生活方式改变对精神分裂症患者抗精神病药物的影响

Nagda Elmasry, Eman Ali, Rofaida Abdelmoez
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Patients and methods A total of 36 patients underwent programmed lifestyle modification, which include pharmacological intervention and lifestyle interventions, including psychoeducational, dietary, and exercise programs. The psychoeducational program focused on the roles of eating and activity in weight management. Dietary program included individualized well-balanced diet plan for each patient by a clinical nutritionist in the hospital according to patient’s measurements, physical health, and acceptance. Exercise program included aerobic exercise intervention and stretching-toning control program, which was planned by the physical trainer of the hospital in the playground. Assessment is done at the beginning of the study and monthly through 3-month duration. We used Positive and Negative Syndrome Scale to assess and follow-up symptoms of schizophrenia, GASS for follow-up of adverse effects of antipsychotics, and Health Promoting Lifestyle Profile Scale II to detect the effect of lifestyle modification. Results The mean age of the studied group of patients was 34.5±5.87 years, with 56.41% of them being male. Overall, 25% of patients were found to have MetS at the beginning of the study, and after 3 months of commitment to the program of lifestyle modification, they decreased to 16.67%. There was a significant difference between the studied participants regarding metabolic parameters throughout the 3 months. There was significant improvement in all other dimensions of Positive and Negative Syndrome Scale and significant improvement in total GASS scale after the second months of commitment of lifestyle modification, with significant improvement in all dimension except for cardiovascular and screening for diabetes. 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引用次数: 0

摘要

精神分裂症影响身体健康,表现为行为改变,如体力活动减少、倾向于孤立,以及饮食行为改变,包括食物(垃圾食品和脂肪)摄入量增加和糖摄入量增加。精神分裂症患者倾向于增加香烟和咖啡因的摄入量。所有这些都会对身体健康产生不良影响,因为它们增加了发生合并症的风险,如高血压、糖尿病和代谢综合征(MetS)。虽然精神分裂症有治疗方法,但它有严重的副作用,包括嗜睡和行动迟缓、体重增加、干扰性生活,以及增加患糖尿病和高血压的机会。患者和方法共有36例患者接受了程序性生活方式改变,包括药物干预和生活方式干预,包括心理教育、饮食和运动计划。心理教育项目侧重于饮食和活动在体重管理中的作用。饮食计划包括由医院的临床营养师根据患者的测量、身体健康和接受程度为每位患者制定个性化的均衡饮食计划。运动方案包括有氧运动干预和拉伸-塑形控制方案,由医院体能教练在操场策划。评估在研究开始时进行,每月进行一次,持续3个月。采用阳性和阴性综合征量表对精神分裂症的症状进行评估和随访,采用GASS对抗精神病药物不良反应进行随访,采用健康促进生活方式量表II检测生活方式改变的效果。结果研究组患者平均年龄34.5±5.87岁,男性占56.41%。总体而言,25%的患者在研究开始时发现有MetS,在3个月的生活方式改变计划后,这一比例降至16.67%。在整个3个月内,研究参与者之间的代谢参数有显著差异。在生活方式改变的第二个月后,阳性和阴性综合征量表的所有其他维度都有显著改善,总GASS量表也有显著改善,除心血管和糖尿病筛查外,所有维度都有显著改善。结论精神分裂症和抗精神病药物对患者的生活方式有影响,使其更易患高血压、糖尿病、MetS等医学合并症,并对久坐生活、饮食和吸烟有影响。这可以通过实施生活方式改变计划来避免,该计划旨在改善生活质量,减轻精神分裂症的症状,并通过增加对治疗的坚持来减少复发的次数。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of lifestyle modification on schizophrenia patients on antipsychotics
Background Schizophrenia affects physical health, represented in the form of change in behavior, such as decrease in physical activity, tendency to isolation, and changes in eating behavior, including increase intake of food (junk food and fat) and increase in consumption of sugar. Patients with schizophrenia tent to increase consumption of cigarettes and caffeine. All of these contribute toward having a bad effect on physical health, as they increased the risk of occurrence of comorbid diseases, such as hypertension, diabetes mellitus, and metabolic syndrome (MetS). Although there is treatment for schizophrenia, it has serious adverse effects, including sleepiness and slowness, weight gain, interference with sex life, and increased chance of developing diabetes and hypertension. Patients and methods A total of 36 patients underwent programmed lifestyle modification, which include pharmacological intervention and lifestyle interventions, including psychoeducational, dietary, and exercise programs. The psychoeducational program focused on the roles of eating and activity in weight management. Dietary program included individualized well-balanced diet plan for each patient by a clinical nutritionist in the hospital according to patient’s measurements, physical health, and acceptance. Exercise program included aerobic exercise intervention and stretching-toning control program, which was planned by the physical trainer of the hospital in the playground. Assessment is done at the beginning of the study and monthly through 3-month duration. We used Positive and Negative Syndrome Scale to assess and follow-up symptoms of schizophrenia, GASS for follow-up of adverse effects of antipsychotics, and Health Promoting Lifestyle Profile Scale II to detect the effect of lifestyle modification. Results The mean age of the studied group of patients was 34.5±5.87 years, with 56.41% of them being male. Overall, 25% of patients were found to have MetS at the beginning of the study, and after 3 months of commitment to the program of lifestyle modification, they decreased to 16.67%. There was a significant difference between the studied participants regarding metabolic parameters throughout the 3 months. There was significant improvement in all other dimensions of Positive and Negative Syndrome Scale and significant improvement in total GASS scale after the second months of commitment of lifestyle modification, with significant improvement in all dimension except for cardiovascular and screening for diabetes. Conclusion Schizophrenia and antipsychotics have an effect on lifestyle of the patients, leading to more exposure of them to medical comorbidities such as hypertension, diabetes mellitus, and MetS, and it also effects the sedentary life, diet, and smoking. This can be avoided by applying a lifestyle modification program that targets to improve quality of life, symptoms of schizophrenia, and decreased number of relapses by increasing adherence to treatment.
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