Health Effects of an Individualized Lifestyle Intervention for People with Psychotic Disorders in Psychiatric Outpatient Services: A Two Year Follow-up

Figures & data

Figure 1. The process of the lifestyle intervention.

Table 1. The part of the intervention provided for the participants and frequency of utilization (n = 54).

		n (%)
Face-to-face counseling related to individual lifestyle factors	Only one–two times	7 (13.0)
	Three times	11 (20.4)
	Four times	36 (66.7)
Dietary advice	Yes	51 (94.4)
	No	3 (5.6)
Individual written prescription to increase physical activity	Yes	19 (35.2)
	No	35 (64.8)
Interventions for reduction of alcohol consumption for smoking cessation	Yes	3 (5.6)
	No	51 (94.4)
	Yes	6 (11.1)
	No	47 (87)
	Support from primary care	1 (1.9)
Coordinated individual plan	Yes	9 (16.7)
	No	45 (83.3)
Participation in educational group-based sessions	Not at all	15 (27.8)
	One–two times	6 (11.1)
	Three–four times	11 (20.4)
	Five–six times	22 (40.7)

Figure 2. Flow of participants.

Table 2. The baseline characteristics of the participants in the intervention and control groups.

Demographical variables Intervention (N = 54)			Control (N = 13)
	n (%)	Mean (SD)	n (%)	Mean (SD)
Gender
Male	35 (65.8)		7 (53.8)
Female	19 (35.2)		6 (46.2)
Age, years		46.0 (10.6)		46.3 (9.5)
Marital status
Not married	38 (70.4)		10 (76.9)
Married	6 (11.1)		2 (15.4)
Divorced/widowed	5 (9.3)		1 (7.7)
Missing	5 (9.3)		0
Household status
Lives alone	38 (70.4)		6 (46.2)
Spouse	6 (11.1)		4 (30.8)
Parents	3 (5.6)		0
Other	2 (3.7)		2 (15)
Missing	5 (9.3)		1 (7.7)
Having children:
Yes	17 (31.6)		6 (46.2)
No	31 (57.3)		7 (53.8)
Missing	6 (11.1)		0
Housing accommodation
House	8 (14.8)		1 (7.7)
Apartment	32 (59.3)		8 (61.5)
Lodge	1 (1.9)		1 (7.7)
Supported accommodation	5 (9.3)		1 (7.7)
Institution	0		1 (7.7)
Other	3 (5.6)		1 (7.7)
Missing	5 (9.3)		0
Educational level
9-year school	12 (22.2)		2 (15.4)
High school	24 (44.4)		4 (30.8)
College/university	13 (24.1)		7 (53.8)
Missing	5 (9.3)		0
Work situation
Disability pension	38 (70.4)		8 (61.5)
Sheltered work	3 (5.6)		0
Unemployed	0		2 (15.4)
Student	0		1 (7.7)
Housewife/husband	1 (1.9)		0
Open-market employment/entrepreneurs	7 (13.0)		2 (15)
Missing	5 (9.3)		0
Psychiatric care contact (years)		20 (10.1)		17.7 (12.4)
Missing		6		1

Table 3. Baseline and follow-up data.

Measures	Intervention N = 54 n	M (SD)	Range	Control N = 13 n	M (SD)	Range
Sagittal abdominal diameter (cm)
T1	53	26.91 (3.83)	17.5–35.0	13	24.31 (3.76)	19.5–30.0
T2	37	26.24 (4.12)	17.5–35	10	24.05 (3.50)	20.0–29.5
T3	37	26.98 (3.58)	17.0–35.5	11	23.55 (2.81)	19.0–28.5
Waist circumference (cm)
T1	53	111.96 (15.64)	49.5–150	13	107.92 (14.99)	92–130
T2	43	111.87 (14.36)	67–146	10	107.75 (14.41)	92–131
T3	42	113.57 (13.12)	87–147	12	104.08 (13.44)	88–126.5
Body Mass Index
T1	53	32.44 (5.98)	18.31–46.98	13	30.83 (6.17)	22.55–41.97
T2	45	31.81 (6.01)	18.98–47.06	10	31.50 (4.53)	24.82–39.04
T3	44	31.83 (5.68)	18.73–47.45	12	30.14 (5.47)	21.97–38.47
Glycated hemoglobin A1c (HbA1c)
T1	54	37.94 (7.48)	26–79	13	35.77 (5.18)	27–47
T2	43	38.40 (7.08)	27–71	11	34.91 (5.49)	24–45
T3	41	40.17 (11.38)	29–94	11	33.27 (3.88)	25–38
Systolic blood pressure (mmHg)
T1	52	126.83 (13.50)	100–165	13	123.08 (18.12)	94–160
T2	42	125.71 (13.19)	103–160	10	119.90 (12.75)	105–145
T3	41	128.37 (13.08)	100–156	11	129.73 (14.56)	110–149
Diastolic blood pressure (mmHg)
T1	52	80.40 (8.94)	60–100	13	78.23 (10.27)	63–99
T2	42	80.36 (9.28)	60–105	10	81.50 (12.02)	68–100
T3	41	80.59 (9.02)	60–100	11	84.64 (11.84)	70–105
How much exercise and exerted physically in leisure
T1	49	2.00 ( 0.98)	1–4	13	2.31 ( 0.48)	2–3
T2	36	2.44 ( 0.97)	1–4	10	2.60 (0.70)	2–4
T3	27	2.33 ( 0.88)	1–4	7	2.57 (1.13)	1–4
How much time moderately exertive activities
T1	49	2.96 (1.10)	1–5	13	2.77 (1.30)	1–5
T2	36	2.67 (1.31)	1–5	10	2.80 ( 0.92)	1–4
T3	27	2.63 (1.08)	1–5	7	2.43 (0.98)	1–4
Consumption of greens and root vegetables
T1	49	3.98 (1.66)	1–7	13	3.62 (1.39)	2–7
T2	36	4.14 (1.74)	1–7	10	3.40 (1.96)	1–6
T3	27	4.44 (1.83)	1–7	8	4.13 (1.36)	2–6
Consumption of fruit and berries
T1	49	4.27 (2.03)	1–7	13	3.77 (1.83)	1–6
T2	36	4.00 (1.97)	1–7	10	3.80 (1.93)	1–7
T3	27	4.37 (2.10)	1–7	8	4.38 (1.60)	2–6
Salutogenic health indicator scale
T1	49	3.94 (1.06)	1.67–6.00	12	4.09 (1.35)	1.17–6.00
T2	36	3.98 (0.98)	1.83–6.00	9	4.40 (0.90)	2.42–5.33
T3	27	4.09 (0.82)	2.58–6.00	8	4.49 (0.48)	3.83–5.00
Hopkins Symptom Checklist-25
T1	49	1.72 (0.50)	1.00–2.72	13	1.65 (0.53)	1.15–3.04
T2	37	1.72 (0.46)	1.00–2.68	9	1.57 (0.80)	1.12–3.68
T3	27	1.76 (0.48)	1.00–2.84	8	1.38 (0.28)	1.12–1.88

Table 4. Results from the unadjusted multigroup 2-level multilevel analyses of the differences in effects between the intervention and control groups.

Variable	Model fit comparison (BIC) Unadjusted Adjusted		Grupp	Slope (SE)	Chi2 (df = 1)	p-value	Cohen’s d
Sagittal abdominal diameter			Intervention	–0.16 (0.21)	0.01	.92
	827.83	847.03					0.04
			Control	–0.11 (0.37)
Waist circumference			Intervention	0.91 (0.71)	4.80	.03
	1301.12	1317.84					0.55
			Control	–1.11 (0.59)
			Intervention	0.02 (0.15)
Body Mass Index	900.37	911.06			0.04	.85	0.05
			Control	–0.05 (0.50)
			Intervention	1.11 (0.58)
Glycated hemoglobin A1c	1115.52	1116.54			12.15	<.001	0.96
			Control	–1.04* (0.21)
			Intervention	1.33 (1.03)
Systolic blood pressure	1353.93	1366.83			0.21	.65	0.14
			Control	2.28 (1.80)
			Intervention	0.20 (0.80)
Diastolic blood pressure	1257.57	1277.06			1.95	.16	0.35
			Control	2.98 (1.81)
			Intervention	0.15* (0.06)
Physical activity in leisure time	307.90	333.77			4.96	.03	0.54
			Control	–0.05 (0.07)
			Intervention	0.02 (0.06)
Moderately exertive activities	300.02	314.44			0.06	.81	0.06
			Control	0.06 (0.14)
			Intervention	0.19 (0.16)
Consumption of greens and root vegetables	578.30	585.39			0.02	.88	0.04
			Control	0.23 (0.22)
			Intervention	0.01 (0.14)
Consumption of fruit and berries	612.52	617.52			0.25	.62	0.12
			Control	0.17 (0.30)
			Intervention	0.09 (0.07)
Salutogenic health indicator scale	378.32	390.21			0.01	.94	0.02
			Control	0.10 (0.17)
			Intervention	0.01 (0.03)
Hopkins Symptom Checklist -25	174.25	187.67			0.28	.59	0.13
			Control	0.27 (0.49)

Note: * = p < .05; BIC = Bayesian information criterion.