Psychosocial hybrid interventions for weight and sedentary behavior management among patients with severe mental disorders: A systematic review and meta-analysis

Background: Severe mental disorders, such as schizophrenia, bipolar disorders, and other psychosis have been associated with risk of premature mortality, predominantly due to cardiovascular diseases and metabolic syndrome. The aim of this systematic review and meta-analysis was to examine the efficacy of hybrid psychosocial interventions combining face-to-face and eHealth components for patients with severe mental disorders on reduction of weight and waist circumference.

Method: The electronic search on PubMED, PsycINFO, EMBASE, Web of Science were conducted, and data were extracted twice. A supplementary search was also conducted. Interventions with severe mental disorder patients reporting outcomes related to obesity, metabolism, metabolic syndrome, and inflammation were included. Data were synthesized using a systematic narrative synthesis framework, and formal quality assessments to address the risk of bias. A meta-analysis was also conducted.

Results: After following the steps recommended by PRISMA statements, 14 studies were included in the systematic review and four studies were included in meta-analysis. The pooled analysis demonstrated that hybrid interventions were not able to significantly promote waist circumference changes [SMD (cm) = -0.19, 95% CI = -0.60, 0.22; Z = 0.91; p = 0.36; two studies] nor weight reduction [SMD (kg) = -0.21, 95% CI = -0.43, 0.01; Z = 1.90; p = 0.06; four studies] in patients with severe mental disorders.

Conclusion: More studies should focus on hybrid mental health psychosocial for weight control and sedentary lifestyle need to be elaborated to verify their effectiveness in improving sedentary lifestyle and promoting weight reduction in people with severe mental disorders.