Les clientèles psychiatriques sont plus à risque de souffrir de surpoids que la population générale, ce qui est en partie liée aux perturbations métaboliques fréquemment associées à la prise de médicaments psychotropes. L’objectif de la présente étude est d’évaluer l’efficacité du programme Mieux-Être « Wellness », un programme d’Éducation thérapeutique du patient (ETP) en groupe visant la modification des habitudes de vie.

Un total de 47 patients a participé à l’étude et l’efficacité du programme a été mesurée à partir de variables anthropométriques (poids, masse corporelle, périmètre abdominal) et cliniques (symptômes psychiatriques, observance à la médication, qualité de vie) auprès d’un groupe expérimental et d’un groupe témoin de type liste d’attente.

Il n’y a pas de différences significatives entre les groupes sur la plupart des variables après le volet intensif du programme d’une durée de 12 semaines, mais les résultats obtenus trois mois après la fin du programme sous-tendent un effet significatif sur le poids, l’Indice de masse corporelle et le périmètre abdominal et sur certains aspects de la qualité de vie.

Les résultats de l’étude suggèrent qu’un programme d’Éducation thérapeutique du patient (ETP) basé sur la modification des habitudes de vie pourrait avoir des répercussions positives sur la santé de clientèles psychiatriques variées. L’implantation de tels programmes semble souhaitable dans les milieux cliniques.

Patients with severe psychiatric disorders such as psychosis, bipolar disorder, and depression have a greater risk of suffering from being overweight or from obesity than the general population. This can in part be explained by medication-induced weight gain related to the use of antipsychotics, antidepressants and mood stabilizers. Fortunately, non-pharmacological interventions targeting modifications in lifestyle behaviors exist to help patients deal with weight gain and weight management. The main objective of this study is to assess the effectiveness of one of these interventions developed in Quebec (Canada), the Wellness Program.

The 12-week program, consisting of two to three weekly individual and group sessions, was administered to patients diagnosed with a severe psychiatric disorder (i.e. Psychotic Disorders, Bipolar Disorders, Major Depressive Disorder) and referred to a general hospital for significant weight problems. Topics of program sessions included: physical conditioning, nutrition, meal cooking, psychoeducation, motivation, relaxation training, and optional walking sessions. A total of 47 participants took part in this study and either initially received the intervention (n=31) or were placed in a waitlist control group and later received the intervention (n=16). The effectiveness of the program was measured using objective anthropometric (weight, Body Mass Index, waist circumference) and clinical (psychiatric symptoms, medication adherence, quality of life) variables from both experimental and control groups. Assessments were conducted at the end of the 12-week intervention and at a 3-month follow-up.

After three months of active intervention, there were no significant differences between the two groups for most of the variables studied. Patients in the experimental group did show greater improvements in weight loss, Body Mass Index and waist circumference compared to the control group, but these positive changes were not statistically significant given the small sample size of the study. However, the results obtained at follow-up three months after the end of the program showed a significant impact of the program, albeit small, on weight, Body Mass Index, waist circumference and on some aspects of quality of life in the experimental group.

Non-pharmacological interventions targeting healthy lifestyle behaviors and weight management, such as the Wellness Program, seem effective in improving anthropometric variables and quality of life in patients with severe psychiatric disorders such as psychosis and mood disorders. Given the potential clinical benefits, implementation in clinical settings and widespread dissemination is recommended. Indeed, these programs have the potential to limit weight gain associated with medications used to treat psychiatric disorders and to improve quality of life for these patients.