Sixteen studies were included in the review (242 completing; the total number of patients recruited was not reported in 3 studies). There were 2 randomised controlled trials (RCTs; n=50), 5 quasi-experimental studies, 4 cohort studies and 5 case studies.
Five of the 7 studies scoring 50% or more on study quality were smoking cessation studies. Most of the studies were small (sample size less than 20). The drop-out rates ranged from 0 to 60% (mean 16.6). Only one study did not use a reliable and valid outcome measure. None of the studies followed up the patients beyond 6 months.
Smoking (7 studies, including 2 RCTs): 5 studies reported smoking cessation rates ranging from 35 to 50% post-treatment and from 12 to 18% after 6 months; the other 2 studies did not report cessation rates. Cessation rates tended to be higher when nicotine replacement of bupropion was used and with atypical rather than typical antipsychotics. None of the studies showed a worsening of positive psychotic symptoms or of side-effects of medications. Three studies showed an improvement in negative symptoms.
Weight (5 studies, 37 people recruited; results reported for 20 people): 17 of the 20 patients with results data lost weight during the intervention.
Exercise (3 studies, 33 people completing): 2 studies showed improvements in aerobic fitness, while the third showed patients exercised more frequently with contingency management.
Nutrition (1 quasi-experimental study comparing intervention with usual treatment, 11 patients): the results were inconclusive. Two patients in each treatment group showed a positive change in shopping behaviour, while two patients in the intervention group showed a negative change.