Disordered Eating in Patients With Remission Schizophrenia: A Highly Prevalent but Largely Under-Explored Condition Despite Its Potential Relation to Psychopathology

Abstract

Background:

Disordered eating (DE) remains a relatively under-researched topic in schizophrenia.

Aim:

This study aimed to investigate prevalence and biopsychosocial correlates of DE in patients with remission schizophrenia.

Method:

A total of 208 stable patients with schizophrenia including those with DE (n = 75; Eating Attitudes Test [EAT-40] scores ⩾30 or binge eating disorder [BED] diagnosis or Night Eating Questionnaire [NEQ] scores >30) and those with healthy eating (n = 133) were evaluated in terms of Positive and Negative Syndrome Scale (PANSS) positive scale, Calgary Depression Scale for Schizophrenia (CDSS), Childhood Trauma Questionnaire (CTQ) and Pittsburg Sleep Quality Index (PSQI).

Results:

At least one component of DE was noted in 36.1% of patients with remission schizophrenia, including BED (17.8%) patients, the risk of NES (NEQ > 30; 20.7%) and risk of eating disorder (EAT-40 ⩾ 30; 14.4%). Metabolic risk factors including elevated weight circumference (p < .001), overweight (p < .001), obesity (p < .001) and hypercholesterolemia (p = .039) were significantly more prevalent in in the DE versus healthy eating group. PANSS excitement (p = .008) and hostility (p = .022), CDSS total (p = .003) and emotional abuse (p = .003) and PSQI total (p < .001) scores were significantly higher in the DE versus healthy eating group. NEQ scores were negatively correlated with years in remission (r = −.189, p = .006) and positively correlated with PANSS delusions (r = .217, p = .002), excitement (r = .211, p = .002) and hostility (r = .207, p = .003) scores and CTQ physical abuse scores (r = .153, p = .027).

Conclusions:

Presence of comorbid DE in the setting of remission schizophrenia seems to be closely related to more frequent excitement/hostility symptoms and a shortened remission time, besides its association with metabolic risk factors, childhood emotional abuse, comorbid depression and poor sleep quality. Screening for DE in patients with schizophrenia, regardless of the phase, seems to be of critical importance to prevent adverse outcomes of unrecognized DE on physical, emotional and mental well-being of patients during the entire course of disease.