Eating Disorders in Schizophrenia

Abstract

BackgroundDue to their frequency and negative impact on quality of life, eating disorders in schizophrenia need to be considered and highlighting.ObjectiveTo identify the risk of eating disorders (ED) and its correlates among mental patients.MethodsIt was a descriptive and analytic study. It included 53 inpatients with DSM-5 diagnoses of schizophrenia or schizoaffective disorder, followed in the department of Psychiatry at the Hedi Chaker University Hospital of Sfax in Tunisia, during the three months of August, September and October 2016. Data collections were conducted using questionnaire exploring sociodemographic and medical data. The SCOFF (sick, control, one, fat, food) Questionnaire was used to screen ED. A total score of ≥ 2 was used as a cutoff point to select persons at risk of ED.ResultsThe average age of our patients was 30.47 ± 9.5 years old. The majority of our patients was male (71.7%) and single (71%). The mean of extra Body mass was 27.9. The mean duration of disease was 9.9 ± 8.1 years and patients were mostly (54%) in atypical neuroleptics. According to the SCOFF Questionnaire, 35.8% had a risk of ED. Female gender and treatment with atypical neuroleptics were significantly associated to ED risk with respectively P = 0.02 and P = 0.038.ConclusionEating disorders remain underestimated among patients suffering from schizophrenia. Yet, its screening prevention and management are crucial and must be multidisciplinary for optimal care.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Biopsychosocial factors associated with disordered eating behaviors in schizophrenia

“…As the third part, there were significant differences in the EAT-26 scores regarding the duration of psychosis and category of antipsychotic medications, which are consistent with the findings of Sallemi et al [16], Sentissi et al [21], Kouidrat et al [6], Blouin et al [18], and Fawzi et al [34]. These results, however, are inconsistent with the results obtained by Kouidrat et al [22] that showed no significant differences between TFEQ scores, category of antipsychotic medications, and duration of psychosis.…”

“…This finding is consistent with the results obtained by Kouidrat et al [ 22 ], suggesting no significant gender difference in uncontrolled eating. However, a significantly higher risk of DEBs in the female gender was reported by Sallemi et al [ 16 ] and Sentissi et al [ 21 ]. Regardless of the results of Sallemi et al [ 16 ] and Sentissi et al [ 21 ], the present study together with wider literature proposed that DEBs were equally evident in men and women with schizophrenia, which is contrary to the general population that females are typically more affected [ 6 ].…”

“…However, the prevalence of DEBs among schizophrenic patients was 35.8% in the study by Sallemi et al [ 16 ] through the SCOFF questionnaire, and 30% in the study conducted by Fawzi et al [ 34 ] using the 40-item Eating Attitudes Test (EAT-40). The disparity in the frequency of DEBs between the present study and the studies by Sallemi et al [ 16 ] and Fawzi et al [ 34 ] may be due to the type of questionnaires, the number of participants, socio-demographic characteristics, and disregarding schizophrenic patients with type 2 diabetes and/or currently smoking patients. However, the above results confirmed the hypothesis that the prevalence of DEBs in schizophrenic patients is higher compared to the general population.…”

“…Additionally, recent animal and clinical researches have suggested that antipsychotics can lead to changes in dietary habits and hyperphagic effects, thereby causing a lack of satiation and increased appetite [15][16][17].…”

“…This evidence is consistent with previous research on schizophrenia patients, indicating that the treatment with atypical antipsychotics is associated with more frequent DEBs compared to typical antipsychotics [ 18 – 21 ]. In this regard, Sallemi et al [ 16 ] used the SCOFF questionnaire to examine 53 Tunisian patients and reported DEBs among 35.8% of participants (mostly women and those with the use of atypical neuroleptics). Besides, Sentissi et al [ 21 ] evaluated eating behaviors of 153 schizophrenic patients using the Three-Factor Eating Questionnaire (TFEQ) and reported that DEBs in patients are influenced by gender and treatment with atypical antipsychotics.…”