Effect of lifestyle coaching versus care coordination versus treatment as usual in people with severe mental illness and overweight: Two-years follow-up of the randomized CHANGE trial

Jakobsen, Ane Storch; Speyer, Helene; Nørgaard, Hans Christian Brix; Karlsen, Mette; Birk, Merete; Hjorthøj, Carsten; Mors, Ole; Krogh, Jesper; Gluud, Christian; Pisinger, Charlotta; Nordentoft, Merete
October 2017
PLoS ONE;10/6/2017, Vol. 12 Issue 10, p1
Academic Journal
The objective of this trial was to assess the long-term effect of the CHANGE lifestyle coaching intervention for 428 people with abdominal obesity and schizophrenia spectrum disorders on cardiovascular risk. In this randomized, superiority, multi-center clinical trial, participants were randomized to 12 months of either lifestyle coaching plus care coordination (N = 138), care coordination alone, (N = 142) or treatment as usual (N = 148). There was no effect after 12 months, but we hypothesized that there might have been a delayed treatment effect. Our primary outcome at two-year follow-up was 10-year risk of cardiovascular disease standardized to 60 years of age. After two-years the mean 10-year cardiovascular-disease risk was 8.7% (95% confidence interval (CI) 7.6–9.9%) in the CHANGE group, 7.7% (95% CI 6.5–8.9%) in the care coordination group, and 8.9% (95% CI 6.9–9.2%) in the treatment as usual group (P = 0.24). Also, there were no intervention effects for any secondary or exploratory outcomes, including cardiorespiratory fitness, weight, physical activity, diet and smoking. No reported adverse events could be ascribed to the intervention. We conclude that there was neither any direct nor any long-term effect of individual lifestyle coaching or care coordination on cardiovascular risk factors in people with abdominal obesity and schizophrenia spectrum disorders. The trial was approved by the Ethics Committee of Capitol Region Copenhagen, Denmark (registration number: H-4-2012-051) and the Danish Data Protection Agency (registration number: 01689 RHP-2012-007). The trial was funded by the Mental Health Services of the Capital Region of Denmark, the Lundbeck Foundation, the Tryg Foundation, the Danish Ministry of Health, and the Dæhnfeldts Foundation.


Related Articles

  • Switching to olanzapine long-acting injection from either oral olanzapine or any other antipsychotic: comparative post hoc analyses. Ciudad, Antonio; Anand, Ernie; Berggren, Lovisa; Casillas, Marta; Schacht, Alexander; Perrin, Elena // Neuropsychiatric Disease & Treatment;2013, Vol. 9, p1737 

    Background: A considerable proportion of patients suffering from schizophrenia show suboptimal responses to oral antipsychotics due to inadequate adherence. Hence, they are likely to benefit from switching to a long-acting injectable formulation. These post hoc analyses assessed the clinical...

  • Pharmacoeconomic perspective on antipsychotic therapy:Managing costs and maximizing treatment outcomes. Love, Raymond C. // American Journal of Health-System Pharmacy;11/15/2002, Vol. 59 Issue 22, pS3 

    Introduces a series of papers focusing on a pharmacoeconomic perspective on antipsychotic therapy. Impact of mental illness on medical care costs; Long-term and disabling nature of schizophrenia; Emergence of atypical antipsychotic drug therapy, a less toxic option for the treatment of...

  • Alternative Complement Pathway in Schizophrenia. Boyajyan, Anna; Khoyetsyan, Aren; Chavushyan, Andranik // Neurochemical Research;Jun2010, Vol. 35 Issue 6, p894 

    In the present study, we evaluated functional activity of the alternative pathway of complement in schizophrenia by measuring the alternative pathway hemolytic activity (AH50) of complement as well as hemolytic activity of the complement C3 component (C3H50) in the blood of patients with...

  • The C/At is out of the bag: a gene for mental illness. Wong, M-L // Pharmacogenomics Journal;2001, Vol. 1 Issue 1, p13 

    Presents information on C/At, a gene for mental illness. Characteristics of schizophrenia; Evidence for a genetic contribution to schizophrenia; Efficacy of antipsychotic drug therapy.

  • Lack of effect of antipsychotics on BNDF and NGF levels in hippocampus of Wistar rats. Samira Valvassori; Laura Stertz; Ana Andreazza; Maria Rosa; Flávio Kapczinski; Emilio Streck; João Quevedo // Metabolic Brain Disease;Jun2008, Vol. 23 Issue 2, p213 

    Abstract  Schizophrenia is a common and serious mental disorder, in which the majority of patients require long-term antipsychotic treatment. Several studies have suggested that schizophrenia is associated with decreased neurotrophins such as brain-derived neurotrophic factor (BDNF) and...

  • trifluoperazine. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p760 

    A definition of the term "trifluoperazine" is presented. The term pertains to a type of drug that produces an antipsychotic effect. In addition, trifluoperazine is reportedly used in the treatment of the mental disorder, schizophrenia.

  • Pervasive developmental disorders and psychoses in adult life. Clarke, David J.; Littlejohns, Carl S.; Corbett, John A.; Joseph, Susan; Clarke, D J; LittleJohns, C S; Corbett, J A; Joseph, S // British Journal of Psychiatry;Nov89, Vol. 155, p692 

    Of five patients with pervasive developmental disorders (PDDs), four developed psychotic illnesses in adult life. The other was treated with antipsychotic medication for many years following a mistaken diagnosis of schizophrenia.

  • Long-Acting Risperidone in Early-Episode Schizophrenia. Dubois, Vincent; Megens, Jozef; Mertens, Claudine; Geerts, Paul // Acta Psychiatrica Belgica;2011, Vol. 111 Issue 1, p9 

    Methods : This was a multi-centre, non-interventional, and observational study. The aim was assessment of the clinical outcome of a 12-month treatment with long-acting risperidone in 105 patients with diagnosis of schizophrenia (DSM-IV-TR) for whom treatment was started early in the course of...

  • A one-year prospective study of the safety, tolerability and pharmacokinetics of the highest available dose of paliperidone palmitate in patients with schizophrenia.  // BMC Psychiatry;2012, Vol. 12 Issue 1, p26 

    The article focuses on the research article presented by Danielle Coppola and colleagues on the study of pharmacokinetics related to the dose of paliperidone palmitate (PP) in patients with schizophrenia in the U.S. It offers information on the schizophrenia which is a serious and chronic mental...

  • Impulsivity and Risk Taking in Bipolar Disorder and Schizophrenia. Reddy, L Felice; Lee, Junghee; Davis, Michael C; Altshuler, Lori; Glahn, David C; Miklowitz, David J; Green, Michael F // Neuropsychopharmacology;Jan2014, Vol. 39 Issue 2, p456 

    Impulsive risk taking contributes to deleterious outcomes among clinical populations. Indeed, pathological impulsivity and risk taking are common in patients with serious mental illness, and have severe clinical repercussions including novelty seeking, response disinhibition, aggression, and...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics