A single-blind, randomised controlled trial of a physical health nurse intervention to prevent weight gain and metabolic complications in first-episode psychosis: the Physical Health Assistance in Early Psychosis (PHAstER) study

[摘要] Background Factors that contribute to the early mortality observed inpsychotic disorders, specifically obesity, smoking and sedentarybehaviour, occur early in the disorder.AimsWe aimed to determine whether the integration of a physicalhealth nurse in the care of young people with first-episodepsychosis could prevent clinically significant weight gain (≥7%body weight). Secondary outcomes included rates of smoking,metabolic syndrome and sedentary behaviour.MethodIn this single-blind, randomised controlled trial, participants whohad received under 4 weeks of antipsychotic medication wererandomly allocated to either the intervention (addition of aphysical health nurse to their care) or treatment as usual (TAU)for 12 weeks.ResultsOf the 77 participants, there were follow-up data for 86.8% (n =33) of the intervention group and 82.1% (n = 32) of the TAU group.After 12 weeks, 27.3% of the intervention group experiencedclinically significant weight gain compared with 34.4% of the TAUgroup (odds ratio 0.72, 95% CI 0.25–2.06, P = 0.54). After 6months, 40.7% of the intervention group gained clinically significant weight compared with 44.1% of the TAU group (P = 0.79).There was no difference in mean change in weight betweengroups after 12 weeks (2.6 kg v. 2.9 kg, P = 0.87) or 6 months(3.6 kg v. 4.3 kg, P = 0.64). There were no differences in the ratesof tobacco smoking cessation, prevalence of metabolicsyndrome or physical activity levels.ConclusionsThis intervention failed to prevent the metabolic complicationsthat are highly prevalent in psychotic disorders in the short tomedium term, indicating that more intensive interventions arerequired.

[学科分类] 计算机科学（综合）

[关键词] Psychotic disorders;antipsychotics;metabolic syndrome;obesity;schizophrenia