Abstract

Author(s)

Tracy Burrows, Scott Teasdale, Janice Plain, Deanne Harris, Tetyana Rocks, Adrienne Forsyth, Georgina Latimer, Michelle Roberton, Julia Schindlmayr.

Introduction

Accredited Practising Dietitians (APDs) are health professionals equipped to take a lead role in multidisciplinary teams to provide effective, evidence based dietary interventions for the prevention, treatment and management of mental illness and/or associated physical illness. A body of research work was undertaken with two distinct aims (1) to determine the extent of research undertaken on the effectiveness of dietary interventions for individuals with a mental disorder on dietary intake, mental health symptomology and physical health outcomes, (2) to explore the extent of the evidence of experimental studies evaluating the cost effectiveness of dietary interventions in individuals with mental disorders

Methods

Systematic reviews were undertaken for each aim through searching a range of online databases to identify published research studies. Each review was inclusive of a range of mental health conditions including disordered eating, severe mental illness, substance use, depression and anxiety. For each review standardised screening and data extraction was undertaken using recognised international methodology.

Results

Aim 1

A total of 46 reviews were included across areas of: disordered eating (N=3), severe mental illness (N=31), substance use disorders (N=3), and depression and anxiety (N=9), totalling 46 included systematic reviews within this rapid review. The majority of reviews were published within the last five years (i.e. since 2016) (N=27), and included studies conducted in adult populations (N=28). Most reviews in the areas of severe mental illness and depression and anxiety reported conclusions in support of the positive effects of dietary intervention, including for nutrition education and behaviour change type interventions.

Aim 2

A total of 13 articles reporting on eight studies were included. Seven studies were in community settings (e.g. outpatient clinics), and one study in the community housing setting. All studies were in adults, seven included male and female participants. Defined mental disorder diagnoses included serious/severe mental disorders (n=3), major depression (n=2), schizophrenia, schizoaffective disorder or first-episode psychosis (n=1), any mental disorder (n=1), and bulimia nervosa (n=1). Five interventions were multi-behaviour, two were diet only and one was an eating disorder treatment. Cost analyses included cost-utility (n=3), cost-effectiveness (n=1), cost-utility and cost-effectiveness (n=3), and a costing study (n=1). Two studies (25%) reported positive results in favour of cost effectiveness, and four studies reported a mix of positive and neutral results.

Discussion

Dietitians have a defined role statement for mental health, a position paper, and from the reviews support that dietary interventions show promising results to improve mental health and may be a cost effective approach.