1. Lifestyle and psychosocial functioning A. P. M. Stiekema 1, A. Looijmans 2, L. van der Meer 13, R. Bruggeman 4, R. A. Schoevers 5, E. Corpeleijn 2, F. Jörg 4,6 1. Department of Rehabilitation, Lentis Mental Health Care, Zuidlaren, Netherlands. 2. Epidemiology, University Medical Center Groningen, Groningen, The Netherlands 3. BCN Neuroimaging Center, University Medical Center Groningen, Groningen, Netherlands. email: a.stiekema@lentis.nl phone: 0031 (0)50 409 7662 4. Rob Giel Research center, University Medical Center Groningen, Groningen, Netherlands. 5. Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands. 6. Department of Research and Education, Friesland Mental Health, Leeuwarden, The Netherlands The effect of a lifestyle intervention on psychosocial functioning and well-being in patients with severe mental illness 1 Hennekens CH, Hennekens AR, Hollar D, Casey DE, 2005. Schizophrenia and increased risks of cardiovascular disease, Am. Heart J., 150(6), 1115–1121. 2 Meyer JM, Stahl SM (2009). The metabolic syndrome and schizophrenia. Acta Psychiatr Scand 119: 4–14. 3 Onken SJ, Dumont JM, Ridgway P, Dornan D, Ralph R, 2002. Mental Health Recovery: What helps and what hinders? Report to the National Technical Assistance Center for State Mental Health Planning, National Association of State Mental Health Program Directors, Alexandria, VA. *MANSA: Manchester Short Assessment of Quality of Life; HoNOS: Health of the Nation Outcome Scale; CDSS: Calgary Depression Scale for Schizophrenia; PANSS-r: Positive And Negative Syndrome Scale-remission. Background The shorter life expectancy of severe mentally ill (SMI) patients is partly due to increased risk on cardiometabolic diseases 1, which is related to an unhealthy lifestyle 2. Studies investigating lifestyle interventions in SMI residential patients are lacking. Objective Assess the effect of a lifestyle intervention for SMI residential patients on 1)risk factors for cardiometabolic syndrome 2)psychosocial effects. Methods Random assignment of 29 long- term care teams to the lifestyle intervention (INT) or treatment as usual (TAU). n INT =400; n TAU =414; mainly with a psychotic disorder. Assessments at baseline, 3 and 12 months. Outcomes: waist circumference, quality of life (MANSA * ), psychosocial functioning (HoNOS * ), depression (CDSS * ), symptomatology (PANSS-R * ). Analysis: linear mixed models adjusted for baseline scores (intention-to-treat analysis). The intervention Lifestyle interventions were aimed at team level. Lifestyle coach students set up a diet-and- exercise intervention program to change the obesogenic environment and stimulate health behaviors (e.g. workshops on healthy diet, more exercise activities). After three months, staff members took over the program activities, supported by a lifestyle coach. Conclusion A lifestyle intervention addressing the obesogenic environment of severe mentally ill residential patients shows no improvements in waist circumference or psychosocial outcomes after 12 months in intention-to-treat analysis. Throughout the study, patients were mostly satisfied with their quality of life, reported nearly absence of depressive symptoms, showed only minor problems in psychosocial functioning, and reported only mild psychotic symptoms, leaving few room for improvement. As research has shown that improvement in long-term hospitalized patients is a slow process 3, further research should examine the long-term effect of a lifestyle intervention on psychosocial well-being. Results There were no significant differences in waist circumference, quality of life, psychosocial functioning, depression and symptomatology (all p’s > 0.05). Figure 2. Quality of Life. Higher scores reflect better quality of life. Mean MANSA total score (range 12–84) Mean PANSS-r total score (range 8–56) Mean CDSS total score (range 0–27) Mean HoNOS total score (range 0–48) Figure 3. Depression. Higher scores reflect more depressive symptoms. Figure 4. Psychosocial functioning. Higher scores reflect worse functioning. Figure 5. Psychotic symptoms. Higher scores reflect more (severe) symptoms. Mean waist circumference Figure 1. Waist circumference.