title: Mental health starts with physical health: current status and future directions of non-pharmacological interventions to improve physical health in first-episode psychosis.
abstract: People with psychotic disorders have reduced life expectancy compared with the general population. This difference is primarily due to increased prevalence of cardiovascular disease associated with antipsychotic drugs and with modifiable risk factors, including weight gain, low exercise, poor diet, and high prevalence of cigarette smoking. We review non-pharmacological interventions for physical health behaviour in patients with chronic and first-episode psychosis. Our findings suggest that weight loss and attenuation of weight gain are achievable but limited and might not persist beyond the end of an intervention. Evidence for smoking cessation interventions is scarce. The case for early intervention to prevent deterioration of physical health is strong. We propose a framework for development of interventions, which addresses three main factors largely absent in previous research: (1) examination of aetiological factors related to poor physical health, (2) theory-driven interventions that target aetiological factors, and (3) assessment of feasibility.
authors.affiliation: Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia. Electronic address: jessegates@hotmail.com.
authors.forename: Jesse
authors.initials: J
authors.lastname: Gates
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, VIC, Australia.
authors.forename: Eóin
authors.initials: E
authors.lastname: Killackey
authors.affiliation: Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Phillips
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, VIC, Australia.
authors.forename: Mario
authors.initials: M
authors.lastname: Álvarez-Jiménez
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000517:prevention & control; D015444:Exercise; D006293:Health Promotion / Q000379:methods*; D006304:Health Status; D006801:Humans; D008603:Mental Health; D011618:Psychotic Disorders / Q000188:drug therapy*; D012907:Smoking; D016540:Smoking Cessation; D015430:Weight Gain / Q000187:drug effects; D061217:Weight Reduction Programs
chemical_list: D014150:Antipsychotic Agents