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Meta-Analysis
. 2022 Apr 13;22(1):261.
doi: 10.1186/s12888-022-03854-x.

Patient-reported outcomes of lifestyle interventions in patients with severe mental illness: a systematic review and meta-analysis

Laura M Pape  1 , Marcel C Adriaanse  2 , Jelle Kol  2 , Annemieke van Straten  3 , Berno van Meijel  4   5   6
Affiliations
Meta-Analysis

Patient-reported outcomes of lifestyle interventions in patients with severe mental illness: a systematic review and meta-analysis

Laura M Pape et al. BMC Psychiatry. .

Abstract

Background: Lifestyle interventions for severe mental illness (SMI) are known to have small to modest effect on physical health outcomes. Little attention has been given to patient-reported outcomes (PROs).

Aim: To systematically review the use of PROs and their measures, and quantify the effects of lifestyle interventions in patients with SMI on these PROs.

Methods: Five electronic databases were searched (PubMed/Medline, Embase, PsycINFO, CINAHL, and Web of Science) from inception until 12 November 2020 (PROSPERO: CRD42020212135). Randomised controlled trials (RCTs) evaluating the efficacy of lifestyle interventions focusing on healthy diet, physical activity, or both for patients with SMI were included. Outcomes of interest were PROs.

Results: A total of 11.267 unique records were identified from the database search, 66 full-text articles were assessed, and 36 RCTs were included, of which 21 were suitable for meta-analyses. In total, 5.907 participants were included across studies. Lifestyle interventions had no significant effect on quality of life (g = 0.13; 95% CI = - 0.02 to 0.27), with high heterogeneity (I2 = 68.7%). We found a small effect on depression severity (g = 0.30, 95% CI = 0.00 to 0.58, I2 = 65.2%) and a moderate effect on anxiety severity (g = 0.56, 95% CI = 0.16 to 0.95, I2 = 0%).

Discussion: This meta-analysis quantifies the effects of lifestyle interventions on PROs. Lifestyle interventions have no significant effect on quality of life, yet they could improve mental health outcomes such as depression and anxiety symptoms. Further use of patient-reported outcome measures in lifestyle research is recommended to fully capture the impact of lifestyle interventions.

Keywords: Lifestyle intervention; Patient-reported outcome; Severe mental illness; Systematic review, Meta-analysis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of study search and selection
Fig. 2
Fig. 2
Cochrane risk of bias assessment 2.0
Fig. 3
Fig. 3
Forest plots of quality of life, depression severity and anxiety severity
See this image and copyright information in PMC

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