- Email: [email protected]
45 – Non-pharmacological management of weight gain: A national, multicentric study for schizophrenia and severe mental disorders patients
52
ABSTRACTS / Schizophrenia Research 98 (2008) 3–199
Assessment of Functioning (GAF) scale. Clinical and functional outcomes are analyzed using a linear mixed model controlling for age, gender, disease duration, baseline hospitalization status and antipsychotic treatment patterns. Results presented in this report are based on the complete e-STAR data from Spain. Results: A total of 1622 patients (63.6% male, mean age 38.4 ± 11.2 years) participated in e-STAR from Spain, 1345 were initiated on RLAI and 277 were treated with oral antipsychotics. RLAI treated patients had significantly longer disease duration (12.6 ± 9.5 years vs. 10.9 ± 9.7 years, p b 0.01) than those treated with oral antipsychotics. During the 2-year study, clinical symptoms and functioning improved in both groups. As revealed by the mixed-model regression, RLAI patients, compared to oral patients, had significantly greater improvement on CGIS scores (−1.10 vs. −0.88, p b 0.02) and GAF scores (16.4 vs. 14.6, p b 0.03). Baseline hospitalization status and disease duration were significant explanatory variables in the mixed model regression. Conclusions: This 2-year, prospective, observational study showed that compared to oral antipsychotics, RLAI treatment was associated with greater improvement in clinical symptoms and functioning in patients with schizophrenia.
(28.3%) lost 2 kg or more. Patients went from 8.5 (SD ± 3.5) meetings during the study to an amount of 13. Physical activity increased after the intervention (Mc Nemar, p b .01). Before intervention 158 (53.5%) patients were practicing any kind of activity and after 214 (72.5%) were doing physical activity. Conclusions: The intervention showed positive outcomes on weight gain, blood pressure, waist and hip circumferences in a short-term evaluation. A randomized controlled trial with this intervention has already started and is expected to have even larger effect sizes since patients in the waiting list tend to gain weight. Acknowledgement: Unrestricted research Grant from Eli Lilly.
doi:10.1016/j.schres.2007.12.111
S. Castelein 1, R. Bruggeman 1, J.T. Van Busschbach 1, M. Van Der Gaag 2,3, A.D. Stant 1, H. Knegtering 1, D. Wiersma 1.
doi:10.1016/j.schres.2007.12.112
46 – THE EFFECTIVENESS OF MINIMALLY GUIDED PEER SUPPORT GROUPS FOR PEOPLE SUFFERING FROM PSYCHOSIS: A RANDOMIZED CONTROLLED TRIAL
1
Cognitive and Non-pharmacological Treatment 45 – NON-PHARMACOLOGICAL MANAGEMENT OF WEIGHT GAIN: A NATIONAL, MULTICENTRIC STUDY FOR SCHIZOPHRENIA AND SEVERE MENTAL DISORDERS PATIENTS C. Attux 1, L.C. Martini 1, C.M. Araújo 1, A.M. Roma 1, E.M. Mullan 1, B.P. Baptista 1, F.A. Pimentel 1, P.L. Castro 1, M.G. Camargo 1, D.F. Canguçu 1, R.A. Bressan 1. UNIFESP – Federal University of São Paulo, Brazil
1
Presenting Author details: rodrigo.affonseca-bressan@ iop.kcl.ac.uk Rua Machado Bittencourt, 222, 04044-000 São Paulo, Brazil, Tel.: +55 11 50844833. Background: Weight gain and metabolic syndrome are serious health concerns for schizophrenia and other severe mental illness patients because they increase the risk of cardiovascular diseases. The primary objective of the study was to evaluate the effectiveness of the intervention in a national multicentric study, comparing weight and BMI (body mass index), blood pressure, waist circumference and physical activity levels changes before and after the intervention were evaluated as a secondary objective. Methods: The intervention includes 13 weekly 1-h group sessions discussing topics, such as healthy diet, lifestyle, physical activity, psychoeducation and self-esteem with patients and their relatives. Groups are enrolled by a mental health professional, which is trained and supervised by our team. At each assessment moment, weight, height, waist circumference and blood pressure were measured. Results: Completed data for the initial assessment were available for 385 patients. 286 (74.31%) patients finished the study. Patients lost on average 0.6 kg (SD ± 3.3) and BMI remained stable. Waist measures and blood pressure levels presented small but significant decreases. Weight remained stable (±2 kg) in 157 (55.5%) patients and 80
University Medical Center Groningen, University of Groningen, The Netherlands 2 Parnassia Psychiatric Institute, Den Haag, The Netherlands 3 VU University, Amsterdam, The Netherlands Presenting Author details: [email protected] Hanzeplein 1, 9700 RB Groningen, Netherlands, Tel.: +31 503611956; fax: +31 503611699. Background: As in other groups of patients with chronic illnesses, patients with psychotic disorders and schizophrenia in particular, report a need for peer support groups to share experiences. This need is even more important since one of the major side effects of experiencing psychosis is the negative influence on ones social life. The validity of this request to make these groups a standard part of care is barely questioned, but till now there is no empiric evidence of its effect and no standard guidelines are available. Methods: With the aim to investigate the effect of a minimally guided peer support group for people with psychosis on quality of life, social network, social support, self-efficacy and self-esteem and to evaluate the methodology and economic consequences, we conducted a multicentre randomized controlled trial comparing the effects of these groups added to the usual care with care as usual alone. Results: The results showed a positive effect on social network and on social support. Patients in the experimental group improved on contact with peers, also outside the sessions and had more positive social contacts supporting their self-esteem. No statistically significant differences between groups in changes on quality of life, self-efficacy and self-esteem were found. There was however an effect on quality of life, social support and self-efficacy when, within the experimental group, completers with non-completers were compared. The economic evaluation showed that the groups can be implemented without negative financial consequences. The methodology was positively evaluated by both participants and nurses guiding the groups. Conclusions: This first RCT showed that peer support groups are a useful intervention for people suffering from psychosis enabling mutual relationships outside the sessions. The study gives also evidence for the importance of intervention adherence as an important predictor of effect.
ABSTRACTS / Schizophrenia Research 98 (2008) 3–199
Assessment of Functioning (GAF) scale. Clinical and functional outcomes are analyzed using a linear mixed model controlling for age, gender, disease duration, baseline hospitalization status and antipsychotic treatment patterns. Results presented in this report are based on the complete e-STAR data from Spain. Results: A total of 1622 patients (63.6% male, mean age 38.4 ± 11.2 years) participated in e-STAR from Spain, 1345 were initiated on RLAI and 277 were treated with oral antipsychotics. RLAI treated patients had significantly longer disease duration (12.6 ± 9.5 years vs. 10.9 ± 9.7 years, p b 0.01) than those treated with oral antipsychotics. During the 2-year study, clinical symptoms and functioning improved in both groups. As revealed by the mixed-model regression, RLAI patients, compared to oral patients, had significantly greater improvement on CGIS scores (−1.10 vs. −0.88, p b 0.02) and GAF scores (16.4 vs. 14.6, p b 0.03). Baseline hospitalization status and disease duration were significant explanatory variables in the mixed model regression. Conclusions: This 2-year, prospective, observational study showed that compared to oral antipsychotics, RLAI treatment was associated with greater improvement in clinical symptoms and functioning in patients with schizophrenia.
(28.3%) lost 2 kg or more. Patients went from 8.5 (SD ± 3.5) meetings during the study to an amount of 13. Physical activity increased after the intervention (Mc Nemar, p b .01). Before intervention 158 (53.5%) patients were practicing any kind of activity and after 214 (72.5%) were doing physical activity. Conclusions: The intervention showed positive outcomes on weight gain, blood pressure, waist and hip circumferences in a short-term evaluation. A randomized controlled trial with this intervention has already started and is expected to have even larger effect sizes since patients in the waiting list tend to gain weight. Acknowledgement: Unrestricted research Grant from Eli Lilly.
doi:10.1016/j.schres.2007.12.111
S. Castelein 1, R. Bruggeman 1, J.T. Van Busschbach 1, M. Van Der Gaag 2,3, A.D. Stant 1, H. Knegtering 1, D. Wiersma 1.
doi:10.1016/j.schres.2007.12.112
46 – THE EFFECTIVENESS OF MINIMALLY GUIDED PEER SUPPORT GROUPS FOR PEOPLE SUFFERING FROM PSYCHOSIS: A RANDOMIZED CONTROLLED TRIAL
1
Cognitive and Non-pharmacological Treatment 45 – NON-PHARMACOLOGICAL MANAGEMENT OF WEIGHT GAIN: A NATIONAL, MULTICENTRIC STUDY FOR SCHIZOPHRENIA AND SEVERE MENTAL DISORDERS PATIENTS C. Attux 1, L.C. Martini 1, C.M. Araújo 1, A.M. Roma 1, E.M. Mullan 1, B.P. Baptista 1, F.A. Pimentel 1, P.L. Castro 1, M.G. Camargo 1, D.F. Canguçu 1, R.A. Bressan 1. UNIFESP – Federal University of São Paulo, Brazil
1
Presenting Author details: rodrigo.affonseca-bressan@ iop.kcl.ac.uk Rua Machado Bittencourt, 222, 04044-000 São Paulo, Brazil, Tel.: +55 11 50844833. Background: Weight gain and metabolic syndrome are serious health concerns for schizophrenia and other severe mental illness patients because they increase the risk of cardiovascular diseases. The primary objective of the study was to evaluate the effectiveness of the intervention in a national multicentric study, comparing weight and BMI (body mass index), blood pressure, waist circumference and physical activity levels changes before and after the intervention were evaluated as a secondary objective. Methods: The intervention includes 13 weekly 1-h group sessions discussing topics, such as healthy diet, lifestyle, physical activity, psychoeducation and self-esteem with patients and their relatives. Groups are enrolled by a mental health professional, which is trained and supervised by our team. At each assessment moment, weight, height, waist circumference and blood pressure were measured. Results: Completed data for the initial assessment were available for 385 patients. 286 (74.31%) patients finished the study. Patients lost on average 0.6 kg (SD ± 3.3) and BMI remained stable. Waist measures and blood pressure levels presented small but significant decreases. Weight remained stable (±2 kg) in 157 (55.5%) patients and 80
University Medical Center Groningen, University of Groningen, The Netherlands 2 Parnassia Psychiatric Institute, Den Haag, The Netherlands 3 VU University, Amsterdam, The Netherlands Presenting Author details: [email protected] Hanzeplein 1, 9700 RB Groningen, Netherlands, Tel.: +31 503611956; fax: +31 503611699. Background: As in other groups of patients with chronic illnesses, patients with psychotic disorders and schizophrenia in particular, report a need for peer support groups to share experiences. This need is even more important since one of the major side effects of experiencing psychosis is the negative influence on ones social life. The validity of this request to make these groups a standard part of care is barely questioned, but till now there is no empiric evidence of its effect and no standard guidelines are available. Methods: With the aim to investigate the effect of a minimally guided peer support group for people with psychosis on quality of life, social network, social support, self-efficacy and self-esteem and to evaluate the methodology and economic consequences, we conducted a multicentre randomized controlled trial comparing the effects of these groups added to the usual care with care as usual alone. Results: The results showed a positive effect on social network and on social support. Patients in the experimental group improved on contact with peers, also outside the sessions and had more positive social contacts supporting their self-esteem. No statistically significant differences between groups in changes on quality of life, self-efficacy and self-esteem were found. There was however an effect on quality of life, social support and self-efficacy when, within the experimental group, completers with non-completers were compared. The economic evaluation showed that the groups can be implemented without negative financial consequences. The methodology was positively evaluated by both participants and nurses guiding the groups. Conclusions: This first RCT showed that peer support groups are a useful intervention for people suffering from psychosis enabling mutual relationships outside the sessions. The study gives also evidence for the importance of intervention adherence as an important predictor of effect.