ISRCTN ISRCTN91030407
DOI https://doi.org/10.1186/ISRCTN91030407
ClinicalTrials.gov (NCT) Nil known
Clinical Trials Information System (CTIS) Nil known
Protocol serial number 181024
Sponsor University of Zurich
Funders University of Zurich / Psychiatric University Clinic Zurich; Fonds für wissenschaftliche Zwecke im Interesse der Heilung von psychischen Krankheiten. , Stiftung zur Förderung von Psychiatrie und Psychotherapie
Submission date
18/10/2024
Registration date
30/10/2024
Last edited
14/11/2024
Recruitment status
Recruiting
Overall study status
Ongoing
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
People with severe mental illness (SMI) often have unhealthy eating habits, even though they usually understand what a healthy diet is and want to follow it. This study aims to compare the effects of a new group therapy approach with the usual treatment methods.

Who can participate?
People between 18 and 65 years old with a diagnosis of depression, bipolar disease or psychosis with a Body-Mass-Index (BMI) over 25 and the desire to lose weight.

What does the study involve?
The study involves two groups and participants will be assigned randomly to one of the groups. The control group involves the usual treatment (nutritional counseling and standard group therapy). The intervention group involves the usual treatment, but the standard group therapy is replaced with a new group therapy specificially designed to help patients change their dietary behavior. The new group therapy takes place once a week for a duration of 8 weeks. All patients will be tested before and after the treatment (blood sample, stool sample, dietary behavior, physical activity, psychological assessment, sociodemographic data, medical history, current medication and treatment).

What are the possible benefits and risks of participating?
There is no additional risk for the control group. For the intervention group, there is a minimal risk associated with the psychotherapy elements of the new group therapy, which has not been tested yet.
Nutritional counseling is known to have positive effects on dietary behavior. In general, group therapy is an effective psychotherapeutic intervention.
Participants will receive CHF 100 for their time spent.

Where is the study run from?
The Psychiatric University Hospital Zurich, Switzerland.

When is the study starting and how long is it expected to run for?
October 2024 to June 2027

Who is funding the study?
Stiftung zur Förderung von Psychiatrie und Psychotherapie (Zürich, Switzerland)
Fonds für wissenschaftliche Zwecke im Interesse der Heilung von psychischen Krankheiten (Zürich, Switzerland)

Who is the main contact?
Dr med. Florian Hotzy, florian.hotzy@pukzh.ch
Dr Eileen Neumann, eileen.neumann@gmx.ch

Contact information

Dr Eileen Neumann
Public, Scientific, Principal investigator

Psychiatrische Universitätsklinik Zürich
Militärstrasse 8
Zürich
8021
Switzerland

ORCiD logoORCID ID 0000-0001-8543-6265
Phone +41583847471
Email eileen.neumann@pukzh.ch

Study information

Primary study designInterventional
Study designMonocenter open-label randomized head-to-head study with two study arms
Secondary study designRandomised controlled trial
Study type Participant information sheet
Scientific titleBehavioral therapy to induce a healthier lifestyle and more self-efficacy in psychiatric patients (HEALTH study): A naturalistic randomized controlled trial
Study acronymHEALTH
Study objectivesStudy participants receiving the HEALTH intervention will have better anthropometric measures (BMI and WHR) after the intervention (T1) and in the long term (T2) compared to individuals receiving TAU only.
Ethics approval(s)

Submitted 13/11/2024, Kantonale Ethikkommission Zürich (Stampfenbachstrasse 121, Zürich, 8090, Switzerland; +41 43 259 79 70; info.kek@kek.zh.ch), ref: 2024-02177

Health condition(s) or problem(s) studiedPsychosis, depression, bipolar disease
InterventionHEALTH Intervention:
The intervention is planned to consist of 8 group sessions in groups of 5–10 patients every 7 days.
The sessions cover the following main topics:
- Healthy diet
- Physical activity
- Circadian rhythm
Therapeutic focus is set on: behavioral therapy support to identify and change problem behavior, small goals (microsteps), and enhance self efficacy.

The control group will receive treatment as usual (TAU):
Nutritional counseling plus group sessions in a standard group therapy (e.g. art therapy or recreational contact group).

RedCap software will be used for assignment either to the intervention or control group (allocation ratio 1:1, block randomization).
Intervention typeBehavioural
Primary outcome measure(s)

1. BMI is measured using weight and height at baseline (T0), week 9 (T1), and week 24 (T2)
2. WHR is measured using a measuring tape at baseline (T0), week 9 (T1), and week 24 (T2)

Key secondary outcome measure(s)

1. Inflammatory markers are measured using a venous blood sample of 24 ml at baseline (T0), week 9 (T1), and week 24 (T2)
2. Gut microbiome composition is measured using a stool sample at baseline (T0), week 9 (T1), and week 24 (T2)
3. Dietary behavior is measured using the Rapid-Eating-Assessment of Participants-Short version (REAP-S), Food-Frequency-Questionnaire (FFQ), Practical Knowledge about Balanced Meals scale (PKB-7), and Salzburg Emotional Eating Scale (SEES) at baseline (T0), week 9 (T1), and week 24 (T2)
4. Physical activity is measured using the Xiaomi Smart Band 8 and a self-rating scale for physical activity at baseline (T0), week 9 (T1), and week 24 (T2)
5. Psychological assessment is measured using the Goal Attainment Scale (GAS), Beck Depression Inventory (BDI), Self-efficacy Scale (SWE), Symptom-Checklist (SCL-K-9), World Health Organization Quality of Life (WHOQOL-BREF), and Schlafqualitäts-Fragebogen (PSQI) at baseline (T0), week 9 (T1), and week 24 (T2)

Completion date30/06/2027

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
Upper age limit65 Years
SexAll
Target sample size at registration100
Key inclusion criteria1. Age 18-65 years
2. SMI including ICD-10 F2 or F3 diagnosis
3. BMI >25 kg/m² and desire to lose weight
Key exclusion criteria1. Comorbid substance use disorder (F1) or eating disorder (F5)
2. Current medical conditions such as acute infectious disease
3. Taking medication to reduce weight (e.g. GLP-1 receptor agonists) and participating in another nutritional counselling
Date of first enrolment01/01/2025
Date of final enrolment31/12/2026

Locations

Countries of recruitment

  • Switzerland

Study participating centre

Psychiatrische Universitätsklinik Zürich
Militärstrasse 8, Postfach 2019
Zürich
8021
Switzerland

Results and Publications

Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
IPD sharing planThe datasets generated during and / or analysed during the current study will be available upon request from Dr. med. Florian Hotzy (florian.hotzy@pukzh.ch).

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Participant information sheet Participant information sheet 11/11/2025 11/11/2025 No Yes

Editorial Notes

14/11/2024: Ethics submission date and reference added.
18/10/2024: Study's existence confirmed by Psychiatric University Clinic Zurich.