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Evaluation of an exercise physiology service in a youth mental health service

Published online by Cambridge University Press:  19 August 2020

M. Pearce
Affiliation:
Orygen, Melbourne, Victoria, Australia
L. Foote
Affiliation:
Orygen, Melbourne, Victoria, Australia
E. Brown
Affiliation:
Orygen, Melbourne, Victoria, Australia Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
B. O’Donoghue*
Affiliation:
Orygen, Melbourne, Victoria, Australia Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
*
*Address for correspondence: Brian O’Donoghue, Orygen, 35 Poplar Rd, Parkville, Victoria3052, Australia. (Email: [email protected])

Abstract

Background

Individuals who experience serious mental health disorders are at an increased risk of physical illness co-morbidity and early intervention is crucial. Recommendations to embed an exercise physiologist service into a mental health service have not been fully evaluated.

Objectives

This study aimed to determine (i) demographics and clinical characteristics of the young people referred to exercise physiology, (ii) adherence to metabolic monitoring, (iii) baseline physical health and (iv) level of engagement after referral.

Methods

This is a naturalistic cohort study and included all young people referred to the exercise physiology service between 2015 and 2019 at Orygen, a specialist youth mental health service in the north-western region of Melbourne.

Results

During the study period of 45 months, 312 young people were referred to exercise physiology, and of those, 51.3% were male. The mean age was 19.8 years. In regard to primary diagnoses, 47.4% had a psychotic disorder and 33.7% an affective disorder. Baseline weight measurements were completed for 71.8% of young people. The proportion of young people who were classified as overweight or obese increased from 55.1% to 70.4% (p < 0.001). For those referred, 61.5% attended either an individual session or a group session. A total of 29.5% did not attend their appointment following referral.

Conclusions

As over half of young people had poor physical health at presentation, integrating an exercise physiology service into a youth mental health service is a novel and needed intervention. However, there still needs to be an emphasis on metabolic monitoring and engagement.

Type
Original Research
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The College of Psychiatrists of Ireland

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References

Allison, DB, Mentore, JL, Heo, M, Chandler, LP, Cappelleri, JC, Infante, MC, Weiden, PJ (1999). Antipsychotic-induced weight gain: a comprehensive research synthesis. American Journal of Psychiatry 156, 16861696.Google ScholarPubMed
Chanen, AM, McCutcheon, L, Kerr, IB (2014) HYPE: a cognitive analytic therapy-based prevention and early intervention programme for borderline personality disorder. In Handbook of Borderline Personality Disorder in Children & Adolescents, pp. 361–383.CrossRefGoogle Scholar
Firth, J, Siddiqi, N, Koyanagi, A, Siskind, D, Rosenbaum, S, Galletly, C, Allan, S, Caneo, C, Carney, R, Carvalho, AF (2019). The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness. The Lancet Psychiatry 6, 675712.CrossRefGoogle ScholarPubMed
Hahn, LA, Galletly, CA, Foley, DL, Mackinnon, A, Watts, GF, Castle, DJ, Waterreus, A, Morgan, VA (2014). Inadequate fruit and vegetable intake in people with psychosis. Australian and New Zealand Journal of Psychiatry 48, 10251035.CrossRefGoogle ScholarPubMed
International Diabetes Federation (2006) The IDF consensus worldwide definition of the Metabolic Syndrome (https://www.idf.org/e-library/consensus-statements/60-idfconsensus-worldwide-definitionof-the-metabolic-syndrome.html)Google Scholar
International Physical Health in Youth (iphYs) Working Group (2013) Healthy Active Lives (HeAL) consensus statement (https://www.iphys.org.au/)Google Scholar
Lawrence, D, Hancock, KJ, Kisely, S (2013). The gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: retrospective analysis of population based registers. BMJ 346, f2539.CrossRefGoogle ScholarPubMed
Lawrence, D, Kisely, S (2010). Review: inequalities in healthcare provision for people with severe mental illness. Journal of Psychopharmacology 24 (Suppl. 4), 6168.CrossRefGoogle ScholarPubMed
Lawrence, D, Mitrou, F, Zubrick, S (2009). Smoking and mental illness: results from population surveys in Australia and the United States. BMC Public Health 9, 285.CrossRefGoogle ScholarPubMed
Lederman, O, Grainger, K, Stanton, R, Douglas, A, Gould, K, Perram, A, Baldeo, R, Fokas, T, Naumann, F, Semaan, A, Hewavasam, J, Pontin, L, Rosenbaum, S (2015). Consensus statement on the role of Accredited Exercise Physiologists within the treatment of mental disorders: A guide for mental health professionals. Australasian Psychiatry 24, 347351.CrossRefGoogle Scholar
Leucht, S, Burkard, T, Henderson, J, Maj, M, Sartorius, N (2007). Physical illness and schizophrenia: a review of the literature. Acta Psychiatrica Scandinavica 116, 317333.CrossRefGoogle ScholarPubMed
McGorry, PD, Edwards, J, Mihalopoulos, C, Harrigan, SM, Jackson, HJ (1996). EPPIC: an evolving system of early detection and optimal management. Schizophrenia Bulletin 22, 305326.CrossRefGoogle ScholarPubMed
National Health and Medical Research Council (2013) Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children in Australia. Melbourne: NHMRC (https://www.nhmrc.gov.au/about-us/publications/clinical-practice-guidelines-management-overweight-and-obesity)Google Scholar
Newcomer, J, Hennekens, C (2007). Severe mental illness and risk of cardiovascular disease. JAMA 298, 17941796.CrossRefGoogle ScholarPubMed
Nyboe, L, Lund, H (2013). Low levels of physical activity in patients with severe mental illness. Nordic Journal of Psychiatry 67, 4346.CrossRefGoogle ScholarPubMed
O’Donoghue, B, Mifsud, NG, Tindall, RM, Foote, L, Hartmann, JA, Obst, K, Simmons, MB, McGorry, PD & Killackey, E (2019) Physical health assistance in early recovery of psychosis: study protocol for a randomized controlled trial. Early Intervention in Psychiatry. doi:10.1111/eip.12884CrossRefGoogle Scholar
Oud, MJ, Meyboom-de Jong, B (2009). Somatic diseases in patients with schizophrenia in general practice: their prevalence and health care. BMC Family Practice 10, 32.CrossRefGoogle ScholarPubMed
Rice, SM, Halperin, S, Cahill, S, Cranston, I, Phelan, M, Hetrick, SE, Blaikie, S, Edwards, J, Koutsogiannis, J, Davey, CG (2017). The Youth Mood Clinic: an innovative service for the treatment of severe and complex depression. Australasian Psychiatry 25, 112116.CrossRefGoogle ScholarPubMed
Rosenbaum, S, Tiedemann, A, Ward, PB, Curtis, J, Sherrington, C (2015). Physical activity interventions: an essential component in recovery from mental illness. British Journal of Sports Medicine 49, 1544.CrossRefGoogle ScholarPubMed
Teasdale, SB, Ward, PB, Samaras, K, Firth, J, Stubbs, B, Tripodi, E, Burrows, TL (2019). Dietary intake of people with severe mental illness: systematic review and meta-analysis. The British Journal of Psychiatry 214, 251259.CrossRefGoogle ScholarPubMed
Thompson, A, Hetrick, SE, Álvarez-Jiménez, M, Parker, AG, Willet, M, Hughes, F, Gariup, M, Gomez, DL, McGorry, PD (2011). Targeted intervention to improve monitoring of antipsychotic-induced weight gain and metabolic disturbance in first episode psychosis. Australian & New Zealand Journal of Psychiatry 45, 740748.CrossRefGoogle ScholarPubMed
Yung, AR, McGorry, PD, Francey, SM, Nelson, B, Baker, K, Phillips, LJ, Berger, G, Amminger, GP (2007). PACE: a specialised service for young people at risk of psychotic disorders. Medical Journal of Australia 187, S43S46.CrossRefGoogle ScholarPubMed