Author, year, country | Design, no. of trial arms | Participants: no. analysed, mean age, % female mental health diagnoses, SMI inclusiona | Health behaviours or variables promoted as a part of intervention | Intervention description (length, delivery mode) Control/comparison group | Primary review outcomes assessed Weight, physical activity (PA), diet | Secondary review outcomes assessed Body mass index (BMI)/waist circumference (WC)/mental health (MH)/sedentary behaviour |
---|---|---|---|---|---|---|
RCT, 2 | 56, 39, 64%, obsessive-compulsive disorder (SMI only) | Physical activity | Intervention: weekly education and exercise sessions plus US $5 reimbursement for each session attended. Participants were also instructed to exercise on their own between 2 and 4 days during the week (12 weeks, F2F) Control: weekly hourlong psychoeducation sessions | PA: IPAQ | MH: Beck Anxiety Inventory, Beck Depression Inventory, Yale-Brown Obsessive-Compulsive Scale | |
Alvarez-Jimenez, 2006, Spain [42] | RCT, 2 | 61, 27, 25%, first episode psychosis (SMI only) | Weight, physical activity, diet | Intervention: 10 to 14 sessions to develop strategies to enhance control over factors associated with antipsychotic-induced weight gain such as energy intake and activity (3 months, F2F) Control: provide patients with the same physical care that is offered in a comprehensive early psychosis programme | Weight: maintenance (kg) | BMI |
Attux, 2013, Brazil [43] | RCT, 2 | 126, intervention, 36 control, 39, 40%, schizophrenia, other psychosis (SMI only) | Physical activity, diet, mental health | Intervention: lifestyle wellness programme consisting of weekly sessions discussing various health measures and behaviours (12 weeks. F2F) Control: TAU | Weight: maintenance (kg) PA: IPAQ | BMI WC: cm |
RCT, 2 | 139, 41.6, 41%, schizophrenia spectrum disorder, bipolar disorder, nonorganic psychotic syndrome (SMI only) | Physical activity, diet Smoking, alcohol | Intervention: smoking cessation support including NRT, plus 16 sessions of CBT focussing on CVD risk factors considered most problematic by the participant (30 weeks, F2F and phone) Control: smoking cessation support including NRT only | PA: IPAQ Diet: study-specific question | WC: cm MH: Beck Depression Inventory; Brief Psychiatric Rating Scale; Global Assessment of Functioning Sedentary behaviour: IPAQ | |
Bartels, 2013, USA [47] | RCT, 2 | 104, 44, 62%, schizophrenia, schizoaffective disorder, bipolar disorder, major depression, other (SMI only) | Weight, physical activity, diet | Intervention: in SHAPE programme. Fitness club membership and health promotion coach. (12 months, F2F) Control: fitness club membership to the same local fitness clubs (YMCAs) | Weight: loss (lb) PA: IPAQ | BMI |
Bartels, 2015, USA [48] | RCT, 2 | 210, 44, 51%, schizophrenia, schizoaffective disorder, bipolar disorder, major depression (SMI only) | Physical activity, diet | Intervention: in SHAPE programme. Fitness club membership and health promotion coach (12 months, F2F) Control: fitness club membership to the same local fitness clubs (YMCAs) | Weight: loss (lb) PA: IPAQ Diet: Brief Block Food Frequency Questionnaire | BMI WC: in |
Battaglia, 2015, Italy [49] | RCT, 2 | 18, 35, 0%, schizophrenia, schizoaffective disorder (SMI only) | Physical activity | Intervention: two soccer sessions per week. Every training session was approximately 100–120 min (12 weeks, F2F) Control: TAU | Weight: maintenance (kg) | BMI |
Beebe, 2011, USA [50] | RCT, 2 | 79, 47, 47%, schizophrenia, schizoaffective disorder (SMI only) | Physical activity | Intervention: WALC-S, 4 group discussions of the basics of walking for exercise and information on walking safely. Walking groups three times a week (16 weeks, F2F) Control: 4 group sessions focused on other health behaviours. Walking groups three times a week | PA: study specific | |
Bersani, 2017, Italy [51] | RCT, 2 | 32, 52, 50%, schizophrenia, bipolar disorder, major depressive disorder (SMI only) | Physical activity, diet Sleep, smoking, alcohol, | Intervention: five sessions of group psychoeducation on developing and maintaining a healthy lifestyle, booklet of information and promotion of self-monitoring (5 weeks, F2F) Control: five sessions to discuss clinical outcomes, watch and discuss a movie or receive education information on pharmacological therapy | PA: IPAQ Diet: Questionnaire of Mediterranean Diet Adherence | MH: Brief Psychiatric Rating Scale |
Bonfioli, 2018, Italy [52] | RCT, 2 | 302, intervention 45, control 48, 47%, schizophrenia and other functional psychoses, affective psychoses (SMI only) | Physical activity, diet | Intervention: seven health education group sessions, plus weekly group walking sessions under the guidance of an expert trainer (6 months, F2F) Control: TAU | PA: study specific Diet: study specific | |
Brown, 2006, UK [53] | RCT, 2 | 17, intervention 45, control 42, 86%, psychosis, major affective illness, severe personality disorder (SMI only) | Weight, physical activity, diet Smoking, other substance use | Intervention: six individual health promotion sessions, following the Lilly “Meaningful Day” manual, tailored to the needs of the individual (6 weeks, F2F) Control: TAU | Weight: loss (kg) PA: Godin leisure-time questionnaire | BMI MH: Hamilton Anxiety and Depression Scale |
Brown, 2009, UK [54] | RCT, 2 | 26, intervention 50, control 47, 69%, serious mental illness (SMI only) | Weight, physical activity, diet Smoking, other substance use | Intervention: five semi-structured sessions of supervised health promotion interventions from the Lilly “Meaningful Day” package (10 weeks, F2F) Control: TAU | Weight: loss (kg) PA: Godin leisure-time questionnaire Diet: Dietary Instrument for Nutrition Education | MH: Hamilton Anxiety and Depression |
Brown, 2011, USA [55] | RCT, 2 | 89, 44, 61%, serious mental illness (SMI only) | Weight, physical activity, diet | Intervention: RENEW programme. Weekly sessions in which participants learn about nutrition, participate in physical activity, set individualised goals and eat a meal together (3 months, F2F + phone) Control: TAU | Weight: loss (lbs) | |
RCT, 2 | 222, intervention 41, control 39, 66%, depression (non-SMI) | Physical activity | Intervention: maximum of 13 sessions between the patient and the physical activity facilitator, who helped patients set personal targets about incorporating physical activity into their lifestyle with the gradual building up of physical activity as a regular behaviour (8 months, F2F + phone) Control: TAU | PA: study-specific question | MH: Beck Depression Inventory | |
Chao 2011, USA [58] | RCT, 3 | 53, 46.8, 33%, major depressive disorder, bipolar disorder, schizophrenia spectrum disorder, posttraumatic stress disorder, anxiety disorder, NOS (SMI only) | Physical activity | Intervention: pedometer use with self-monitoring through daily logbook recordings (2 weeks, F2F) Control: TAU Comparison 2: pedometer use with seal to avoid self-monitoring of daily step count | Weight: loss (kg) PA: IPAQ | MH: Center for Epidemiologic Studies Depression Scale |
Daley, 2008, UK [59] | RCT, 2 | 31, np, 100%, post-natal depression (non-SMI) | Physical activity | Intervention: two consultations and two phone calls, aimed to equip individuals with the skills, knowledge and confidence needed to participate in regular exercise. Checklist exercise diary and pedometer also provided (12 weeks, F2F and phone) Control: TAU | PA: Godin leisure-time questionnaire | MH: Edinburgh Postnatal Depression Scale |
RCT, 2 | 85, intervention 32, control 29, 100%, post-natal depression (non-SMI) | Physical activity | Intervention: two personalised consultations centred on equipping women with the skills, knowledge and confidence needed to participate in regular exercise. Information leaflets, telephone support calls and a pedometer were also provided (6 months, F2F + phone) Control: sent the study “looking after yourself” leaflet at baseline and exercise was not further encouraged beyond receipt of this single leaflet | Weight: loss (kg) PA: IPAQ | BMI MH: Edinburgh Postnatal Depression Scale | |
Daumit, 2013, USA [62] | RCT, 2 | 288, 45, 50%, schizophrenia, schizoaffective disorder, bipolar disorder, major depression, other, (SMI only) | Weight, physical activity, diet | Intervention: three contact types: group weight-management sessions, individual weight-management sessions and group exercise (6 months, F2F) Control: standard nutrition and physical-activity information. Health classes offered quarterly, with content unrelated to weight | Weight: loss (kg) | BMI WC: cm |
Druss, 2010, USA [63] | RCT, 2 | 65, 48, 70%, bipolar disorder, schizophrenia, major depression, posttraumatic stress disorder (SMI only) | Physical activity, diet Medication management, chronic disease management | Intervention: monthly group sessions led by mental health peer specialists (6 months, F2F) Control: TAU | PA: Behavioural Risk Factor Surveillance System | |
Druss, 2018, USA [64] | RCT, 2 | 400, 50, 64%, schizophrenia, schizoaffective disorder, bipolar disorder, depression, obsessive-compulsive disorder, posttraumatic stress disorder (SMI only) | Physical activity, diet | Intervention: 6 group and one-on-one peer coaching sessions. Structured manual and worksheets to support development of key competencies and skills (np, F2F) Control: TAU | Diet: Block Fat-Sugar-Fruit-Vegetable Screener | |
Erickson, 2016, USA [65] | RCT, 2 | 108, 50, 11%, schizophrenia, schizoaffective disorder, bipolar disorder, other (SMI only) | Physical activity, diet | Intervention: 8 weekly education classes, followed by monthly booster classes for the remainder of the year. Small rewards (e.g. US $10 gift certificates) were provided for achieving weight loss and exercise goals. Group exercise activities led by instructors offered but optional (12 months, F2F) Control: participants were encouraged to exercise and eat healthy and were given publicly available, printed self-help materials regarding weight loss, exercise and nutrition | Weight: 5% loss | |
Erickson, 2017, USA [66] | RCT, 2 | 104, 51, 19%, schizophrenia, schizoaffective disorder, bipolar disorder, other (SMI only) | Weight, physical activity, diet | Intervention: 8 weekly education classes, followed by monthly booster classes for the remainder of the year, as well as individual nutrition counselling (12 months, F2F) Control: self-help educational handouts on health issues | Weight: loss (kg) PA: study specific | WC (cm) |
Evans, 2005, Australia [67] | RCT, 2 | 34, 34, 57%, schizophrenia, schizoaffective disorder, schizophreniform psychosis, bipolar disorder, depression (SMI only) | Physical activity, diet | Intervention: six individual nutrition education sessions plus passive nutritional education from the booklet Food for the Mind (3 months, F2F) Control: Food for the Mind booklet only | Weight: loss (kg) | BMI WC: cm |
Forsberg, 2008, Sweden [68] | CRCT, 2 | 35, intervention 40, control 43, 39%, schizophrenia, bipolar disorder, other psychotic disorder, other psychiatric diagnosis (SMI only) | Physical activity, diet | Intervention: study circles (5–12 residents) twice a week for one session on the diet and the other on physical activity (12 months, F2F) Control: aesthetic study circle as attention control focusing on non-health-related skills | Weight: loss (kg) PA: pedometer | BMI WC: cm |
Forsyth, 2015, Australia [69] | RCT, 2 | 94, range: 18–84, 28%, depression, anxiety (non-SMI) | Physical activity, diet | Intervention: based on Chronic Disease Management Plan Six visits to a dietician/exercise physiology (12 weeks, F2F) Control: participants received phone calls from the DEPs at similar intervals to the intervention consultations, but no advise | Weight: loss (kg) PA: Active Australia Survey Diet: Diet History Questionnaire | BMI MH: Depression Anxiety and Stress Scale |
CRCT, 2 | 325, 44, 42% psychotic disorder (SMI only) | Physical activity, diet Smoking, alcohol, other substance use | Intervention: patient-tailored IMPACT therapy, supported by a manual, a reference book and a service user handbook. Participants had the option to receive 3-monthly newsletters throughout the trial period (12 months, F2F) Control: all care coordinators in participating CMHTs offered best practice treatment as usual training on physical health awareness, including the provision of health promotion leaflets on healthy dietary routines and physical exercise, together with information on general and community support for a healthy lifestyle | PA: IPAQ | BMI WC: cm MH: Positive and Negative Syndrome Scale, Global Assessment of Functioning, Montgomery-Asberg Depression Rating Scale | |
Gillhoff, 2010, Switzerland [72] | RCT, 2 | 50, 48, 46%, bipolar disorder (SMI only) | Weight, physical activity, diet | Intervention: quality of life for persons with bipolar disorder programme. Seven lifestyle sessions, 4 nutrition sessions and weekly instructions pertaining to physical activity (5 months, F2F) Control: TAU | Weight: loss (kg) | BMI WC: cm |
Goldberg, 2013, USA [73] | RCT, 2 | 71, 52, 19%, schizophrenia or schizoaffective disorder, major depression, bipolar disorder, posttraumatic stress or anxiety disorder (SMI only) | Weight, physical activity, diet | Intervention: MOVE! programme. Psychoeducation including individual and group face-to-face counselling and telephone care individual sessions (6 months, F2F) Control: brochures and handouts about diet and exercise | Weight: loss (lb) PA: study specific Diet: study-specific question | WC: np |
Goracci, 2016, Italy [74] | RCT, 2 | 160, 49, 80%, bipolar disorder, recurrent unipolar depression (mixed) | Weight, physical activity, diet, mental health Sleep | Intervention: weekly sessions based on a comprehensive, standardized and integrated manualized programme. All information was adapted to both unipolar and bipolar patients and to Italian culture and habits (3 months, F2F) Control: TAU | Weight: loss (kg) | BMI WC: cm MH: Patient Health Questionnaire-9, Clinical Global Impression — Severity of Illness |
Green, 2014, USA [75] | RCT, 2 | 36, 49, 81%, np (taking antipsychotic medication) (SMI only) | Weight, physical activity, diet | Intervention: PREMIER, with adaptations. Weekly group sessions, including a half hour walk. Food and exercise diaries encouraged (12 weeks, F2F) Control: TAU | Weight: loss (lbs) | |
RCT, 2 | 200, 47, 72%, schizophrenia spectrum disorder, bipolar disorder or affective psychosis, posttraumatic stress disorder (SMI only) | Weight, physical activity, diet Sleep, blood pressure | Intervention: STRIDE. Weekly group meetings with 20 min of physical activity, supplemented by monthly individual telephone sessions. Participants were taught to keep records of food intake and received a workbook and a resistance band for strength training (12 months, F2F + phone) Control: TAU | Weight: loss (kg) | BMI | |
Gyllensten, 2017, Sweden [80] | CRCT, 2 | 73, 38, 41%, schizophrenia, Neuropsychiatric disorder, psychosis other, bipolar disorder, other (SMI only) | Physical activity | Intervention: exergames controlled by body movements integrated into supported housing (10 months, NA) Control: ordinary TV games in sitting position controlled by hand control | PA: physical activity habits | |
RCT, 2 | 340, 40, 49%, schizophrenia, schizoaffective disorder, first-episode psychosis (SMI only) | Weight, physical activity, diet | Intervention: STEPWISE intervention. Groups of participants attended a foundation course of four weekly sessions, followed by 1:1 support contact, mostly by telephone, approximately every 2 weeks for the remainder of the intervention period (12 months, F2F + phone) Control: printed advice on lifestyle and the risks associated with weight gain | Weight: loss (kg), % maintained or lost weight PA: accelerometer | BMI WC: cm MH: Brief Psychiatric Rating Scale, Patient Health Questionnaire-9 | |
Iglesias-Garcia, 2010, Spain [83] | RCT, 2 | 14, 40, 21%, schizophrenia (SMI only) | Physical activity, diet | Intervention: structured educative programme provided information and counselling on three domains: nutrition, exercise and healthy habits and self-esteem. Weekly sessions included structured information given to patients and group discussion lead by the nurse about any aspect of the programme (3 months, F2F) Control: attended to the clinic once a week to assess the anthropometric parameters | Weight: loss (kg) | BMI WC: cm |
RCT, 2 | 56, 40, 72%, severe depression (SMI only) | Diet, mental health | Intervention: 7 dietary support sessions, with a focus on increasing diet quality (12 weeks, F2F) Control: “befriending” as a form of attention control | PA: IPAQ Diet: ModiMedDiet | BMI MH: Montgomery-Asberg Depression Rating Scale, Hospital Anxiety and Depression Scale, Clinical Global Impression — Improvement Scale | |
Jean-Baptiste, 2007, USA [86] | RCT, 2 | 14, 47, 50%, schizophrenia, schizoaffective disorder (SMI only) | Weight, physical activity, diet | Intervention: weekly sessions using principles based on the LEARN programme. Exercise was encouraged and pedometers provided. Participants were provided with a specific listing of foods they could purchase and that they would be reimbursed for, up to US $25 a week (16 weeks, F2F) Control: TAU | Weight: loss (lb) | |
Khazaal, 2007, Switzerland [87] | RCT, 2 | 48, 41, 54%, schizophrenia, schizoaffective disorder, bipolar disorder, schizotypal disorder, other (depression, personality disorders) (SMI only) | Weight, diet | Intervention: weekly sessions. The apple-pie group was conceived as a handbook for a CBT treatment for severe psychiatric patients and adopts techniques such as Socratic questioning suited for patients with psychotic disorders (12 weeks, F2F) Control: an informative 2-h group session. At the end of the session, patients were given nutritional recommendations in the form of a written summary and were encouraged to refer frequently to these guidelines and maintain their effort to lose weight | Weight: loss (kg) | BMI |
RCT, 2 | 245, 55, 15%, schizophrenia, bipolar disorder, major depressive disorder, other SMI diagnosis (SMI only) | Physical activity, diet CVD risk behaviours | Intervention: Life Goals Collaborative Care included a self-management component, with 5 weekly group sessions, a care management component consisting of 6 monthly contacts and provider support in which the health specialist disseminates a care plan that includes patients’ health status and behaviour goals to their primary care and mental health providers after the last care management contact (12 months, F2F + phone) Control: TAU | PA: IPAQ | BMI WC: in MH: Patient Health Questionnaire-9, Generalized Anxiety Disorder 7-item, PTSD CheckList — Civilian Version, Internal State Scale (ISS), Behavior Symptom Identification Scale | |
Kwon, 2006, Korea [90] | RCT, 2 | 43, intervention 32, control 30, 52%, schizophrenia, schizoaffective disorder (SMI only) | Weight, physical activity, diet | Intervention: 8 sessions including education about keeping food and exercise diaries, eating behaviour improvement and lifestyle modification for weight control (12 weeks, F2F) Control: Food & exercise diaries only | Weight: loss (kg) | BMI |
Lee, 2014, USA [91] | RCT, 2 | 16, 44, 46%, Schizophrenia spectrum disorders, bipolar disorder, major depression (SMI only) | Physical activity, BMI, waist circumference Blood pressure | Intervention: weekly phone calls, involving behavioural counselling for physical activity that included goal setting, self-monitoring, feedback on goal achievement and social support. Pedometer supplied (8 weeks, phone) Control: written information regarding physical activity (e.g. exercise suggestions) | PA: IPAQ | BMI WC: in |
Littrell, 2003, USA [92] | RCT, 2 | 70, 34, 39%, schizophrenia, schizoaffective disorder (SMI only) | Weight, physical activity, diet | Intervention: weekly psychoeducation classes using “Solutions for Wellness” modules (16 weeks, F2F) Control: TAU | Weight: maintenance (lb) | BMI |
Lovell, 2014, UK [93] | RCT, 2 | 93, 26, 40%, schizophrenia, schizoaffective disorder, schizophrenia spectrum disorder, NOS (SMI only) | Weight, physical activity, diet | Intervention: 8 individual psychoeducation sessions, including optional group activities, plus a booklet and website to provide additional support (12 months, F2F) Control: TAU | Weight: loss (kg) PA: IPAQ Diet: food frequency questionnaire | BMI WC: cm MH: Calgary Depression Scale |
Marzolini, 2009, Canada [94] | RCT, 2 | 13, 45, 38%, schizophrenia, schizoaffective disorder (SMI only) | Physical activity, mental health | Intervention: twice weekly supervised group exercise sessions (12 weeks, F2F) Control: TAU | Weight: loss (kg) | BMI WC: cm MH: Mental Health Inventory |
RCT, 2 | 332, 47, 45% schizophrenia, schizoaffective disorder, bipolar disorder (SMI-only) | Physical activity, diet | Intervention: 8 group sessions focusing on physical activity, with the aim for participants to reach 10,000 steps per day, plus 16 group sessions providing basic knowledge about healthy dietary habits, with a focus on a Mediterranean diet for cardiovascular protection. Included food diary (6 months, F2F) Control: TAU | PA: IPAQ Diet: PREvención con DIetaMEDiterránea” (PREDIMED) | BMI WC: cm MH: Clinical Global Impressions Scale | |
Mauri, 2008, Italy [97] | RCT, 2 | 33, 39, 58%, bipolar I disorder, bipolar II disorder, schizoaffective disorders, psychotic depression SMI only | Physical activity, diet | Intervention: psychoeducation programme consisting of consecutive intensive weekly meetings with the goal of obtaining a weight loss of 2 kg/month. The programme was adapted to psychiatric patients by simplifying some steps (12 weeks, F2F) Control: TAU | Weight: loss (kg) | BMI MH: Global Assessment Scale of Functioning |
McCreadie, 2005, UK [98] | CRCT, 3 | 91, 45, 29%, schizophrenia (SMI only) | Diet | Intervention: free fruit and vegetables provided for a period of 6 months and associated instructions. Such instruction included meal planning and the purchase, storage and preparation of food, with particular reference to fruit and vegetables (6 months, F2F) Control: TAU Comparison 2: receive free fruit and vegetables for a period of 6 months (no instructions) | Diet: Scottish Health Survey Questionnaire | MH: Positive and Negative Syndrome Scale |
RCT, 2 | 57, intervention 53, control 55, 35%, schizophrenia, schizoaffective disorder (SMI only) | Physical activity, diet Blood sugar | Intervention: Diabetes Awareness and Rehabilitation Training (DART) comprised a 24-week intervention with three modules. Participants met in groups with 6 to 8 of their peers and one diabetes-trained mental health professional (6 months, F2F) Control: 3 brochures from the American Diabetes Association relevant to diabetes management | Weight: loss (lb) PA: accelerometer, Yale Physical Activity Scale | BMI WC: in | |
RCT, 3 | 207, intervention 56, control 54, comparison 54, 4%, schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder with psychosis, posttraumatic stress disorder (SMI only) | Weight, physical activity, diet | Intervention: two online modules per week (6 months, web) Control: educational handout on the benefits of weight loss Comparison 2: Move SMI. Same content as intervention but in F2F format | Weight: loss (kg), 5% loss PA: IPAQ | BMI | |
CRCT, 2 | 289, 51, 53%, schizophrenia, schizoaffective disorder, bipolar affective disorder, other psychoses (SMI only) | Weight, physical activity, diet Smoking, alcohol, other CVD risk measures | Intervention: weekly or fortnightly appointments with a nurse or health-care assistant to develop and discuss goals to lower CVD risk (6 months, F2F) Control: TAU + British Heart Foundation leaflets | PA: IPAQ | BMI WC: cm | |
RCT, 2 | 44, 44, 48%, depression (non-SMI) | BMI, mental health, sedentary behaviour Sleep, blood pressure | Intervention: behavioural activation programme consisting of up to 12 support sessions, plus physical activity promotion (4 months, F2F and/or phone) Control: behavioural activation programme only | PA: accelerometer | MH: Clinical Interview Schedule-Revised, Patient Health Questionnaire-9 Sedentary behaviour: Accelerometer | |
Petzold, 2018, Germany [107] | RCT, 2 | 83, 49, 72%, mental and behavioural disorders due to psychoactive substance abuse, schizophrenia, schizotypal and delusional disorders, mood disorders, neurotic stress-related and somatoform disorders (mixed) | Physical activity, diet, mental health | Intervention: MoVo-LISA, a psychological group intervention to increase physical activity. Two group sessions and one single session to discuss benefits and barriers to physical activity, individual goals and plans (1 week, F2F) Control: a healthy diet intervention which used behavior change strategies exactly MoVo-LISA but targeted a healthy diet instead of physical activity. | PA: IPAQ, pedometer Diet: dietary pattern index | |
Ratliff, 2012, USA [108] | RCT, 3 | 26, intervention 49, control 47, comparison 50, 43%, schizophrenia, schizoaffective disorder, NOS (SMI only) | Weight, physical activity, diet | Intervention: SIMPLE programme, specifically designed to be used with SMI populations. Individuals in the contingency management attendance group received monetary reward for each of the 8 weight loss groups they attended (8 weeks, F2F) Control: instructed to continue with their habitual patterns of eating and activity Comparison: SIMPLE programme, received monetary reward for weight loss | Weight: loss (kg) PA: Godin leisure-time questionnaire | BMI WC: cm |
Skinar, 2005, USA [109] | RCT, 2 | 20, intervention, 40 control, 36, 66%, mood or psychotic disorder (SMI only) | Weight, physical activity, diet Stress | Intervention: exercise sessions (4 p/week) + weekly health seminars (12 weeks, F2F) Control: asked to journal their physical activity | Weight: loss (kg) | BMI MH: Symptom Checklist — 90 |
RCT, 3 | 428, 39, 56%, schizophrenia, schizoaffective disorder, persistent delusional disorder (SMI-only) | Physical activity, diet Smoking | Intervention: CHANGE lifestyle coaching. Weekly home visits with systematic exploration of possibilities for physical activity in daily life (12 months, F2F) Control: TAU Comparison 2: CARE. Care coordinator facilitated contact to primary care in order to ensure that the patients received optimal treatment of physical health problems | Weight: loss (kg) PA: Physical Activity Scale Diet: dietary quality score | BMI WC: cm MH: Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms Sedentary behaviour: Physical Activity Scale | |
Strom, 2013, Sweden [113] | RCT, 2 | 48, 49, 83%, depression (non-SMI) | Physical activity | Intervention: weekly modules in a guided self-help programme administered through an Internet-based system. Pedometers provided (9 weeks, web) Control: wait list | PA: IPAQ | MH: Montgomery-Asberg Depression Rating Scale, Beck Depression Inventory: Second Version, Beck Anxiety Inventory |
RCT, 2 | 101, np, 47%, schizophrenia, depression, bipolar disorder, anxiety, (SMI only) | Weight, physical activity, diet, BMI, waist circumference Medication compliance | Intervention: weekly education sessions and discussion on healthy lifestyle topics and participants’ progress with the implementation of healthy lifestyle components into their everyday life (12 weeks, F2F) Control: education booklet | Weight: loss (kg) | BMI WC: cm | |
Weber, 2006, USA [116] | RCT, 2 | 15, np, 71%, schizophrenia, schizoaffective disorder (SMI only) | Weight, physical activity, diet | Intervention: weekly group sessions based on cognitive/behavioural strategies to promote risk reduction that was demonstrated successful in the Diabetes Prevention Project (DPP). Each person kept a food and activity diary which was turned in at the beginning of each session (16 weeks, F2F) Control: TAU | Weight: loss (lb) | BMI |