Effectiveness of a cognitive behavioral weight management intervention in obese patients with psychotic disorders compared to patients with nonpsychotic disorders or no psychiatric disorders: results from a 12-month, real-world study.
Effectiveness of a cognitive behavioral weight management intervention in obese patients with psychotic disorders compared to patients with nonpsychotic disorders or no psychiatric disorders: results from a 12-month, real-world study.
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与非精神障碍或无精神障碍的肥胖患者相比，认知行为体重管理干预对患有精神障碍的肥胖患者的有效性：一项为期 12 个月的真实世界研究的结果。
DOI：
10.1097/jcp.0b013e31825cccd2
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发表时间：
2012
影响因子：
2.9
通讯作者：
Correll,ChristophU
中科院分区：
文献类型：
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作者：
Zhang,Jian-Ping;Weiss,JeffreyJ;McCardle,Melissa;Klopchin,Hope;Rosendahl,Eileen;Maayan,Lawrence;Convit,Antonio;Kane,JohnM;Manu,Peter;Correll,ChristophU
精神障碍患者的行为减肥干预研究很少，与其他肥胖患者相比的疗效尚不清楚。因此，我们比较了认知行为减肥干预在患有精神障碍、其他精神疾病和没有精神疾病的肥胖受试者中的效果。MethodsA对222名连续入选的肥胖患者进行了为期12个月的自然主义研究，每周进行一次团体或个人认知行为体重管理（体重指数[BMI]，43.7±9.6 kg/m2）（PSD，n= 47），其他精神疾病（OPD，n= 49），无精神疾病（NPD，结果PSD患者的治疗持久性较好治疗时间（8.7±4.4个月）明显长于门诊（22.4%和5.4±4.3个月）和非门诊（22.2%和4.9±4.7个月）（均P< 0.01;需治疗人数3）。在末次观察值结转分析中，PSD患者在12个月时的基线体重减轻百分比更高（5.1%±9.3%），高于OPD和NPD患者（2.7%±5.5%和2.4%±6.3%）; 9个月和12个月时BMI下降百分比高于两组9个月和12个月时，NPD组的BMI分别为（2.1 ± 3.5）kg/m2和（2.3 ± 4.1）kg/m2，NPD组的BMI分别为（1.1± 2.3）kg/m2和（1.2± 2.4）kg/m2，两组比较差异有统计学意义（P<0.0 5）。此外，42.6%的PSD患者体重减轻5%或以上，而OPD和NPD患者体重减轻5%或以上的比例分别为18.4%和23.0%（所有患者P< 0.01;需要治疗的人数分别为5和6）。最强的体重减轻预测因子是治疗持续时间（β= 0.51-0.54; P< 0.001）。NPD（P= 0.001）和OPD组状态（P= 0.036）、较低的小组会议比例（P= 0.002）、较高的抑郁（P= 0.028）和较低的基线BMI（P= 0.030）预测了肥胖。不坚持和抑郁症应该有针对性地提高减肥成功率。
ObjectiveStudies of behavioral weight loss intervention in patients with psychotic disorders are sparse, and its efficacy compared to other obese patients is unknown. Therefore, we compared the effect of a cognitive-behavioral weight loss intervention in obese subjects with psychotic disorders, other psychiatric diagnoses, and without psychiatric disorders.MethodsA 12-month naturalistic study of weekly group or individual cognitive-behavioral weight management in 222 consecutively enrolled obese patients (body mass index [BMI], 43.7±9.6 kg/m 2) with psychotic spectrum disorders (PSDs, n= 47), other psychiatric disorders (OPDs, n= 49), and no psychiatric disorder (NPD, n= 126).ResultsPatients with PSD had greater treatment persistence (48.9%) and longer treatment duration (8.7±4.4 months) than those with OPD (22.4% and 5.4±4.3 months) and NPD (22.2% and 4.9±4.7 months)(P< 0.01 for all; number needed to treat, 3). In last-observation-carried-forward analyses, patients with PSD had greater percent baseline weight loss at 12 months (5.1%±9.3%) than patients with OPD and with NPD (2.7%±5.5% and 2.4%±6.3%); greater percent BMI loss at 9 and 12 months than both groups (P< 0.05 for all) and greater BMI loss at 9 months (2.1±3.5 kg/m 2) and 12 months (2.3±4.1 kg/m 2) than NPD patients (1.1±2.3 and 1.2±2.4 kg/m 2). Furthermore, weight loss of 5% or more occurred in 42.6% of patients with PSD versus 18.4% and 23.0% in OPD and NPD patients (P< 0.01 for all; numbers needed to treat, 5 and 6). The strongest weight loss predictor was treatment duration (β= 0.51–0.54; P< 0.001). Attrition was predicted by NPD (P= 0.001) and OPD group status (P= 0.036), lower proportion of group sessions (P= 0.002), higher depression (P= 0.028), and lower baseline BMI (P= 0.030).ConclusionsPatients with PSD had greater weight loss than other obese patients. Nonadherence and depression should be targeted to enhance weight loss success.