***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Psychological treatments have been shown to be effective in patients with psychosis . However , the studies published to date have included participants across wide age ranges , so few conclusions can be reached about the effectiveness of such treatments in relation to age . AIMS To evaluate outcomes by age in a r and omised controlled trial design ed to evaluate the effectiveness of cognitive-behavioural therapy ( CBT ) , supportive counselling and treatment as usual . METHOD Outcomes were evaluated in terms of symptoms , social functioning , insight and therapeutic alliance according to age at 3- and 18-month follow-up . RESULTS Younger participants responded better to supportive counselling than to treatment as usual and CBTover 3 months . Older participants responded better to CBT than to supportive counselling over 18 months . Younger participants showed a greater increase in insight after CBT compared with treatment as usual and supportive counselling , and were more difficult to engage in therapy . CONCLUSIONS Young people may have different needs with regard to engagement in psychological treatments . Treatment providers need to take age-specific factors into account BACKGROUND People with schizophrenia make poor dietary choices . AIMS To measure the impact of giving free fruit and vegetables for 6 months on eating habits in schizophrenia . METHOD We r and omly allocated 102 people with schizophrenia in two areas of Scotl and to receive free fruit and vegetables for 6 months , supported by instruction in meal planning and food preparation ; free fruit and vegetables alone ; or to continue as before .  Diet was assessed using the Scottish Health Survey question naire . Blood sample s to measure micronutrients were taken and mental state , body mass index , level of physical activity and future risk of coronary heart disease ( CHD ) were assessed . RESULTS After the intervention , those who received free fruit and vegetables , or free fruit and vegetables and associated instruction , were consuming significantly more fruit and vegetables than those in the treatment as usual group . Consumption fell to pre-intervention levels 12 months after the intervention stopped . There was no between-group difference at any time in blood micronutrients , body mass index , physical activity or risk of CHD . CONCLUSIONS The diet of people with schizophrenia improved when they were given free fruit and vegetables but this was given free fruit and vegetables but this was not sustained after withdrawal of the intervention . A support programme added no benefit Obesity and diabetes have caused problems for individuals with schizophrenia long before atypical antipsychotic agents . The prevalence of obesity , insulin resistance , impaired glucose tolerance , type 2 diabetes mellitus , dyslipidemia , and the Metabolic Syndrome has increased in people with schizophrenia as compared to the general population . Risk reduction studies for persons with obesity , diabetes , and cardiovascular disease indicate that cognitive/behavioral interventions that promote motivation and provide strategies to overcome the barriers in adherence to diet and activity modification are effective interventions for weight management and risk reduction . In the l and mark multi-center r and omized-controlled trial study , the Diabetes Prevention Project ( DPP ) , a cognitive/behavioral intervention , was more successful in producing weight loss and preventing diabetes than the drugs metformin , troglitazone or placebo . This pilot study examined the effectiveness of a cognitive/behavioral group intervention , modified after the DPP program , in individuals with schizophrenia or schizoaffective disorder taking atypical antipsychotics in a large urban public mental health system . Outcome measures included body weight , body mass index , waist-hip ratios , and fasting glucose levels . Both groups demonstrated elevated fasting glucose levels and were obese with a mean BMI of 33 . The group that received the cognitive/behavioral group intervention  lost more weight than the treatment as usual group . The CB group participants lost an average of 5.4 lb or 2.9 % of body weight , and those in the control group lost 1.3 lb or 0.6 % body weight . The range of weight loss for the treatment group was from 1 to 20 lb . This pilot study has demonstrated that weight loss is possible with cognitive/behavioral interventions in a population with a psychotic disorder Objective : To undertake a preliminary study to assess the feasibility of clinical implementation and evaluate the effectiveness of a novel adventure- and recreation-based group intervention in the rehabilitation of individuals with schizophrenia . Methods : In a 2-year , prospect i ve , case – control study , 23 consecutively referred , clinical ly stabilized schizophrenia patients received the new intervention  over an 8-month period ; 31 patients on the wait list , considered the  control group  , received st and ard clinical care that included some recreational activities .  Symptom severity , self-esteem , self-appraised cognitive abilities , and functioning were documented for both groups with st and ardized rating scales administered at baseline , on completion of treatment , and at 12 months posttreatment . Results : Treatment adherence was 97 % , and there were no dropouts . Patients in the study group showed marginal improvement in perceived cognitive abilities and on domain-specific functioning measures but experienced a significant improvement in their self-esteem and global functioning ( P < 0.05 ) , as well as a weight loss of over 12 lb . Improvement was sustained over 1 year with further occupational and social gains . Conclusion : In the context of overcoming barriers to providing early intervention for youth and preventing metabolic problems among older adults with schizophrenia , adventure- and recreation-based interventions could play a useful complementary role BACKGROUND The main objective was to assess the efficacy of a weight management program design ed for out patients taking olanzapine for schizophrenia or schizoaffective disorder and to compare these patients with a r and omized control group . The effects of the weight management program were also assessed with regard to safety and quality of life . METHOD Forty-eight patients were enrolled in a 12-week , r and omized , multicenter weight management study . Thirty-three patients were r and omly allocated to an intervention group in which they received olanzapine within a weight management program .  Fifteen patients were allocated to a control group in which they were given olanzapine treatment as usual out patients . Weight , body mass index ( BMI ) , and measurements of safety and quality of life were evaluated . The study was conducted from January 7 , 2003 , to September 16 , 2003 . RESULTS Thirty-six patients ( 75 % ) completed this study . We found significant differences in weight ( -3.94 + /- 3.63 kg vs. -1.48 + /- 1.88 kg , p = .006 ) and BMI ( -1.50 + /- 1.34 vs. -0.59 + /- 0.73 , p = .007 ) change from baseline to endpoint between the intervention and control groups , respectively . Significant differences in weight reduction were initially observed at week 8 ( p = .040 ) . No significant differences were found with regard to the safety outcomes . When the ratio of low-density lipoproteins to high-density lipoproteins was calculated , change from baseline was greater in the intervention group than the control group ( -0.19 vs. -0.04 ) , but the difference was not statistically significant ( p = .556 ) . After the completion of the weight management program , there was a trend toward statistical difference in the physical health score changes between the weight management and control groups ( 1.12 in the intervention group vs. -0.93 in the control group , p = .067 ) . CONCLUSION The weight management program was effective in terms of weight reduction in patients with schizophrenia or schizoaffective disorder taking olanzapine and was also found to be safe in terms of psychiatric symptoms , vital signs , and laboratory data . In addition , such a weight management program might improve quality of life in patients with schizophrenia or schizoaffective disorder with respect to their physical well-being Although the benefits of exercise are well documented , few published research studies have examined exercise in persons with schizophrenia . This pilot examined a 16-week walking program for out patients diagnosed with schizophrenia ( N = 10 ) .  Six-minute walking distance , body mass index , percent body fat and severity of psychiatric symptoms were measured . Experimental participants in the walking group experienced significant reductions in body fat ( p = 0.03 ) compared to a control group not participating in the exercises during the same time period . Experimental participants also had greater aerobic fitness , lower body mass indexes , and fewer psychiatric symptoms than controls at the conclusion of the program . Research is needed to identify effective exercise interventions and feasible delivery modalities for persons with schizophrenia in community setting Obesity is a major problem nationwide and even more prevalent among people with psychiatric disabilities . This study examined the efficacy of a psychiatric rehabilitation weight loss program .  Twenty-one individuals participated in the 12-week intervention . Another 15 individuals served as matched controls . Results indicate the intervention group improved more than the control group for weight , body mass index , waist circumference and physical activity . The intervention group lost 2.7 kg ( 6 lbs ) and the control group gained 0.5 kg ( 1 lb ) . A  weight loss program incorporating psychiatric rehabilitation principles was effective for people with psychiatric disabilities at a community based program Background : Increasingly alarmed by the health risks ( that is , weight gain , elevated lipids , and poor glucose tolerance ) posed by novel antipsychotic medications , clinicians who treat schizophrenia are attempting to help patients improve lifestyle factors . Unfortunately , schizophrenia research has neglected exercise as a legitimate adjunctive treatment for schizophrenia . Objective : To assess the extent to which stable patients with schizophrenia would adhere to an exercise program if offered access to a fitness facility . Methods : Ten of 20 stable patients with schizophrenia or schizoaffective disorder who were treated with olanzapine for at least 4 weeks had the opportunity to receive access to a Young Men 's Christian Association ( YMCA ) fitness facility , based on r and om allocation . The intervention included a free membership to the YMCA for 6 months , with access to all the fitness amenities and equipment . The mean dosage of olanzapine was 11.5 mg daily for the YMCA group . Results : Of the 10 subjects , 2 did not attend at all . One subject met criteria for full attendance for each of the 6 months and lost 15 kg . Dropout rates were as follows : 90 % at 6 months , 70 % at 5 months , and 40 % at 4 months . The main reason they gave for poor attendance was lack of motivation . The mean weight gain was 2 kg in the YMCA group . Conclusion : Most subjects did not regularly exercise or attend . They cited poor motivation as the main reason . The subject who exercised regularly lost a significant amount of weight BACKGROUND Obesity is common in persons with schizophrenia . Besides its adverse health effects , obesity reduces quality of life and contributes to the social stigma of schizophrenia . METHOD This 14-week , multicenter , open-label , rater-blinded , r and omized study evaluated the effects of a group-based behavioral treatment ( BT ) for weight loss in overweight and obese stable patients with DSM-IV schizophrenia or schizoaffective disorder who had been switched from olanzapine to risperidone .  Participants were r and omly assigned to receive BT or usual clinical care ( UC ) . BT included 20 sessions during which patients were taught to reduce caloric intake . In UC , patients were encouraged to lose weight but received no special advice about weight reduction . The primary outcome measure was change in body weight . RESULTS Seventy-two patients were enrolled . The mean + /- SD weight loss at endpoint was significant in both groups ( p < .05 ) and numerically greater in patients receiving BT than in those receiving UC ( -2.0 + /- 3.79 and -1.1 + /- 3.11 kg , respectively ) . More patients in the BT group than in the UC group had lost > or = 5 % of their body weight at endpoint ( 26.5 % [ 9/34 ] and 10.8 % [ 4/37 ] , respectively ; p = .082 ) . A post hoc analysis of patients attending at least 1 BT session showed that significantly more patients in the BT than the UC group had lost > or = 5 % of their body weight at endpoint ( 32.1 % [ 9/28 ] vs. 10.8 % [ 4/37 ] , respectively , p = .038 ) and at week 14 ( complete population ; 40.9 % [ 9/22 ] and 14.3 % [ 4/28 ] , respectively , p = .027 ) . CONCLUSION BT may be an effective method for weight reduction in patients with chronic psychotic illness OBJECTIVE Patients with schizophrenia treated with clozapine  often gain weight . This study evaluated the effects of dietary control and physical activity among obese in patients with schizophrenia being treated with clozapine . METHODS Fifty-three clozapine-treated obese patients with schizophrenia in a veterans hospital in eastern Taiwan who had a body mass index greater than 27 ( weight divided by height in meters squared ) and who were taking clozapine  were r and omly assigned to a study group of 28 or a control group of 25 . The study group was placed on a diet that reduced calorie intake by 200 to 300 kcal per day ( to 1,300 to 1,500 kcal per day for women and to 1,600 to 1,800 kcal per day for men ) and a six-month regimen of regular physical activity in which participants used approximately 600 to 750 kcal per week ( level 
    Output:
    
Adjunctive non-pharmacological interventions , either individual or group interventions , or cognitive-behavioural therapy as well as nutritional counselling were effective in reducing or attenuating antipsychotic-induced weight gain compared with treatment as usual , with treatment effects maintained over follow-up .
Preventive approaches have the potential to be more effective , acceptable , cost-efficient and beneficial