ‘Embase’ electronic databases. Studies investigating the effect a physical health intervention had on service users who had experienced a FEP were included in the review.

Results:

Fifteen studies met inclusion criteria: 12 quantitative studies and 3 qualitative. Exercise, dietary advice, smoking cessation and motivational coaching were some of the physical health interventions utilised in the identified studies. Positive effects were seen in terms of physical health markers wherever they were investigated, particularly when the intervention was delivered early. The impact on psychiatric symptoms and longer-term impacts on health were less frequently assessed.

Conclusions:

Physical health interventions have a positive impact on service users who have experienced a FEP. More research is warranted in this area in Ireland. These studies should include controls, have longer follow-up periods and should assess the impact on psychiatric health.

Keywords

Early interventionpsychosisexercisenutritionfirst-episode psychosisphysical health intervention
Type
Review Article
Information
Irish Journal of Psychological Medicine , Volume 38 , Issue 1: Themed Issue: Physical Health in Mental Illness , March 2021 , pp. 62 - 75
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The College of Psychiatrists of Ireland

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References

Abdel-Baki, A, Brazzini-Poisson, V, Marois, F, Letendre, É, Karelis, A (2013). Effects of aerobic interval training on metabolic complications and cardiorespiratory fitness in young adults with psychotic disorders: a pilot study. Schizophrenia Research 149, 112–115.CrossRefGoogle ScholarPubMed
Ashton, M, Rigby, A, Galletly, C (2013). Evaluation of a community-based smoking cessation programme for people with severe mental illness. Tobacco Control 24, 275–280.CrossRefGoogle ScholarPubMed
Bonfioli, E, Mazzi, M, Berti, L, Burti, L (2017). Physical health promotion in patients with functional psychoses receiving community psychiatric services: results of the PHYSICO-DSM-VR study. Schizophrenia Research 193, 406–411.CrossRefGoogle ScholarPubMed
Brooke, L, Lin, A, Ntoumanis, N, Gucciardi, D (2018). Is sport an untapped resource for recovery from first episode psychosis? A narrative review and call to action. Early Intervention in Psychiatry 13, 358–368.CrossRefGoogle ScholarPubMed
Brown, A, Lubman, D, Paxton, S (2011). Reducing sexually-transmitted infection risk in young people with first-episode psychosis. International Journal of Mental Health Nursing 20(1), 12–20.CrossRefGoogle ScholarPubMed
Clinicaltrials.gov. (2019). Feasibility and relevance of high-intensity functional training in patients with first-episode psychosis - tabular view - ClinicalTrials.gov. (https://clinicaltrials.gov/ct2/show/record/NCT03409393). Accessed 19 September 2019.Google Scholar
Curtis, J, Kalucy, M, Lappin, J, Samaras, K,Rosenbaum, S, Ward, P (2016). Keeping the body in mind for youth experiencing psychosis: translating research into routine practice. Early Intervention in Psychiatry 10, 1.Google Scholar
Curtis, J, Kalucy, M, Lappin, J, Samaras, K,Rosenbaum, S, Ward, P (2014). Keeping the body in mind for youth experiencing psychosis: translating research into routine practice. Early Intervention in Psychiatry 10, 41.Google Scholar
Curtis, J, Watkins, A, Rosenbaum, S, Teasdale, S, Kalucy, M, Samaras, K, Ward, P (2015). Evaluating an individualized lifestyle and life skills intervention to prevent antipsychotic-induced weight gain in first-episode psychosis. Early Intervention in Psychiatry 10, 267–276.CrossRefGoogle ScholarPubMed
Curtis, J, Zhang, C, McGuigan, B, Pavel-Wood, E, Morell, R, Ward, P, Watkins, A, Lappin, J (2018). y-QUIT: smoking prevalence, engagement, and effectiveness of an individualized smoking cessation intervention in youth with severe mental illness. Frontiers in Psychiatry 9.CrossRefGoogle ScholarPubMed
De Hart, M, Correll, CU, Bobes, J, Cetkovich-Bakmas, M, Cohen, D, Asai, I, Ndetei, DM (2011). Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry 10, 52–77.CrossRefGoogle Scholar
De Leon, J, Diaz, F, Rogers, T, Browne, D, Dinsmore, L (2002). Initiation of daily smoking and nicotine dependence in schizophrenia and mood disorders. Schizophrenia Research 56, 47–54.CrossRefGoogle ScholarPubMed
Firth, J, Carney, R, Elliott, R, French, P, Parker, S, McIntyre, R, McPhee, J, Yung, A (2016a). Exercise as an intervention for first-episode psychosis: a feasibility study. Early Intervention in Psychiatry 12, 307–315.CrossRefGoogle ScholarPubMed
Firth, J, Carney, R, French, P, Elliott, R, Cotter, J, Yung, A (2016b). Long-term maintenance and effects of exercise in early psychosis. Early Intervention in Psychiatry 12, 578–585.CrossRefGoogle ScholarPubMed
Firth, J, Carney, R, Jerome, L, Elliott, R, French, P, Yung, A (2016c). The effects and determinants of exercise participation in first-episode psychosis: a qualitative study. BMC Psychiatry 16.CrossRefGoogle ScholarPubMed
Firth, J, Cotter, J, Elliott, R, French, P, Yung, A (2015). A systematic review and meta-analysis of exercise interventions in schizophrenia patients. Psychological Medicine 45, 1343–1361.CrossRefGoogle ScholarPubMed
Firth, J, Siddiqi, N, Koyanagi, A, Siskind, D, Rosenbaum, S, Galletly, C et al. (2019). The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness. The Lancet Psychiatry 6.Google ScholarPubMed
Foley, D, Morley, K (2011). Systematic review of early cardiometabolic outcomes of the first treated episode of psychosis. Archives of General Psychiatry 68, 609.CrossRefGoogle Scholar
Gates, J, Killackey, E, Phillips, L, Álvarez-Jiménez, M (2015). Mental health starts with physical health: current status and future directions of non-pharmacological interventions to improve physical health in first-episode psychosis. The Lancet Psychiatry 2, 726–742.CrossRefGoogle ScholarPubMed
Griffiths, L, Bold, J, Smith, J, Bradley, E, Band, M, Hird-Smith, R (2016). Exercise and lifestyle therapy improves weight maintenance in young people with psychosis. Medicine & Science in Sports & Exercise 48, 382.CrossRefGoogle Scholar
Hallgren, M, Skott, M, Ekblom, Ö, Firth, J, Schembri, A, Forsell, Y (2018). Exercise effects on cognitive functioning in young adults with first-episode psychosis: FitForLife. Psychological Medicine 49, 431–439.CrossRefGoogle ScholarPubMed
HSE.ie. (2019). Programme Documents & Resources: Psychosis-HSE.ie. https://www.hse.ie/eng/about/who/cspd/ncps/mentalhealth/psychosis/resources/. Accessed 11 September 2019.Google Scholar
Kalucey, M, Rosenbaum, S, Curtis, J, Watkins, A, Teasdale, S, Samaras, K, Ward, PB (2016). Sleep quality in youth with first-episode psychosis participating in an individualized lifestyle and life-skills intervention - the keeping the body in mind program. Early Intervention in Psychiatry 10, 1(187).Google Scholar
Kolenic, M, Franke, K, Hlinka, J, Matejka, M, Capkova, J, Pausova, Z, Uher, R, Alda, M, Spaniel, F, Hajek, T (2018). Obesity, dyslipidemia and brain age in first-episode psychosis. Journal of Psychiatric Research 99, 151–158.CrossRefGoogle ScholarPubMed
Lambden, B, Berge, J, Forsell, Y (2018). Structured physical exercise and recovery from first episode psychosis in young adults, the FitForLife study. Psychiatry Research 267, 346–353.CrossRefGoogle ScholarPubMed
Larsen, L, Schnor, H, Tersbøl, B, Ebdrup, B, Nordsborg, N, Midtgaard, J (2019). The impact of exercise training complementary to early intervention in patients with first-episode psychosis: a qualitative sub-study from a randomized controlled feasibility trial. BMC Psychiatry 19, 1.CrossRefGoogle ScholarPubMed
Lieberman, JA, Perkins, D, Belger, A, Chakos, M, Jarskog, F, Boteva, K, Gilmore, J (2001) The early stages of schizophrenia: speculations on pathogenesis, pathophysiology, and therapeutic approaches. Biological Psychiatry 50, 884–897.CrossRefGoogle ScholarPubMed
Lin, J, Chan, S, Lee, E, Chang, W, Tse, M, Su, W, Sham, P, Hui, C, Joe, G, Chan, C, Khong, P, So, K, Honer, W, Chen, E (2015). Aerobic exercise and yoga improve neurocognitive function in women with early psychosis. NPJ Schizophrenia 1.CrossRefGoogle ScholarPubMed
Lovell, K, Wearden, A, Bradshaw, T, Tomenson, B, Pedley, R, Davies, L, Husain, N, Woodham, A, Escott, D, Swarbrick, C, Femi-Ajao, O, Warburton, J, Marshall, M (2014). An exploratory randomized controlled study of a healthy living intervention in early intervention services for psychosis. The Journal of Clinical Psychiatry 75, 498–505.CrossRefGoogle Scholar
McCombe, G, Harrold, A, Brown, K, Hennessy, L, Clarke, M, Hanlon, D, O’Brien, S, Lyne, J, Corcoran, C, McGorry, P, Cullen, W (2019). Key worker–mediated enhancement of physical health in first episode psychosis: protocol for a feasibility study in primary care. JMIR Research Protocols 8, 13115.CrossRefGoogle ScholarPubMed
Mcgorry, P, Killackey, E, Yung, A (2008). Early intervention in psychosis: concepts, evidence and future directions. World Psychiatry 7, 148–156.CrossRefGoogle ScholarPubMed
Naslund, J, Aschbrenner, K, Scherer, E, Pratt, S, Wolfe, R, Bartels, S (2016). Lifestyle intervention for people with severe obesity and serious mental illness. American Journal of Preventive Medicine 50, 145–153.CrossRefGoogle ScholarPubMed
Nihr.ac.uk (2019). Guidance on applying for feasibility studies (https://www.nihr.ac.uk/documents/nihr-research-for-patient-benefit-rfpb-programme-guidance-on-applying-for-feasibility-studies/20474). Accessed 28 August 2019.Google Scholar
NSW Health - South Eastern Sydney Local Health District (2019) (https://www.seslhd.health.nsw.gov.au/keeping-body-mind). Accessed 19 September 2019.Google Scholar
Pedley, R, Lovell, K, Bee, P, Bradshaw, T, Gellatly, J, Ward, K, Woodham, A, Wearden, A (2018). Collaborative, individualised lifestyle interventions are acceptable to people with first episode psychosis; a qualitative study. BMC Psychiatry 18.CrossRefGoogle ScholarPubMed
Pillinger, T, Beck, K, Stubbs, B, Howes, OD (2017). Cholesterol and triglyceride levels in first-episode psychosis: systematic review and meta-analysis. The British Journal of Psychiatry 211, 339–349.CrossRefGoogle ScholarPubMed
Rasmussen, S, Rosebush, P, Anglin, R, Mazurek, M (2016). The predictive value of early treatment response in antipsychotic-naive patients with first-episode psychosis: haloperidol versus olanzapine. Psychiatry Research 241, 72–77.CrossRefGoogle ScholarPubMed
Stubbs, B, Williams, J, Gaughran, F, & Craig, T (2016a). How sedentary are people with psychosis? A systematic review and meta-analysis. Schizophrenia Research 171, 103–109.CrossRefGoogle ScholarPubMed
Teasdale, S, Harris, S, Rosenbaum, S, Watkins, A, Samaras, K, Curtis, J, Ward, P (2014). Individual dietetic consultations in first episode psychosis: a novel intervention to reduce cardiometabolic risk. Community Mental Health Journal 51, 211–214.CrossRefGoogle ScholarPubMed
Teasdale, S, Ward, P, Rosenbaum, S, Samaras, K, Stubbs, B (2017). Solving a weighty problem: systematic review and meta-analysis of nutrition interventions in severe mental illness. British Journal of Psychiatry 210, 110–118.CrossRefGoogle ScholarPubMed
Teasdale, S, Ward, P, Rosenbaum, S, Watkins, A, Curtis, J, Kalucy, M, Samaras, K (2016b). A nutrition intervention is effective in improving dietary components linked to cardiometabolic risk in youth with first-episode psychosis. British Journal of Nutrition 115, 1987–1993.CrossRefGoogle ScholarPubMed
Teasdale, S, Ward, P, Samaras, K, Firth, J, Stubbs, B, Tripodi, E, Burrows, T (2019). Dietary intake of people with severe mental illness: systematic review and meta-analysis. The British Journal of Psychiatry 214, 251–259.CrossRefGoogle ScholarPubMed
Thompson, A, Hetrick, S, Álvarez-Jiménez, M, Parker, A, Willet, M, Hughes, F, Gariup, M, Gomez, D, McGorry, P (2011). Targeted intervention to improve monitoring of antipsychotic-induced weight gain and metabolic disturbance in first episode psychosis. Australian & New Zealand Journal of Psychiatry 45, 740–748.CrossRefGoogle ScholarPubMed
Usher, C, Thompson, A, Griebeler, M, Senders, A, Seibel, C, Ly, R, Murchison, C, Hagen, K, Afong, K, Bourdette, D, Ross, R, Borgatti, A, Shinto, L (2019). Meals, mindfulness, & moving forward: a feasibility study to a multi-modal lifestyle approach in early psychosis. Early Intervention in Psychiatry 13, 147–150.CrossRefGoogle ScholarPubMed
Vancampfort, D, Rosenbaum, S, Schuch, F, Ward, P, Probst, M, Stubbs, B (2015). Prevalence and predictors of treatment dropout from physical activity interventions in schizophrenia: a meta-analysis. General Hospital Psychiatry 39, 15–23.CrossRefGoogle ScholarPubMed
WHO. (2017). Physical activity fact sheet.Google Scholar
World Health Organization (2004). Global strategy on diet, physical activity and health. WWW Document (http://www.who.int/dietphysicalactivity/en/)Google Scholar