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Lifestyle Psychiatry

Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Psychiatry | doi: 10.3389/fpsyt.2018.00707

Less medication use in inpatients with severe mental illness receiving a multidisciplinary lifestyle enhancing treatment. The MULTI study III

 Jeroen Deenik1, 2*, Diederik Tenback1, Harold v. Driel1, Erwin Tak3, Ingrid Hendriksen4 and Peter v. Harten1, 2
  • 1GGZ Centraal, Netherlands
  • 2School for Mental Health and Neuroscience, Maastricht University, Netherlands
  • 3Tak Advies en Onderzoek, Netherlands
  • 4LivIng Active, Netherlands

Besides having an unhealthy lifestyle contributing to premature mortality, inpatients with severe mental illness (SMI) use high dosages of medication. Previous research has shown improved health after lifestyle improvements in SMI. In addition, we aimed to retrospectively study whether a multidisciplinary lifestyle enhancing treatment (MULTI) was associated with changes in medication use after 18 months, as compared with patients that continued treatment as usual (TAU) and explored mediation by a change in physical activity. We conducted an observational study within a cohort of inpatients with SMI, who received MULTI (N = 65) or continued TAU (N = 49). Data on their somatic and psychotropic medications were collected, converted into defined daily dose (DDD), and analyzed using linear multilevel regression, correcting for baseline value and differences between groups in age, diagnosis, and illness severity. Compared with TAU, the DDD for psychotropic medication significantly decreased with MULTI (B = -0.55, P = 0.02). Changes in total activity did not mediate this association, suggesting that multiple components of MULTI contributed. Corrected between-group analyses for subgroups of medication were not possible due to lack of power and skewed distributions. Within-group data showed a decreased proportion of users as well as median DDD in both groups for almost all medications. In addition to previously reported health improvements after 18 months of MULTI, we observed a significant decrease in dose of psychotropic medication in MULTI compared to TAU. This first study evaluating a wide range of medications indicates a possible effect of lifestyle improvements on medication use in inpatients with SMI. Findings need to be confirmed in future controlled studies, however.

Keywords: medication, Antipsychotics, Physical activity (exercise), Hospitalization (hospital stay), Severe mental illness (SMI), Schizophrenia, lifestyle, side effects

Received: 22 Sep 2018; Accepted: 03 Dec 2018.

Edited by:

Joseph Firth, Western Sydney University, Australia

Reviewed by:

Simon Rosenbaum, University of New South Wales, Australia
Mats Hallgren, Karolinska Institute (KI), Sweden  

Copyright: © 2018 Deenik, Tenback, Driel, Tak, Hendriksen and Harten. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mr. Jeroen Deenik, GGZ Centraal, Amersfoort, Netherlands, j.deenik@ggzcentraal.nl