Background
obesity, mental illness, ASD, cognitive behavior, comorbidity, anxiety, Attention Deficit Hyperactivity Disorder, sleep behavior, ADHD, autism spectrum disorders, depression
OBESITY, ADVERSE EFFECTS, DISORDERS
In recent years, increasing attention has been given to lifestyle and their effects on mental health. Various studies consistently show that adults with mental illness (MI) have higher rates of physical ill health and die earlier than those in the general population, largely due to treatable conditions associated with modifiable risk factors such as smoking, obesity, substance misuse, and adverse effects of medication [Unhealthy lifestyle and poor physical health are also frequently seen among children with MI, such as autism spectrum disorders (ASD), Attention Deficit Hyperactivity Disorder (ADHD), depression, and anxiety disorders, compared to children without MI [Research on lifestyle-related factors and integrated lifestyle programs for children and their families in the general population is increasing [Based on the programs for children without MI, the Movementss study has been developed. This is a multi-modal lifestyle intervention program with a systematic approach focusing on four lifestyle parameters (i.e., movement/physical activity, nutrition intake, sleep behavior, and screen time restoration) for children with MI and their families. The trial will focus on the relationship between an integrated lifestyle intervention program and the quality of life for children with mental illness and their families. To assess the added value of this lifestyle intervention, children will be randomized into two groups: intervention and care as usual group. The intervention involves family-based education on a healthy lifestyle in combination with cognitive behavior therapy (CBT) for the child and psychomotor systematic therapy (PMST) for the whole family given by mental health professionals. In PMST, the child and caregiver work in a body-oriented manner, and they both learn concrete skills (i.e., an action-oriented approach) [Since a healthy lifestyle contains multiple elements (i.e., nutrition, sleep, screen time, and physical activity), the intervention will have a tailored approach, where the child and caregiver will take the lead in their goal setting. An integrated approach focusing on multiple lifestyle factors (including psycho-education and skills training), social (peer)support, and guided by qualified professionals does have the best chance of success [The primary objective of the Movementss study is to quantify the short-term (after 12 weeks) and long-term (after 6 and 12 months) effectiveness on quality of life compared to care as usual (CAU) in children aged 6–12 years with MI. We hypothesize that the lifestyle intervention will be more effective than CAU. The second aim is to examine the short- and long-term effects of the lifestyle intervention compared to CAU on outcome measures related to mental and physical symptoms and lifestyle problems such as emotional and behavioral problems, cognitive outcomes, sleeping, eating patterns, and weight status. It is hypothesized that lifestyle improvement will have a positive effect on these mental and physical symptoms. Additionally, the third aim is to investigate the cost-effectiveness of the lifestyle intervention compared with CAU. We assume that intervening in lifestyle at such a young age will result in less expensive care in the long term. Also, this study aims to identify potential moderators of adherence or responders to the treatment (e.g., SES, ethnicity, comorbidity). Finally, qualitative questions will be addressed in this study by examining the potential facilitators and barriers to the lifestyle intervention.