Interventions to improve lifestyle and quality-of-life in patients with concurrent mental illness and substance use.
BACKGROUND
Patients with co-existence of psychiatric disorders and substance use have an increased risk of premature death. This is attributable to a higher prevalence of physical comorbidities and a lifestyle related to substance use. Furthermore, they experience low quality-of-life (QoL). Studies addressing lifestyle interventions for these patients are warranted.


OBJECTIVE
To investigate the physical health and QoL in patients with co-existence of psychiatric disorders and substance use, and to analyse for changes in their (a) health, (b) substance use, and (c) QoL after a 24-month health-promotion programme. Further aims were to investigate associations between (a) QoL and number of interventions, (b) QoL and patient characteristics, and (c) QoL and length of participation in the intervention.


METHODS
In this naturalistic cohort study, 64 non-selected patients were engaged in health-promoting interventions added to contemporary treatments. QoL and clinical variables were measured at the beginning of and continuously during the programme by means of the WHOQoL-Bref questionnaire.


RESULTS
At enrolment, the patients' intake of cannabis and alcohol was high. During follow-up, patients consumed significantly fewer caffeinated beverages (p = .038) and fast-food meals (p = .018), and slept significantly less (p = .032). The average dose of antipsychotic medication increased significantly (p = .015). QoL was low at enrolment, but improved significantly overall (p = .009) and in the psychological (p = .020) and environmental domains (p = .012) at follow-up. The difference in total QoL was positively associated with the number of interventions attended.


CONCLUSIONS
This programme shows promise in addressing health promotion for these patients and can easily be integrated into contemporary treatments.
a Department of Affective Disorders, Aarhus University Hospital , Risskov , Denmark.
Anette
A
Juel
b Department of Psychiatry Odense , University Function, Southern University of Denmark , Odense , Denmark.
Christina Blanner
CB
Kristiansen
c Department of Mathematics , Aarhus University , Denmark.
Nikolaj Juul
NJ
Madsen
d Department of Psychiatry Odense , University Function, Southern University of Denmark , Odense , Denmark.
Povl
P
Munk-Jørgensen
e Mental health Center, Psychiatric Hospital , Randers , Denmark.
Peter
P
Hjorth
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006293:Health Promotion / Q000379:methods*; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000628:therapy*; D055815:Young Adult
Physical health; dual diagnosis; intervention programme; quality-of-life; substance use disorders