title: Healthy living interventions and schizophrenia: a systematic review.
abstract: OBJECTIVE
  This paper reports a systematic review of the published and grey literature which has investigated the efficacy of healthy living interventions for adults with a diagnosis of schizophrenia or schizo-affective disorder.
  
  
  BACKGROUND
  Adults with a diagnosis of schizophrenia or schizo-affective disorder have reduced life expectancy when compared with members of the general population, with approximately 59% of excess mortality resulting from natural causes.
  
  
  METHODS
  The review was conducted following guidelines provided by the United Kingdom National Health Service Centre for Reviews and Dissemination, and using the Medline, PsycINFO, CINAHL, Embase, Cochrane Library, National Research Register, and System for Info on Grey Literature databases.
  
  
  RESULTS
  Sixteen studies were identified, examining four types of healthy living interventions: smoking cessation (n = 7), weight management (n = 5), exercise (n = 3) and nutritional education (n = 1). The smoking cessation, weight management and exercise studies showed positive outcomes in the main. The quality of the studies, however, was generally poor. Only two had control groups, most recruited small self-selected samples, six did not standardize for diagnosis, external validity was generally poor and no studies followed participants for longer than 6 months. The best quality evidence was produced by the smoking cessation and weight management studies, which were more methodologically robust and demonstrated promising outcomes.
  
  
  CONCLUSIONS
  Further research is needed to assist the development of effective interventions to help this client group to adopt and maintain healthier lifestyles. Research and practice development in this area may be an important role for nurses in both hospital and community settings.
authors.affiliation: School of Nursing, Midwifery and Health Visiting, Coupland III, University of Manchester, Oxford Road, Manchester M13 9PL, UK. timothy.j.bradshaw@manchester.ac.uk
authors.forename: Tim
authors.initials: T
authors.lastname: Bradshaw
authors.forename: Karina
authors.initials: K
authors.lastname: Lovell
authors.forename: Neil
authors.initials: N
authors.lastname: Harris
mesh_terms: D006293:Health Promotion; D006801:Humans; D008017:Life Expectancy; D024802:Nurse's Role; D012565:Schizophrenic Psychology; D016540:Smoking Cessation; D015431:Weight Loss