Psychosocial Interventions Impact on Cardiometabolic, Neurobiological, Behavioral, and Immune Outcomes in People With a Serious Mental Illness: A Systematic Review

Abstract

Background and aims: Five and a half percent of the population of the United States has a serious mental illness (SMI). Mind-body outcomes represent a direct and operationalizable measurement associated with accelerated aging. These findings may suggest that psychosocial interventions represent the first-ever strategy to increase the lifespan of people with SMI; however, the literature is limited.

Methods: The patient/population, intervention, comparison, and outcomes (PICO) criteria were used to assess study eligibility in partnership with a master's-level librarian. Studies focused on (1) the general population, which later became a population with SMI, (2) psychosocial intervention vs. no psychosocial intervention, and (3) cardiometabolic, neurobiological, behavioral, and immune outcomes. We searched the following databases from 1946 to January 2024: Medline, PsycINFO, Cochrane Central Register of Controlled Trials, Scopus, and PubMed. Thirty-two RCTs fit the criteria. The Methodological Quality Rating Scale assessed the methodological quality of the included studies. Studies assessed four outcome categories: (1) neurobiological, (2) behavioral, (3) immune, and (4) cardiometabolic.

Results: Immune outcomes were the least recorded but significantly differed between the psychosocial intervention treatment group and controls. Behavioral and neurobiological outcomes significantly differed between the treatment group and controls. Cardiometabolic outcomes were the most studied, with inconsistencies in significant vs. nonsignificant differences between intervention and control.

Conclusion: Evidence is growing that psychosocial interventions can improve the lives of people with SMI and potentially reduce accelerated aging. We suggest that psychosocial intervention randomized control trials with mind-body outcomes may represent a viable strategy for reducing disease burden and improving human health. Additional research is needed to examine the correlation between psychosocial interventions and the effects on mind-body outcomes of accelerated aging and SMI. The present systematic review extends this study by identifying the outcomes associated with accelerated aging significantly modified by psychosocial intervention.

Keywords: cardiometabolic risk factors; immune system; neurobiology; premature aging; psychosocial intervention; severe mental disorder.

Figure 1

Study flow diagram for study selection.