Effects of behavioral therapy on weight loss in overweight and obese patients with schizophrenia or schizoaffective disorder
Effects of behavioral therapy on weight loss in overweight and obese patients with schizophrenia or schizoaffective disorder
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DOI：
10.4088/jcp.v66n0208
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发表时间：
2005-02-01
影响因子：
5.3
通讯作者：
Mahmoud, R
中科院分区：
文献类型：
--
作者：
Brar, JS;Ganguli, R;Mahmoud, R
背景：肥胖在精神分裂症患者中很常见。除了对健康产生不利影响外，肥胖还会降低生活质量，并加剧精神分裂症的社会耻辱。方法：这项为期14周、多中心、开放标签、评分者设盲、随机研究评估了基于团体的行为治疗（BT）对超重和肥胖的稳定型DSM-IV精神分裂症或分裂情感障碍患者的减肥效果，这些患者已从奥氮平改用利培酮。参与者被随机分配接受BT或常规临床护理（UC）。BT包括20次会议，在此期间，患者被教导减少热量摄入。在UC中，患者被鼓励减肥，但没有收到关于减肥的特殊建议。主要结果测量是体重的变化。结果：72例患者入选。两组终点时的平均+/- SD体重减轻均具有显著性（p <0.05），接受BT的患者在数值上大于接受UC的患者（分别为-2.0 +/- 3.79和-1.1 +/- 3.11 kg）。在终点时，BT组体重减轻≥ 5%的患者多于UC组（分别为26.5% [9/34]和10.8% [4/37]; p = 0.082）。对至少参加I BT治疗的患者进行的事后分析显示，BT组中在终点时体重减轻≥ 5%的患者显著多于UC组（分别为32.1% [9/28] vs. 10.8% [4/37]，p = .038）和第14周时（完成者人群;分别为40.9% [9/22]和14.3% [4/28]，p = 0.027）。结论：BT可能是慢性精神病患者减肥的有效方法。
Background: Obesity is common in persons with schizophrenia. Besides its adverse health effects, obesity reduces quality of life and contributes to the social stigma of schizophrenia.Method: This 14-week, multicenter, open-label, rater-blinded, randomized study evaluated the effects of a group-based behavioral treatment (BT) for weight loss in overweight and obese stable patients with DSM-IV schizophrenia or schizoaffective disorder who had been switched from olanzapine to risperidone. Participants were randomly assigned to receive BT or usual clinical care (UC). BT included 20 sessions during which patients were taught to reduce caloric intake. In UC, patients were encouraged to lose weight but received no special advice about weight reduction. The primary outcome measure was change in body weight.Results: Seventy-two patients were enrolled. The mean +/- SD weight loss at endpoint was significant in both groups (p < .05) and numerically greater in patients receiving BT than in those receiving UC (-2.0 +/- 3.79 and -1.1 +/- 3.11 kg, respectively). More patients in the BT group than in the UC group had lost greater than or equal to5% of their body weight at endpoint (26.5% [9/34] and 10.8% [4/37], respectively; p = .082). A post hoc analysis of patients attending at least I BT session showed that significantly more patients in the BT than the UC group had lost greater than or equal to5% of their body weight at endpoint (32.1% [9/28] vs. 10.8% [4/37], respectively, p = .038) and at week 14 (completer population; 40.9% [9/22] and 14.3% [4/28], respectively, p = .027).Conclusion: BT may be an effective method for weight reduction in patients with chronic psychotic illness.