Lifestyle intervention on psychotherapy and exercise and their effect on physical and psychological health in outpatients with schizophrenia spectrum disorders. A pragmatic clinical trial

Introduction Patients with Schizophrenia Spectrum Disorders (SSD) often lead unhealthy lifestyles with higher prevalence of obesity and unfavourable cardiometabolic parameters with less life expectancy and often worse quality of life compared with general population. Objectives Evaluate the effectiveness of a combined intervention of exercise and psychoeducation in 48 SSD outpatients with metabolic syndrome (MetS), treated with second-generation antipsychotics and also aimed to explore if the effect persisted in a long-term follow-up of 24 months. Methods The intervention included a 12-week aerobic exercise program and a session of lifestyle psychoeducation. Effectiveness was measured in terms a wide range of outcomes involving physical and psychological health, functioning, quality of life, physical activity and changes in motivation to exercise in the context of the self-determination theory. Results The active intervention group showed benefits after Bonferroni correction over clinical global impression, identified motivation to exercise and changes of physical activity pattern. Maintenance of effects after 24 months of follow-up was observed for identified regulation to exercise and also for negative symptoms of psychosis (Table). Table. Effects assigned-group/time-over *p≤0.05 **p≤0.01. Variables 12weeks 24months Time Groupxtime Groupx timex gender p p p p p HDL (mg/dl) 0.021* Negative Syndrome Scale 0.044* 0.004** BREQ-2- Extrinsic regulation 0.008** 0.004** -External 0.026* -Introyected 0.038* -Identified 0.018* 0.015* 0.003** 0.002** BREQ-2-Intrinsic regulation 0.005** 0.004** Pedometer (steps/day) 0.001** 0.006** Conclusions A combined intervention on SSD outpatients with MetS showed effectiveness over several clinical parameters and functioning. Therefore, should be considered an essential part of the integral treatment in mental health services for SSD patients. Disclosure No significant relationships.

Introduction: Schizophrenia is a chronic psychiatric illness with periods of remission and relapse. Patients vary in the frequency and severity of relapse, time until relapse and time in remission. Discontinuation of antipsychotic medication is by far the most important reason for relapse. A possible method to optimize medication adherence is to treat patients with long-term, depot medication rather than oral medication. Objectives: Primary objective is to compare all cause discontinuation rates in patients with schizophrenia randomized to either one of the two depot medications (aripiprazole depot or paliperidone palmitate) with patients randomized to either one of the two oral formulations of the same medication (aripiprazole or paliperidone) over an 19 month follow-up period. Methods: Pragmatic, randomized, open label, multicenter, multinational comparative trial consisting of a 19 month treatment period. Patients aged 18 years or older, having experienced the first psychosis 1-7 years ago, currently meeting DSM-IV-R criteria for schizophrenia. Patients are randomized 1:1:1:1 to paliperidone palmitate, aripiprazole depot, oral aripiprazole or oral paliperidone. The primary outcome is all cause discontinuation. Results: In the Intent to Treat sample (n=511), no difference was found in time to ACD between the combined oral and combined depot treatment arms, nor between the four individual treatment arms. Conclusions: Even though the scientific evidence comparing oral and depot medication has been inconsistent, most studies were conducted in rigorous clinical settings, which may have biased those results. In contract, given the pragmatic, open label design of the current trial, the results may be more representative of common daily practice.

Disclosure: No significant relationships.
Keywords: long-acting antipsychotics; oral antipsychotic; all-cause discontinuation; schizophrénia EPP0017 Lifestyle intervention on psychotherapy and exercise and their effect on physical and psychological health in outpatients with schizophrenia spectrum disorders. A pragmatic clinical trial.
Introduction: Patients with Schizophrenia Spectrum Disorders (SSD) often lead unhealthy lifestyles with higher prevalence of obesity and unfavourable cardiometabolic parameters with less life expectancy and often worse quality of life compared with general population. Objectives: Evaluate the effectiveness of a combined intervention of exercise and psychoeducation in 48 SSD outpatients with metabolic syndrome (MetS), treated with second-generation antipsychotics and also aimed to explore if the effect persisted in a long-term follow-up of 24 months. Methods: The intervention included a 12-week aerobic exercise program and a session of lifestyle psychoeducation. Effectiveness was measured in terms a wide range of outcomes involving physical and psychological health, functioning, quality of life, physical activity and changes in motivation to exercise in the context of the self-determination theory.
Results: The active intervention group showed benefits after Bonferroni correction over clinical global impression, identified motivation to exercise and changes of physical activity pattern. Maintenance of effects after 24 months of follow-up was observed for identified regulation to exercise and also for negative symptoms of psychosis (Table). Table. Effects assigned-group/time-over *p≤0.05 **p≤0.01.

Conclusions: A combined intervention on SSD outpatients with
MetS showed effectiveness over several clinical parameters and functioning. Therefore, should be considered an essential part of the integral treatment in mental health services for SSD patients. Introduction: The prevalence of schizophrenia is close to 1 percent internationally. According to the 2019 census, the population in the province of León, our study population, is 460,001 inhabitants.
Objectives: To study the distribution of schizofrenia in the area covered by the Complejo Asistencial Universitario de León, Spain.
Methods: This is a retrospective and cross-sectional descriptive study. The data of the hospitalizations of the last 10 years (2009-2019) will be obtained in any service of the CAULE of the 28 basic health areas of the province of León, with a diagnosis of schizophrenia. Prevalence will be calculated. The rate of schizophrenia will be calculated for the decade per 1000 inhabitants. Results: 3133 admissions identified 1576 unique patients. It is the decade of 50-59 where the largest number of hospitalizations is concentrated. Most entered directly into the psychiatry hospital care. It is 2019 where the most income is produced and 2017 the one with the least. The rate of schizophrenia is 3,2 Per 1000 inhabitants. Conclusions: Hospitalizations for schizophrenia is concentrated in the decade of the 40-49 years. The diagnosis of schizophrenia is frecuently delayed until negative symptoms appear. There is an upward trend in hospitalizations per year in the last decade. The rate of schizophrenia is higher in areas where consanguinity is present and where the prison is located.

EPP0019
Implementation of a lifestyle and life-skills intervention to prevent weight-gain and cardiometabolic abnormalities in people with first-episode psychosis: the Keeping the Body in Mind program