A 6-month randomized controlled trial to test the efficacy of a lifestyle intervention for weight gain management in schizophrenia

Background: Patients with schizophrenia have lower longevity than the general population as a consequence of a combination of risk factors connected to the disease, lifestyle and the use of medications, which are related to weight gain.Methods: A multicentric, randomized, controlled-trial was conducted to test the efficacy of a 12-week group Lifestyle Wellness Program (LWP). the program consists of a one-hour weekly session to discuss topics like dietary choices, lifestyle, physical activity and self-esteem with patients and their relatives. Patients were randomized into two groups: standard care (SC) and standard care plus intervention (LWP). Primary outcome was defined as the weight and body mass index (BMI).Results: 160 patients participated in the study (81 in the intervention group and 79 in the SC group). On an intent to treat analysis, after three months the patients in the intervention group presented a decrease of 0.48 kg (CI 95% - 0.65 to 1.13) while the standard care group showed an increase of 0.48 kg (CI 95% 0.13 to 0.83; p=0.055). At six-month follow-up, there was a significant weight decrease of -1.15 kg, (CI 95% -2.11 to 0.19) in the intervention group compared to a weight increase in the standard care group (+0.5 kg, CI 95% -0.42-1.42, p=0.017).Conclusion: in conclusion, this was a multicentric randomized clinical trial with a lifestyle intervention for individuals with schizophrenia, where the intervention group maintained weight and presented a tendency to decrease weight after 6 months. It is reasonable to suppose that lifestyle interventions may be important long-term strategies to avoid the tendency of these individuals to increase weight. Clinicaltrials.gov identifier: NCT01368406Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Eli Lilly do BrasilCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Ministry of EducationJanssen-CilagNovartisRocheConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundacao SafraFundacao ABRADSLundbeckEli Lilly laboratoryUniversidade Federal de São Paulo, Dept Psychiat, BR-04044000 São Paulo, BrazilUniv São Paulo, Med School, Dept & Inst Psychiat, BR-05403010 São Paulo, BrazilCAISM Ctr Atencao Integrada Saude Mental Irmandad, BR-04017030 São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Med, Div Endocrinol, BR-04039002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, BR-04044000 São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Med, Div Endocrinol, BR-04039002 São Paulo, BrazilFAPESP: 2007/00464-6Web of Scienc

A Preliminary Controlled Trial of Cognitive Behavioral Therapy in Clozapine-Resistant Schizophrenia

The use of cognitive-behavior therapy (CBT) in addition to antipsychotic regimen to treat persistent psychotic symptoms of schizophrenia is growing. The aim of this study was to compare the efficacy of CBT to a befriending (BF) control group in patients with schizophrenia who are refractory to clozapine. Twenty-one patients completed the 21-week trial. In comparison with the control group, the CBT group showed a significant improvement in the General Psychopathology and total score of the Positive and Negative Syndrome Scale, as well as an improvement Of Quality of Life scale. The improvement in psychopathology persisted at 6-month follow-up assessment