Improving the physical health of young people with early psychosis with lifestyle interventions: Scoping review

Int J Ment Health Nurs. 2021 Dec;30(6):1498-1524. doi: 10.1111/inm.12922. Epub 2021 Aug 12.

Abstract

People with mental illness experience a shorter life expectancy compared to the general population. Poor physical health trajectory emerges following the onset of psychosis and is further compounded by the initiation of antipsychotic treatment. Young people are particularly at risk as the onset of mental illness mostly occurs between the age of 12 and 25 years. This represents a crucial period for early intervention to prevent a physical ill health trajectory. Furthermore, those who are at ultra-high risk for psychosis should also be targeted for early intervention. Lifestyle interventions have been identified as the first-line physical health promotion practice for improving the physical health of people with severe mental illness. The aim of this study was to conduct a scoping review following the JBI methodological guidance on scoping reviews to explore the current literature on lifestyle intervention trialled for early psychosis, including first-episode psychosis and those who are at ultra-high risk for psychosis. This review also explores the extent of literature examining physical health literacy in this specific population. The literature search was conducted on Medline, Embase, PsycINFO and Scopus. Twenty-two studies were included for the purpose of this scoping review, 21 of which examined the effects of lifestyle interventions and one of which reported on physical health literacy. This scoping review indicates the need for co-designed lifestyle interventions with the involvement of service users, families and carers and a focus on promoting physical health literacy, social support, and an incorporation of a health behaviour change model focus on promoting autonomous motivation. The findings of this study can inform future development of a novel co-designed lifestyle intervention for the targeted population.

Keywords: co-design; early psychosis; health literacy; lifestyle interventions; mental illness; physical health; young people.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Antipsychotic Agents* / therapeutic use
  • Child
  • Humans
  • Life Style
  • Motivation
  • Psychotic Disorders* / drug therapy
  • Psychotic Disorders* / therapy
  • Social Support
  • Young Adult

Substances

  • Antipsychotic Agents