Vol.:(0123456789) 1 3
Community Mental Health Journal
https://doi.org/10.1007/s10597-020-00655-y
BRIEF REPORT
Developing a Sound Body: Open Trial Results of a Group Healthy
Lifestyle Intervention for Young Adults with Psychosis
Julia Browne
1,2,3
· Corinne Cather
1,2,3,6
· Vanya Zvonar
1,2
· Katherine Thayer
4
· Hannah Skiest
1,2
· Diana Arntz
1,2,3
·
Katherine Kritikos
1,2
· Kristina Schnitzer
2,3
· Hannah Brown
5
· A. Eden Evins
1,2,3,6
· Abigail Donovan
1,2,3
Received: 5 February 2020 / Accepted: 31 May 2020
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract
The mortality disparity for persons with schizophrenia spectrum disorders (SSDs) due to cardiovascular disease is a devastat-
ing problem. Many risk factors are present in young adults with psychosis that may be ameliorated with lifestyle interven-
tions. Sixteen participants with SSDs enrolled in an 11-week open trial of a novel lifestyle intervention comprised of group
high intensity interval training exercise and health and wellness education. The aims were to evaluate (1) feasibility and (2)
impact on sedentary behavior, physical activity, nutritional knowledge, physiological outcomes, and psychological well-being
at end of intervention and 11-week follow-up. Attendance rates were 70% or higher for both intervention components and
participants reported increased learning about healthy eating and exercise habits. Moderate to large efect sizes were observed
for physical activity and sedentary behavior with sustained improvements in sedentary behavior at follow-up. Meaningful
changes were not observed in other domains.
Keywords Schizophrenia · Exercise · Nutrition · Pedometer · High intensity interval training
Introduction
Individuals with schizophrenia spectrum disorders (SSDs)
have a 28-year shorter life expectancy compared to those
in the general population (Olfson et al. 2015). This prema-
ture mortality is largely driven by cardiovascular disease,
type 2 diabetes, and respiratory disease (Correll et al. 2017;
Revier et al. 2015). Individuals with SSDs, even early in
the course of illness, have elevated rates of six modifable
risk factors for mortality including hypertension, tobacco
smoking, hyperglycemia, physical inactivity, obesity, and
dyslipidemia (Wildgust and Beary 2010). Specifcally, indi-
viduals with frst-episode psychosis (FEP) have higher rates
of cardiometabolic abnormalities (e.g. hypertension, obesity,
dyslipidemia, and metabolic syndrome Correll et al. 2014;),
diabetes (Rajkumar et al. 2017), and less frequent healthy
lifestyle behaviors (e.g., physical activity or healthy nutri-
tional intake; Hahn et al. 2018) than those in the general
population. Further, antipsychotic medications have been
implicated in the development and exacerbation of these
health problems, namely obesity, hyperglycemia, dyslipi-
demia and metabolic syndrome (De Hert et al. 2012). In
a recent review of 28 articles, Tek and colleagues (2016)
found that the majority of antipsychotic medications were
related to weight gain and increased BMI among persons
with FEP (Tek et al. 2016). As such, it is critical to develop
interventions that target these known cardiometabolic
risks in young adults with psychosis in order to improve
health, health-related quality of life and reduce the mortal-
ity disparity.
Lifestyle interventions targeting exercise and nutrition
have demonstrated signifcant health benefts for those with
SSDs (Bartels et al. 2015; Daumit et al. 2013; Dauwan et al.
* Julia Browne
jbrowne@mgh.harvard.edu
1
Center of Excellence for Psychosocial and Systemic
Research, Department of Psychiatry, Massachusetts General
Hospital, Boston, MA, USA
2
Department of Psychiatry, Massachusetts General Hospital,
Boston, MA, USA
3
Harvard Medical School, Boston, MA, USA
4
Department of Psychiatry, Mount Auburn Hospital,
Cambridge, MA, USA
5
Department of Psychiatry, Boston University School
of Medicine, Boston Medical Center, Boston, MA, USA
6
Center for Addiction Medicine, Department of Psychiatry,
Massachusetts General Hospital, Boston, MA, USA