Non-pharmacological interventions for preventing weight gain in patients with first episode schizophrenia or bipolar disorder: A systematic review

Psychiatry Res. 2019 Nov:281:112556. doi: 10.1016/j.psychres.2019.112556. Epub 2019 Sep 4.

Abstract

Weight gain is a side effect of antipsychotic medication and highly prevalent in people with schizophrenia or bipolar disorder, increasing their overall cardio-metabolic risk. We conducted a systematic review on non-pharmacological interventions for preventing/reducing weight gain or increase in waist-circumference in young, newly diagnosed patients with schizophrenia or bipolar disorder. We searched major electronic databases from inception to 04/2019 on RCTs, pre- and post-test studies, and non-randomized controlled clinical trials. From a potential of 2963 hits, eight studies met the inclusion criteria (n = 438, mean age of 18.8 (13-45) years). The interventions comprised supervised and individually adjusted aerobic exercise activities (5 studies), individual lifestyle counselling vs. control condition (2 RCTs), and dietetic counselling and practical training of cooking and shopping (1 study). Physical activity and practical dietetic interventions seem to be more efficient than lifestyle counselling. However, the results shall be taken with caution due to the non-randomized designs and other methodologically deficits in the majority of the included studies.

Keywords: Bipolar disorder; First episode schizophrenia; Non-pharmacological intervention; Prevention; Weight gain.

Publication types

  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Antipsychotic Agents / adverse effects*
  • Bipolar Disorder / drug therapy*
  • Diet Therapy*
  • Exercise Therapy*
  • Humans
  • Middle Aged
  • Overweight / chemically induced*
  • Overweight / prevention & control*
  • Patient Education as Topic*
  • Schizophrenia / drug therapy*
  • Weight Gain / drug effects*
  • Young Adult

Substances

  • Antipsychotic Agents