Psychosocial Interventions Impact on Cardiometabolic, Neurobiological, Behavioral, and Immune Outcomes in People With a Serious Mental Illness: A Systematic Review
Corresponding Author
Julia C. Hill
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Correspondence: Julia C. Hill ([email protected]; [email protected])
Contribution: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Writing - original draft, Writing - review & editing
Search for more papers by this authorCrystal Noller
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Contribution: Writing - review & editing
Search for more papers by this authorPaul Holtzheimer
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Contribution: Writing - review & editing
Search for more papers by this authorKrista Disano
Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Contribution: Writing - review & editing
Search for more papers by this authorElla Klinsky
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Contribution: Methodology, Project administration
Search for more papers by this authorMona Pudasaini
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Contribution: Methodology, Project administration
Search for more papers by this authorHannah Crowe-Cumella
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Contribution: Formal analysis, Methodology, Project administration, Writing - review & editing
Search for more papers by this authorKaren L. Fortuna
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Collaborative Design for Recovery and Health, Nashua, New Hampshire, USA
Contribution: Project administration, Supervision, Writing - original draft, Writing - review & editing
Search for more papers by this authorCorresponding Author
Julia C. Hill
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Correspondence: Julia C. Hill ([email protected]; [email protected])
Contribution: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Writing - original draft, Writing - review & editing
Search for more papers by this authorCrystal Noller
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Contribution: Writing - review & editing
Search for more papers by this authorPaul Holtzheimer
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Contribution: Writing - review & editing
Search for more papers by this authorKrista Disano
Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Contribution: Writing - review & editing
Search for more papers by this authorElla Klinsky
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Contribution: Methodology, Project administration
Search for more papers by this authorMona Pudasaini
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Contribution: Methodology, Project administration
Search for more papers by this authorHannah Crowe-Cumella
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Contribution: Formal analysis, Methodology, Project administration, Writing - review & editing
Search for more papers by this authorKaren L. Fortuna
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Collaborative Design for Recovery and Health, Nashua, New Hampshire, USA
Contribution: Project administration, Supervision, Writing - original draft, Writing - review & editing
Search for more papers by this authorABSTRACT
Background and Aims
Five and a half percent of the population of the United States has a serious mental illness (SMI). Mind-body outcomes represent a direct and operationalizable measurement associated with accelerated aging. These findings may suggest that psychosocial interventions represent the first-ever strategy to increase the lifespan of people with SMI; however, the literature is limited.
Methods
The patient/population, intervention, comparison, and outcomes (PICO) criteria were used to assess study eligibility in partnership with a master's-level librarian. Studies focused on (1) the general population, which later became a population with SMI, (2) psychosocial intervention vs. no psychosocial intervention, and (3) cardiometabolic, neurobiological, behavioral, and immune outcomes. We searched the following databases from 1946 to January 2024: Medline, PsycINFO, Cochrane Central Register of Controlled Trials, Scopus, and PubMed. Thirty-two RCTs fit the criteria. The Methodological Quality Rating Scale assessed the methodological quality of the included studies. Studies assessed four outcome categories: (1) neurobiological, (2) behavioral, (3) immune, and (4) cardiometabolic.
Results
Immune outcomes were the least recorded but significantly differed between the psychosocial intervention treatment group and controls. Behavioral and neurobiological outcomes significantly differed between the treatment group and controls. Cardiometabolic outcomes were the most studied, with inconsistencies in significant vs. nonsignificant differences between intervention and control.
Conclusion
Evidence is growing that psychosocial interventions can improve the lives of people with SMI and potentially reduce accelerated aging. We suggest that psychosocial intervention randomized control trials with mind-body outcomes may represent a viable strategy for reducing disease burden and improving human health. Additional research is needed to examine the correlation between psychosocial interventions and the effects on mind-body outcomes of accelerated aging and SMI. The present systematic review extends this study by identifying the outcomes associated with accelerated aging significantly modified by psychosocial intervention.
Summary
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Immune outcomes were the least recorded among the studies, but significant differences were shown between the psychosocial intervention treatment group and controls.
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Cardiometabolic outcomes were the most recorded among studies and demonstrated significant and nonsignificant differences between intervention and control groups, even when the intervention type was kept constant across studies.
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Behavioral and neurobiological outcomes demonstrated significant differences between intervention and control.
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Numerous studies supported the hypothesis that psychosocial interventions can impact various mind-body outcomes and reflect the mind-body connection. Therefore, more studies are needed to examine the effect of these interventions on health-related outcomes and their relation to accelerated aging.
Conflicts of Interest
Karen L. Fortuna has a conflicts of interest with Emissary Health. Paul Holtzhiemer receives royalties from Oxford University Press and UpToDate. The other authors declare no conflicts of interest.
Open Research
Data Availability Statement
The authors confirm that the data supporting the findings of this study are available within the article [and/or] its Supporting Information.
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