Nutritional Needs in Mental Healthcare: Study Protocol of a Prospective Analytic Observational Study Assessing Nutritional Status, Eating Behavior and Barriers to Healthy Eating in Psychiatric Inpatients and Outpatients Compared to Healthy Adults

Abstract

BackgroundMental disorders are often associated with unhealthy eating behaviors and metabolic comorbidities. This can result in reduced life expectancy and poorer quality of life in people with mental disorders. This study protocol describes an observational study that examines the nutritional status and eating behaviors of people with severe mental illness (SMI) and the need for psychiatric treatment who were between 18 and 65 years old. In addition, the study focuses on possible barriers for healthy eating that have not yet been examined in this population.MethodsA total of 192 study participants will be recruited: 64 inpatients and 64 outpatients from the Psychiatric Hospital of the University of Zurich with SMI as well as 64 healthy individuals from the general population as a control group. The participants will be interviewed regarding their nutritional status, eating behavior, nutrition knowledge, food and cooking skills, personality, attitudes and feelings toward nutrition. In addition, the severity of symptoms and several control variables (e.g., sociodemographic variables and physical activity) will be assessed. For the patient samples, data will comprise routine medical data, and, if available, routine laboratory data. Inpatients will be interviewed once at the beginning of their treatment. Outpatients will be interviewed at the beginning and after 3 months of treatment (same interview questions). Healthy adults of the control group will be interviewed once at any time during the recruitment period.DiscussionThe described study will identify nutritional needs and possible barriers to healthy eating in patients with mental disorders. The results will help to define recommendations for nutritional risk screening in psychiatric patients and for planning effective nutritional interventions.

Effects of malnutrition on length of stay in patients hospitalized in an acute psychiatric ward

“…In 13.8% of the patients, obesity with nutritional deficiency according to CONUT score was found, which emphasizes the importance to characterize the different nutritional profiles of these patients according to their nutritional status. 29,30 This might allow clinicians to develop adequate nutritional risk screening tools considering specificity of this population 10,11,31 and determined approaches for different clinical situations. 32,33 According to our findings, clinicians should include nutritional status-related analytical parameters for a global assessment of the nutritional status, and to consider them as factors that might influence the organic and mental well-being of patients.…”

“…9 Another limitation is the lack of malnutrition risk screening tools for people with mental disorders. 10 However, there is an increasing interest to study the nutritional status in patients with severe mental disorders, 11,12 given the important burden that diet, lifestyle factors, and their consequences, may have in this population where physical health is often compromised, presenting a higher prevalence of cardiovascular diseases and a reduced life expectancy compared to the general population. 6,13,14 So far, various studies have reported nutritional status as a prognostic marker in a number of diseases.…”

Assessment of Nutritional Status and Risk of Malnutrition Using Adapted Standard Tools in Patients with Mental Illness and in Need of Intensive Psychiatric Treatment

“…This study was based on cross-sectional interview data and anthropometric measurements related to the assessment of the nutritional status and risk of malnutrition in people with SMI and the need for psychiatric treatment. The full prospective observational study was described in a previously published study protocol [21]. In total, 132 psychiatric patients, including 65 inpatients (Sample 1) and 67 outpatients (Sample 2), were interviewed at the beginning of their treatment at the Psychiatric Hospital of the University of Zurich (Psychiatrische Universitaetsklinik Zuerich [PUK]) in Switzerland.…”

“…Interviews were conducted on average 14 days after the participants' admissions. The whole interview, as described in the study protocol [21], lasted for an average of 1 hour, while this study included only some of the questions. The participants were offered a drink, and they were allowed to take breaks according to their preferences and mental conditions.…”

“…The interview and routine medical data were merged and analyzed in SPSS statistics (version 28) software using case identification codes and data. For the comparison of the samples, a sample size of n = 64 patients was calculated for each group (for details, see the corresponding study protocol [21]). First, variables such as BMI, WHR, sumscore of prescribed medications and risk scores, as well as SCL-K-9 and PHQ-D scale values, were calculated.…”