The impact of a multimodal intervention on physical health factors and lifestyle in patients with affective disorders - results from a randomized controlled trial.

Background: Traditional treatment for affective disorders primarily focuses on symptom management through pharmacotherapy and psychotherapy and rarely addresses co-existing physical impairments. Methods: This randomized controlled trial assessed the impact of a six-month multimodal intervention (AWARE) on physical health in patients with bipolar and unipolar depressive disorders. A total of 103 patients, median age 40.75 years (65 % female), were randomized into the AWARE group (n = 50) or treatment as usual (TAU) group (n = 53). The AWARE intervention included five modules focused on activities of daily living, mood management, social relations, physical health, and cognition, with participants receiving approximately 12 sessions. TAU involved standard psychiatric care, Health outcomes were evaluated on sleep, metabolic markers, substance use, medication side effects, and perceived physical health. Statistical analyses used logistic regression for group comparisons and analysis of covariance for continuous outcomes. Results: The AWARE group had significant improvements in sleep onset latency and reported reduced physical pain affecting daily work compared to TAU. However, no statistically significant differences were found in other physical health outcomes, such as metabolic markers, substance use, medication side effects, or perceived physical health. Study limitations include a modest sample size and a relatively short intervention duration. Conclusion: While the AWARE intervention improved sleep and pain management, it did not significantly affect other health markers. Future research should involve longer intervention periods, larger sample sizes, and a comprehensive approach to both mental and physical health.