Participants
eating behavior, anorexia, eating disorders, psychiatric, daytime fatigue, bulimia nervosa, overweight, obesity, DSM-5, reduced appetite
DIABETES MELLITUS, SHOP, ANOREXIA
The medical ethics Committee on Research involving Human Subjects of Radboudumc (CCMO, Arnhem-Nijmegen) approved the study and it is registered under 2021–8224. Written informed consent regarding participation and publication from all parents or guardians for participants under 16 years will be obtained during the randomized controlled trial.Participants will be recruited among new referrals at Karakter Child- and Adolescent Psychiatry and Denkkracht, The Netherlands. Karakter is a hospital for specialist mental health care, and Denkkracht a center for neuropsychological expertise. The selection of participants is a 2-step process. First, our digital intake questionnaire is used to select potential participants. Before the first appointment at the clinic, parents must complete this digital intake questionnaire. This assessment includes age, sex, country of birth, and parents’ educational level. In the section on lifestyle, various questions about physical exercise, healthy eating behavior, sleeping patterns, and screen time are asked. Potential participants are selected when they positively respond to one or more of the following questions:How much time does your child spend in front of a screen compared to peers (How much exercise does your child have compared to peers? (How often does it take longer than 30 min for your child to fall asleep? (How often does your child wake up more than three times per night, or does your child lie awake for more than 20 min per night? (How often does your child wake up before 6 am? (How often does your child experience daytime fatigue? (How many days a week does your child eat breakfast? (How many days a week does your child eat fruit? (How many days a week does your child eat vegetables? (How many times a day does your child get snacks (biscuits, candy, chips)? (How many days a week does your child eat “fast food” (pizza, chips, pancakes, chip shop, snack bar, etc.)? (Secondly, following a positive response to these items, participants are invited for a somatic assessment and eligibility check for the Movementss study by a nurse specialist and child and adolescent psychiatrist. Somatic assessment includes measurement of weight, height, blood pressure, heart rate, head circumstances, an inspection of dysmorphic features, and motor functioning and coordination.For eligibility, participants must meet the following criteria: 1) 6–12 years old at the inclusion date, 2) DSM-5 diagnosis (any presentation), 3) somatic or lifestyle problems assessed by somatic examination and lifestyle screening (overweight, obesity, underweight, unhealthy diet, sleeping problems, inactivity, and screen time use), and 4) willingness to set lifestyle goals. Comorbidities are allowed except for eating disorders (i.e., anorexia or bulimia nervosa) and diabetes mellitus. Exclusion criteria are: 1) unable to respond to questions (parents or children), 2) no access to a home internet connection, 3) insufficient mastery of the Dutch language in parents or children, 4) physically incapable of doing physical exercises, 5) surgery in the past six months or next twelve months impacting physical activity or dietary intake, 6) any somatic condition severely restricting diet, current treatment for the psychiatric diagnosis, and 7) an intelligence quotient (IQ) below 70. Participants receiving this lifestyle intervention cannot start any other treatment during the 12-week-long lifestyle intervention, except for the optimization of pharmacotherapy. For children who receive medication, this will be optimized during the lifestyle intervention. During this optimization, the physical health of the children will be closely monitored since lifestyle-related problems (e.g. sleeping problems, reduced appetite, and overweight) more often occur when using medication. Similarly, participants receiving CAU will receive one session of digital psycho-education on a healthy lifestyle though they will not follow a lifestyle intervention.