Associations of Body Weight and Waist Circumference with Psychopathology, Substance Use, and Well-Being in an Adult Transdiagnostic Sample.

BACKGROUND: Prior studies have established inconsistent associations between body weight and mental health. However, most work has relied on body mass index (BMI) and examination of a single mental health variable. The present study examined associations of BMI and waist circumference with multiple mental health variables in a transdiagnostic psychiatric sample. METHODS: Nursing staff measured waist circumference and calculated the BMI of 742 adults (54.6% female, 45.4% male) presenting for psychiatric treatment. Participants completed the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), Behavior and Symptom Identification Scale (BASIS-24), and Mental Health Continuum-Short Form (MHC-SF) as part of standard clinical monitoring. Suicide risk was assessed using the clinician-administered Mini International Neuropsychiatric Interview (M.I.N.I.). For curve fit estimation regression models, we entered BMI and waist circumference as independent variables separately; we entered seven dependent variables separately: 1) depression, 2) anxiety, 3) substance use, 4) self-harm, 5) interpersonal functioning, 6) well-being, and 7) suicide risk. RESULTS: Increased BMI was associated with decreased well-being and increased depression. Increased waist circumference was associated with worse interpersonal functioning. Non-linear (quadratic) associations were observed between weight and depression, substance use, self-harm, and suicide. LIMITATIONS: Most of the sample was White and only 2.6% was in the underweight category, limiting broad applicability of findings. Cross-sectional design precludes causal attributions. CONCLUSIONS: Given associations between well-being, depression, interpersonal functioning, substance use, self-harm, and suicide with weight, findings may be used to inform mental health treatment, particularly by tailoring interventions to high-risk weight categories (underweight, obese) in psychiatric populations.

Attending to Timely Contingencies: Promoting Physical Activity Uptake Among Adults with Serious Mental Illness with an Exercise-For-Mood vs. an Exercise-For-Fitness Prescription.

Despite evidence for both physical and mental health benefits achieved through regular exercise, most Americans fail to meet minimum recommendations. Altering the behavioral contingency from a focus on long-term health benefits to immediate mood benefits represents a novel method for exercise promotion. The current study examined a single-session exercise-for-mood intervention against two time-matched comparison conditions in 152 patients with serious mental illness attending a partial hospital program, a population marked by significant health disparities. This intervention was compared to a standard exercise-for-fitness intervention and a time-matched no-exercise control. Among patients with high levels of exercise prior to the partial hospital program, the exercise-for-mood intervention yielded significant increases in exercise. Implications for exercise promotion interventions among psychiatrically ill patients are discussed.

Metabolic Syndrome: Psychiatric-Mental Health Nurses' Knowledge of Risks and Care Practices.

Comorbidity of serious mental illness (SMI) and metabolic syndrome contributes to the reduced lifespan of individuals with SMI. Integration of physical and mental health care has been slow. The current study explored the level of knowledge of metabolic syndrome and practices of psychiatric-mental health nurses related to metabolic syndrome risks. Using a knowledge survey and adapted Mental Health Nurse Physical Health Attitude Scale, the researchers surveyed 175 psychiatric nurses through an online social media website. Of respondents, 52% identified all five risk factors for metabolic syndrome. However, only 70.8% knew all recommended physiological monitoring markers. There was no significant relationship between knowledge score and integration of physical health care activities in practice; however, knowledge regarding metabolic syndrome risk factors was high. Currently, integration of this knowledge into care is lagging. Nurse educators must integrate assessment, planning, intervention, and evaluation of physical health status and related needs of individuals with SMI. [Journal of Psychosocial Nursing and Mental Health Services, 54(11), 44-53.].

When Partial Hospitalization Fails: Risk Factors for Inpatient Hospitalization.

Partial hospitalization is an understudied bridge between outpatient and inpatient care. One of its primary functions is to prevent the need for inpatient hospitalization. We examined potential demographic and clinical risk factors for inpatient hospitalization for current partial hospital patients. We conducted separate multiple logistic regression analyses for patients referred from inpatient care and the community. For individuals referred from inpatient care, suicidal ideation and greater psychotic symptoms upon admission to the partial program were associated with acute inpatient re-hospitalization. For individuals referred from the community, suicidal ideation and worse relationship functioning upon partial hospital admission were significant risk factors for inpatient hospitalization. Number of previous inpatient hospitalizations and greater substance abuse were not associated with inpatient hospitalization in either sample. Implications at the provider and program level are discussed.

The incidence of metabolic risk factors in an inpatient psychiatric setting.

Our study examines risk factors for metabolic syndrome on admission to an acute psychiatric facility and the incidence of medical referrals at discharge. Data on demographics, risk factors for metabolic syndrome, other health risk factors, medications, related diagnoses, and primary care providers and referrals were collected from 125 psychiatric patient charts. Comparison analysis was done for two groups: those with two or more risk factors for metabolic syndrome and those with less than two risk factors. Differences between groups were statistically significant for age, waist circumference, body mass index, high-density lipoprotein, triglycerides, and fasting glucose levels. Few patients were referred to their primary care provider for follow-up care. This study has clinical implications for improving assessment of psychiatric patients at risk for developing metabolic syndrome, for designing interventions to help patients adopt lifestyle changes to mitigate these risks, and for working toward fuller integration of psychiatric and primary care.

Does exercise impact mood? Exercise patterns of patients in a psychiatric partial hospital program.

OBJECTIVE: To examine the exercise patterns of patients in a partial hospital (PH) program and to determine whether these patterns are associated with mood symptoms and body mass index (BMI). Methods. Eighty-six participants completed self-report questionnaires upon entry to the PH program. We conducted regression analyses to determine the association of exercise, mood, and BMI. Results. We found that the participants' exercise history did not predict automatic thoughts or depressive symptoms. Current exercise did predict fewer depressive symptoms and lower BMI, but not automatic thoughts. A majority of participants were overweight and reported not exercising, despite acknowledging that they were not physically fit and that exercise is beneficial. Conclusion. We recommend that exercise programs be piloted in PH settings to improve patients' mental as well as physical health. Future research should further examine obstacles to exercising in clinical populations.