Nurse-led lifestyle intervention in a cohort of schizophrenia patients treated with clozapine.
Andrea Mallorquí, Cristina Oliveira, Jose Rios, Maria Pilar Isla-Pera, Joaquin Gil-Badenes, Silvia Amoretti, Miguel Bernardo, Eduard Vieta, Eduard Parellada, Marina Garriga, Clemente García-Rizo
Author Information
Andrea Mallorquí: Neurosciences Institute, Hospital Clinic of Barcelona, Barcelona, Spain; Jaume I University, Castellón, Spain. Electronic address: amallorq@clinic.cat.
Cristina Oliveira: University of Coimbra, Portugal.
Jose Rios: Medical Statistics Core Facility, Hospital Clinic Barcelona, Barcelona, Spain; Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Maria Pilar Isla-Pera: Public Health, Mental Health and Maternal Department, Universitat de Barcelona, Campus de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain.
Joaquin Gil-Badenes: Barcelona Clinic Schizophrenia Unit (BCSU), Neurosciences Institute, Hospital Clinic Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.
Silvia Amoretti: Department of Psychiatry, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.
Miguel Bernardo: Barcelona Clinic Schizophrenia Unit (BCSU), Neurosciences Institute, Hospital Clinic Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.
Eduard Vieta: Bipolar and Depressive Disorders Unit, Neurosciences Institute, Hospital Clinic Barcelona, Barcelona, Spain; University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
Eduard Parellada: Barcelona Clinic Schizophrenia Unit (BCSU), Neurosciences Institute, Hospital Clinic Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.
Marina Garriga: Bipolar and Depressive Disorders Unit, Neurosciences Institute, Hospital Clinic Barcelona, Barcelona, Spain; University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain. Electronic address: magarriga@clinic.cat.
Clemente García-Rizo: Barcelona Clinic Schizophrenia Unit (BCSU), Neurosciences Institute, Hospital Clinic Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.
Patients diagnosed with schizophrenia are characterized by early mortality compared to the general population. The main cause of this premature death reflects medical complications linked to metabolic syndrome (MetS). The use of antipsychotics such as clozapine is associated with weight gain and metabolic disturbances in certain predisposed individuals. Non-pharmacological interventions for weight control have become a key element for secondary prevention in the health of patients diagnosed with schizophrenia. Here, we aim to evaluate the physical health effects of a nurse-led non-pharmacological intervention program in patients with a diagnosis of schizophrenia treated with clozapine. Thirty-one outpatients from the outpatient clinical facility of Hospital Clinic in Barcelona, Spain diagnosed with schizophrenia and other psychotic disorders receiving clozapine treatment were enrolled in a prospective interventional study, comprising an 8-week group program of therapeutic education in a healthy lifestyle. MetS factors, physical activity, diet, and lifestyle were evaluated at baseline, post-intervention (8 weeks), and 3 months after the program. Weight, body mass index, high-density lipoprotein cholesterol, and diet patterns displayed significant differences post-intervention and after 3 months, while only waist, hip perimeter, and lifestyle improved post-intervention. Our results suggest the effectiveness of the lifestyle intervention in patients under clozapine treatment despite its long-time differential effect. Strategies to prevent weight gain and metabolic decline will help prevent premature cardiometabolic disease in this vulnerable population.
