Behavioral Risks for Obesity and Overweight in Patients with Schizophrenia and Bipolar Disorder

Authors

  • Ngampoj Luansuwan Department of Psychiatry, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Daochompu Nakawiro Department of Psychiatry, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Keywords:

Obesity, Overweight, Schizophrenia, Eating behavior, Physical activity

Abstract

Objective: To study the relationship among factors affecting obesity and overweight in schizophrenia and bipolar disorder patient, including eating behavior, physical activity, and type of antipsychotic drugs.

Methods: A cross-sectional study in outpatients at psychiatric clinic, Ramathibodi Hospital is carried out in order to diagnose schizophrenia and bipolar disorder. Body weight, height and medications were recorded. Eating behavior and physical activity were assessed by self reported questionnaire. Data was statistically analyzed to identify correlations.

Results: 111 patient were recruited, of which their mean age is 42.3 year old. 64 of them (57.7%) were diagnosed as schizophrenia and 47 of them (42.3%) were diagnosed as bipolar disorder. Mean body mass index (BMI) of those participants is 25.78 kg/m2 (SD 4.78). 59 of them (53.15%) have obesity and 18 of them (16.21%) are overweight. The current BMI of each patient with each physical activity group is not different from that of the past 6 months (P value 0.90 and 0.72). The group of patients who have high eating behavior score tends to have low BMI, with no statistical significance (P = 0.532, Pearson correlation = -0.63). For 6 months change in BMI, the group of patients who have high eating behavior score tends to have less increase in BMI, with on statistical significance (P = 0.591, Pearson correlation = -0.055). The BMI values of the patients receiving the first and the second generation antipsychotic were not different (P = 0.37) but after 6 months each of them increased by 0.59 and 0.74 kg/m2, respectively. However, they were not significantly different in terms of statistics (P = 0.55). Eating behavior and physical activity of patients receiving first generation antipsychotic and second generation antipsychotic were not different (P = 0.14 and 0.08).

Conclusion: Eating behavior and physical activity may not relate to obesity or overweight in schizophrenia and bipolar disorder patients. Eating behavior and physical activity in patients receiving first generation antipsychotic and second generation antipsychotic were not different.

References

Visscher TL, Seidell JC. The public health impact of obesity. Annu Rev Public Health. 2001;22:355-75. doi:10.1146/annurev.publhealth.22.1.355.

Dickerson FB, Brown CH, Kreyenbuhl JA, Fang L, Goldberg RW, Wohlheiter K, et al. Obesity among individuals with serious mental illness. Acta Psychiatr Scand. 2006;113(4):306-13. doi:10.1111/j.1600-0447.2005.00637.x.

McEvoy JP, Meyer JM, Goff DC, Nasrallah HA, Davis SM, Sullivan L, Meltzer HY, et al. Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophr Res. 2005;80(1):19-32. doi:10.1016/j.schres.2005.07.014.

Homel P, Casey D, Allison DB. Changes in body mass index for individuals with and without schizophrenia, 1987-1996. Schizophr Res. 2002;55(3):277-84. doi:10.1016/S0920-9964(01)00256-0.

DE Hert M, Correll CU, Bobes J, Cetkovich-Bakmas M, Cohen D, Asai I, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry. 2011;10(1):52-77. doi:10.1002/j.2051-5545.2011.tb00014.x.

Brown S, Inskip H, Barraclough B. Causes of the excess mortality of schizophrenia. Br J Psychiatry. 2000;177:212-7. doi:10.1192/bjp.177.3.212.

Lawrence D, Kisely S, Pais J. The epidemiology of excess mortality in people with mental illness. Can J Psychiatry. 2010;55(12):752. doi:10.1177/070674371005501202.

Newcomer JW. Antipsychotic medications: metabolic and cardiovascular risk. J Clin Psychiatry. 2007;68 Suppl 4:8-13.

Likhitsathian S, Srisurapanont M. Prevalence of obesity and metabolic disturbance in Thai schizophrenic patients: a preliminary report. Department of Psychiatry, Faculty of Medicine, Chiang Mai University; 2004.

Vasiknanonte S, Oukantawong S. Metabolic syndrome in antipsychotic treated psychiatric patients. J Psychiatr Assoc Thailand. 2009;54(3):173-85. https://psychiatry.or.th/JOURNAL/54-3/04-Sorayut.pdf.

Holt RI, Peveler RC. Obesity, serious mental illness and antipsychotic drugs. Diabetes Obes Metab. 2009;11(7):665-79. doi:10.1111/j.1463-1326.2009.01038.x.

McElroy SL. Obesity in patients with severe mental illness: overview and management. J Clin Psychiatry. 2009;70 Suppl 3:12-21. doi:10.4088/JCP.7075su1c.03.

Nilsson BM, Forslund AH, Olsson RM, Hambraeus L, Wiesel FA. Differences in resting energy expenditure and body composition between patients with schizophrenia and healthy controls. Acta Psychiatr Scand. 2006;114(1):27-35. doi:10.1111/j.1600-0447.2005.00700.x.

Elmslie JL, Mann JI, Silverstone JT, Williams SM, Romans SE. Determinants of overweight and obesity in patients with bipolar disorder. J Clin Psychiatry. 2001;62(6):486-91; quiz 492-3.

Kalarchian MA, Marcus MD, Levine MD, Haas GL, Greeno CG, Weissfeld LA, et al. Behavioral treatment of obesity in patients taking antipsychotic medications. J Clin Psychiatry. 2005;66(8):1058-63.

Alvarez-Jiménez M, Martínez-García O, Pérez-Iglesias R, Ramírez ML, Vázquez-Barquero JL, Crespo-Facorro B. Prevention of antipsychotic-induced weight gain with early behavioural intervention in first-episode psychosis: 2-year results of a randomized controlled trial. Schizophr Res. 2010;116(1):16-9. doi:10.1016/j.schres.2009.10.012.

Tansupasiri P, Arunpongpaisal S, Pimpanit V, Khiewyoo J. The prevalence of metabolic syndrome in patients with schizophrenia at psychiatric outpatient clinic, Srinagarind Hospital. J Psychiatr Assoc Thailand. 2008;53(1):98-113. https://www.psychiatry.or.th/JOURNAL/53-1/10-Pattanop.pdf.

Rattanawiwatpong P, Khunphasee A, Pongurgsorn C, Intarakamhang P. Validity and reliability of the Thai version of Short Format International Physical Activity Questionnaire (IPAQ). J Thai Rehabil. 2006;16(3):147-60. https://rehabmed.or.th/main/wp-content/uploads/2015/01/L-235.pdf.

O'Neil PM, Currey HS. Hirsch AA, Malcolm RJ, Sexauer JD, Riddle FE, et al. Development and validation of the eating behavior inventory. J Behav Assess. 1979;1(2):123-132. doi:10.1007/BF01322019.

Bureau of Nutrition, Department of Health, Ministry of Public Health. Fatless Belly Thais Project. https://nutrition.anamai.moph.go.th/temp/main/view.php?group=8&id=225. Accessed July 10, 2010.

Kanazawa M, Yoshiike N, Osaka T, Numba Y, Zimmet P, Inoue S. Criteria and classification of obesity in Japan and Asia-Oceania. World Rev Nutr Diet. 2005;94:1-12. doi:10.1159/000088200.

McElroy SL, Frye MA, Suppes T, Dhavale D, Keck PE Jr, Leverich GS, et al. Correlates of overweight and obesity in 644 patients with bipolar disorder. J Clin Psychiatry. 2002;63(3):207-13.

Newcomer JW. Medical risk in patients with bipolar disorder and schizophrenia. J Clin Psychiatry. 2006;67(11):e16.

Ball MP, Coons VB, Buchanan RW. A program for treating olanzapine-related weight gain. Psychiatr Serv. 2001;52(7):967-9. doi:10.1176/appi.ps.52.7.967.

Misawa F, Shimizu K, Fujii Y, Miyata R, Koshiishi F, Kobayashi M, et al. Is antipsychotic polypharmacy associated with metabolic syndrome even after adjustment for lifestyle effects?: a cross-sectional study. BMC Psychiatry. 2011;11:118. doi:10.1186/1471-244X-11-118.

Tansupasiri P, Arunpongpaisal S, Pimpanit V, Khiewyoo J. The prevalence of metabolic syndrome in patients with schizophrenia at psychiatric outpatient clinic, Srinagarind Hospital. J Psychiatr Assoc Thailand. 2008;53(1):98-113. https://www.psychiatry.or.th/JOURNAL/53-1/10-Pattanop.pdf.

Fagiolini A, Frank E, Houck PR, Mallinger AG, Swartz HA, Buysse DJ, Prevalence of obesity and weight change during treatment in patients with bipolar I disorder. J Clin Psychiatry. 2002;63(6):528-33.

Downloads

Published

2012-06-29

How to Cite

1.
Luansuwan N, Nakawiro D. Behavioral Risks for Obesity and Overweight in Patients with Schizophrenia and Bipolar Disorder. Rama Med J [Internet]. 2012 Jun. 29 [cited 2024 Dec. 22];35(2):94-102. Available from: https://he02.tci-thaijo.org/index.php/ramajournal/article/view/120181

Issue

Section

Original Articles