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Effect of the Greek Solutions for Wellness weight management program on quality of life and associated factors in patients with a psychiatric disorder receiving psychotropic medication

Background

Weight gain is a major side effect of treatment with psychotropic agents [1]. Besides its adverse metabolic effects, weight gain may also impair physical functioning and quality of life (QoL) [2]. Clinical weight management programs are reported to improve quality of life in obese individuals not receiving psychotropic therapy [3], but this has not been sufficiently investigated in patients with psychiatric disorders.

The primary objective of this study is to assess the impact of the Greek Solutions for Wellness (SfW) 3-month program, which focuses on nutrition and physical exercise, on QoL in patients with a psychiatric disorder who are taking psychotropic medication and have a weight problem. Secondarily it aims to investigate the impact of baseline patient variables (e.g. age, sex, diagnosis) on QoL at month 3.

Materials and methods

This 26-week prospective observational study enrolled 359 patients from outpatient settings routinely carrying out the Greek SfW, from 23/JAN/2007 to 27/FEB/2008. 297 of them entered the program while 62 others who declined, were used as a control group. The QoL instrument Subjective Well-Being under Neuroleptics (SWN), the Clinical Global Impression (CGI) scale, weight (kg), body mass index (BMI, kg/m2) and waist circumference (WC) (cm) were collected at baseline, months 3 (program completion) and 6 (follow up visit). In addition, diagnosis, disorder duration, treatment regimen and demographic characteristics (age, sex) were recorded. The proportion of patients with a QoL improvement (any SWN increase) was estimated together with their 95% CI in both groups at month 3. Further, stepwise logistic regression models were fitted to adjust the SfW effect on QoL at month 3, controlling for baseline potential confounders and first-degree interactions. A sensitivity analysis was conducted after implausible WC values were found in the database.

Results

Patient characteristics were similar across both groups: Out of 359 patients, a total of 198 (55.2%) were female, the mean age (SD) was 40.6 years (10.9), mean weight (SD) 92.9 kg (17.9), mean BMI (SD) 32.2 kg/m2 (5.6). 52.4% of the patients presented with schizophrenia, 30.9% with bipolar disorder and 16.7% other. The mean illness duration was 10.6 years (SD = 8.7). Out of 353 patients still in the study at month 3, 352 were assessable in terms of SWN increase: 206 patients out of 295 in the SfW group (69.8%) (95%CI = [64.2, 75.0]) showed QoL improvement and 33 out of 57 (57.9%) (95%CI = [44.1, 70.9]) in the control group. After controlling for baseline potential confounders the difference between the two groups was ORinitial = 1.43 [0.76; 2.67]; ORsensitivity = 1.44 [0.77; 2.71]. Covariates significantly associated with an improved QoL at month 3 included a low SWN score (ORinitial = ORsensitivity = 0.94 [0.92; 0.96] and a low CGI-S level (ORinitial = ORsensitivity = 0.62 [0.49; 0.79]).

Conclusions

QoL improvement at 3 months in patients with mental illness as well as weight problems and on psychotropics was associated with low baseline SWN and CGI-S scores, while the big majority of the patients following the Greek SfW program reported an improved QoL.

References

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Acknowledgements

The Hellenic EY-ZHN Study Team

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Correspondence to Vassiliki Psarra.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Psarra, V., Drossinos, V., Mantellou, MV. et al. Effect of the Greek Solutions for Wellness weight management program on quality of life and associated factors in patients with a psychiatric disorder receiving psychotropic medication. Ann Gen Psychiatry 9, S179 (2010). https://doi.org/10.1186/1744-859X-9-S1-S179

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Keywords

  • Bipolar Disorder
  • Waist Circumference
  • Psychotropic Medication
  • Weight Problem
  • Weight Management Program