Risk for eating disorders increased in schizophrenia patients
MedWire News: Antipsychotic-naïve patients with schizophrenia are at greater risk for eating disorders than the general population, results from an Egyptian study suggest.
Writing in Comprehensive Psychiatry, Mounir Fawzi and Mohab Fawzi from Zagazig University explain: "Multiple studies have consistently shown that eating disorders often display a range of additional psychiatric disorders of Axes I or II predominantly characterized by disorders of an anxious and depressive nature.
"To date, however, comorbidity of eating disorders with schizophrenia has been much less studied."
To investigate further, the researchers studied 50 antipsychotic-naïve schizophrenia patients, aged 18-60 years, who were attending a psychiatric outpatient clinic and 50 age- and gender-matched mentally healthy controls from the same geographic area as the patients.
The researchers note that only antipsychotic-naïve patients were recruited for their study as treatment with antipsychotics has previously been associated with disordered eating behaviour.
All of the participants were assessed for demographic and clinical variables. They also completed the Eating Attitudes Test (EAT40), with scores of 30 or higher, on a scale of 0-120, indicating the presence of disordered eating.
The researchers found that patients with schizophrenia had a significantly higher mean EAT40 score than controls, at 23.4 versus 19.7.
Furthermore, 30% of the schizophrenia patients had an EAT40 score of 30 or higher compared with just 12% of controls.
There were no significant differences between schizophrenia patients with and without disordered eating regarding demographic variables, a family history of psychiatric disorders, date and mode of onset of psychotic symptoms, and duration of untreated psychosis.
However, schizophrenia patients with disordered eating had higher total scores on the Positive and Negative Syndrome Scale (PANSS) than those without, at 86 versus 79, as well as higher PANSS positive symptom scores, at 25 versus 20. There were no significant differences between schizophrenia patients with and without disordered eating regarding PANSS negative symptom scores.
The researchers also found that schizophrenia patients with disordered eating consumed significantly more tea and coffee, had lower levels of leisure-time physical activity, and greater body mass index and waist circumference measurements than those without.
Fawzi and Fawzi conclude: "Data of this study show, perhaps for the first time, that disordered eating attitudes, as measured by the EAT40, are higher in a group of Egyptian patients with schizophrenia than in controls.
"However, the lack of difference between patients with and without disordered eating in terms of demographic characteristics and clinical characteristics studied fail to explain the hypothesis that schizophrenia with disordered eating is a distinct subtype of schizophrenia.
"Data indicate, on the other hand, that the presence of disordered eating behavior in patients with schizophrenia is associated with the expression of more active psychotic symptoms."
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By Mark Cowen