One-year efficacy of a lifestyle behavioural intervention on physical and mental health in people with severe mental disorders: results from a randomized controlled trial

Eur Arch Psychiatry Clin Neurosci. 2024 Jun;274(4):903-915. doi: 10.1007/s00406-023-01684-w. Epub 2023 Sep 4.


This multicentric randomized controlled trial (RCT), carried out in six Italian University mental health sites, aims to test the efficacy of a six-month psychosocial intervention (LYFESTYLE) on Body Mass Index (BMI), body weight, waist circumference, fasting glucose, triglycerides, cholesterol, Framingham and HOmeostasis Model Assessment of insulin resistance (HOMA-IR) indexes in patients with schizophrenia, bipolar disorder, and major depression. Moreover, the efficacy of the intervention has also been tested on several other physical and mental health domains. Patients were randomly allocated to receive the six-month experimental intervention (LIFESTYLE) or a behavioural control intervention. All enrolled patients were assessed at baseline and after one year. We recruited 401 patients (206 in the experimental and 195 in the control group) with a diagnosis of schizophrenia or other psychotic disorder (29.9%), bipolar disorder (43.3%), or major depression (26.9%). At one year, patients receiving the experimental intervention reported an improvement in body mass index, body weight, waist circumference, HOMA-IR index, anxiety and depressive symptoms and in quality of life. Our findings confirm the efficacy of the LIFESTYLE intervention in improving physical and mental health-related outcomes in patients with severe mental illnesses after one year.

Keywords: BMI; Bipolar disorder; Comorbidity; Depression; Framingham Risk score; HOMA-IR index; LIFESTYLE; RCT; Schizophrenia; Waist circumference.

Publication types

  • Randomized Controlled Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Behavior Therapy / methods
  • Bipolar Disorder* / rehabilitation
  • Bipolar Disorder* / therapy
  • Body Mass Index*
  • Depressive Disorder, Major* / therapy
  • Female
  • Humans
  • Insulin Resistance / physiology
  • Life Style*
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Psychosocial Intervention
  • Psychotic Disorders / physiopathology
  • Psychotic Disorders / therapy
  • Quality of Life
  • Schizophrenia* / physiopathology
  • Schizophrenia* / rehabilitation
  • Schizophrenia* / therapy
  • Waist Circumference / physiology