EPA guidance on lifestyle interventions for adults with severe mental illness: A meta-review of the evidence

There is growing interest in lifestyle interventions as stand-alone and add-on therapies in mental health care due to their potential benefits for both physical and mental health outcomes. We evaluated lifestyle interventions focusing on physical activity, diet, and sleep in adults with severe menta...

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Main Authors: Isabel Maurus, Sarah Wagner, Johanna Spaeth, Anastasia Vogel, Susanne Muenz, Valentina Seitz, Peter von Philipsborn, Marco Solmi, Joseph Firth, Brendon Stubbs, Davy Vancampfort, Mats Hallgren, Tamás Kurimay, Markus Gerber, Christoph U. Correll, Wolfgang Gaebel, Hans-Jürgen Möller, Andrea Schmitt, Alkomiet Hasan, Peter Falkai
Format: Article
Language:English
Published: Cambridge University Press 2024-01-01
Series:European Psychiatry
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Online Access:https://www.cambridge.org/core/product/identifier/S0924933824017668/type/journal_article
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author Isabel Maurus
Sarah Wagner
Johanna Spaeth
Anastasia Vogel
Susanne Muenz
Valentina Seitz
Peter von Philipsborn
Marco Solmi
Joseph Firth
Brendon Stubbs
Davy Vancampfort
Mats Hallgren
Tamás Kurimay
Markus Gerber
Christoph U. Correll
Wolfgang Gaebel
Hans-Jürgen Möller
Andrea Schmitt
Alkomiet Hasan
Peter Falkai
author_facet Isabel Maurus
Sarah Wagner
Johanna Spaeth
Anastasia Vogel
Susanne Muenz
Valentina Seitz
Peter von Philipsborn
Marco Solmi
Joseph Firth
Brendon Stubbs
Davy Vancampfort
Mats Hallgren
Tamás Kurimay
Markus Gerber
Christoph U. Correll
Wolfgang Gaebel
Hans-Jürgen Möller
Andrea Schmitt
Alkomiet Hasan
Peter Falkai
author_sort Isabel Maurus
collection DOAJ
description There is growing interest in lifestyle interventions as stand-alone and add-on therapies in mental health care due to their potential benefits for both physical and mental health outcomes. We evaluated lifestyle interventions focusing on physical activity, diet, and sleep in adults with severe mental illness (SMI) and the evidence for their effectiveness. To this end, we conducted a meta-review and searched major electronic databases for articles published prior to 09/2022 and updated our search in 03/2024. We identified 89 relevant systematic reviews and assessed their quality using the SIGN checklist. Based on the findings of our meta-review and on clinical expertise of the authors, we formulated seven recommendations. In brief, evidence supports the application of lifestyle interventions that combine behavioural change techniques, dietary modification, and physical activity to reduce weight and improve cardiovascular health parameters in adults with SMI. Furthermore, physical activity should be used as an adjunct treatment to improve mental health in adults with SMI, including psychotic symptoms and cognition in adults with schizophrenia or depressive symptoms in adults with major depression. To ameliorate sleep quality, cognitive behavioural informed interventions can be considered. Additionally, we provide an overview of key gaps in the current literature. Future studies should integrate both mental and physical health outcomes to reflect the multi-faceted benefits of lifestyle interventions. Moreover, our meta-review highlighted a relative dearth of evidence relating to interventions in adults with bipolar disorder and to nutritional and sleep interventions. Future research could help establish lifestyle interventions as a core component of mental health care.
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spelling doaj-art-55028e0e25964ecf9e22ca7a779a5ff72024-12-10T14:10:29ZengCambridge University PressEuropean Psychiatry0924-93381778-35852024-01-016710.1192/j.eurpsy.2024.1766EPA guidance on lifestyle interventions for adults with severe mental illness: A meta-review of the evidenceIsabel Maurus0https://orcid.org/0000-0002-6208-5180Sarah Wagner1Johanna Spaeth2https://orcid.org/0009-0007-6550-0638Anastasia Vogel3Susanne Muenz4https://orcid.org/0000-0002-1088-8459Valentina Seitz5https://orcid.org/0009-0002-6129-2425Peter von Philipsborn6https://orcid.org/0000-0001-7059-6944Marco Solmi7https://orcid.org/0000-0003-4877-7233Joseph Firth8Brendon Stubbs9Davy Vancampfort10Mats Hallgren11Tamás Kurimay12https://orcid.org/0000-0002-5996-8417Markus Gerber13https://orcid.org/0000-0001-6140-8948Christoph U. Correll14https://orcid.org/0000-0002-7254-5646Wolfgang Gaebel15Hans-Jürgen Möller16Andrea Schmitt17https://orcid.org/0000-0002-5426-4023Alkomiet Hasan18Peter Falkai19Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, GermanyDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, GermanyDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, GermanyDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, GermanyDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, GermanyDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, GermanyInstitute for Medical Information Processing, Biometry and Epidemiology (IBE), Munich, Germany Pettenkofer School of Public Health, Ludwig-Maximilians-University Munich, Munich, GermanyDepartment of Psychiatry, University of Ottawa, Ontario, Canada Regional Centre for the Treatment of Eating Disorders and On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, University of Ottawa, Ontario, Canada Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, GermanyDivision of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UKInstitute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UKKU Leuven Department of Rehabilitation Sciences, Leuven, BelgiumDepartment of Public Health Sciences, Karolinska Institutet, Solna, Sweden Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne, AustraliaNorth-Buda Saint John Central Hospital, Buda Family Centered Mental Health Centre, Department of Psychiatry and Psychiatric Rehabilitation, Teaching Department of Semmelweis University, Budapest, HungaryDepartment of Sport, Exercise and Health (DSBG), University of Basel, SwitzerlandDepartment of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA German Center for Mental Health (DZPG), Berlin, GermanyDepartment of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Duesseldorf, Germany WHO Collaborating Centre DEU-131, LVR-Klinikum Düsseldorf, Duesseldorf, GermanyDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, GermanyDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, São Paulo, BrazilDepartment of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany German Center for Mental Health (DZPG), Munich/Augsburg, GermanyDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany German Center for Mental Health (DZPG), Munich/Augsburg, Germany Max Planck Institute of Psychiatry, Munich, GermanyThere is growing interest in lifestyle interventions as stand-alone and add-on therapies in mental health care due to their potential benefits for both physical and mental health outcomes. We evaluated lifestyle interventions focusing on physical activity, diet, and sleep in adults with severe mental illness (SMI) and the evidence for their effectiveness. To this end, we conducted a meta-review and searched major electronic databases for articles published prior to 09/2022 and updated our search in 03/2024. We identified 89 relevant systematic reviews and assessed their quality using the SIGN checklist. Based on the findings of our meta-review and on clinical expertise of the authors, we formulated seven recommendations. In brief, evidence supports the application of lifestyle interventions that combine behavioural change techniques, dietary modification, and physical activity to reduce weight and improve cardiovascular health parameters in adults with SMI. Furthermore, physical activity should be used as an adjunct treatment to improve mental health in adults with SMI, including psychotic symptoms and cognition in adults with schizophrenia or depressive symptoms in adults with major depression. To ameliorate sleep quality, cognitive behavioural informed interventions can be considered. Additionally, we provide an overview of key gaps in the current literature. Future studies should integrate both mental and physical health outcomes to reflect the multi-faceted benefits of lifestyle interventions. Moreover, our meta-review highlighted a relative dearth of evidence relating to interventions in adults with bipolar disorder and to nutritional and sleep interventions. Future research could help establish lifestyle interventions as a core component of mental health care.https://www.cambridge.org/core/product/identifier/S0924933824017668/type/journal_articleaffective disorderdietexerciseschizophreniasleep
spellingShingle Isabel Maurus
Sarah Wagner
Johanna Spaeth
Anastasia Vogel
Susanne Muenz
Valentina Seitz
Peter von Philipsborn
Marco Solmi
Joseph Firth
Brendon Stubbs
Davy Vancampfort
Mats Hallgren
Tamás Kurimay
Markus Gerber
Christoph U. Correll
Wolfgang Gaebel
Hans-Jürgen Möller
Andrea Schmitt
Alkomiet Hasan
Peter Falkai
EPA guidance on lifestyle interventions for adults with severe mental illness: A meta-review of the evidence
European Psychiatry
affective disorder
diet
exercise
schizophrenia
sleep
title EPA guidance on lifestyle interventions for adults with severe mental illness: A meta-review of the evidence
title_full EPA guidance on lifestyle interventions for adults with severe mental illness: A meta-review of the evidence
title_fullStr EPA guidance on lifestyle interventions for adults with severe mental illness: A meta-review of the evidence
title_full_unstemmed EPA guidance on lifestyle interventions for adults with severe mental illness: A meta-review of the evidence
title_short EPA guidance on lifestyle interventions for adults with severe mental illness: A meta-review of the evidence
title_sort epa guidance on lifestyle interventions for adults with severe mental illness a meta review of the evidence
topic affective disorder
diet
exercise
schizophrenia
sleep
url https://www.cambridge.org/core/product/identifier/S0924933824017668/type/journal_article
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