Faculty of Medicine, Department of Psychiatry, Zagazig University, Zagazig, Egypt.
Compr Psychiatry. 2012 Apr;53(3):259-68. doi: 10.1016/j.comppsych.2011.04.064. Epub 2011 Jun 2.
The study aimed to test in a sample of Egyptian antipsychotic naive patients the hypotheses that the disordered eating attitudes co-occur with schizophrenia in a higher frequency than would be expected by chance in the general population and that the disordered eating comorbidity would be associated with more severe schizophrenia psychopathology. Previous studies have been mostly concerned with the impact of the antipsychotics. Studies relating abnormal eating behavior to the schizophrenia psychopathology rather than to its treatment are lacking.
In this case-control cross-sectional study, 50 consecutive antipsychotic naive patients, newly attending the psychiatric outpatient clinic, University Hospital, Zagazig, Egypt, with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnosis of schizophrenia, were assessed by the Positive and Negative Syndrome Scale and compared with 50 nonpsychiatric controls using the Eating Attitudes Test (EAT40).
Patients with schizophrenia had an EAT40 mean score (23.4 ± 7.8) higher than that of controls (19.7 ± 7.2) (P = .015). Prevalence of disordered eating (defined by a score of ≥ 30 on the EAT40) in these patients was higher than in the control group (30% vs 12%, P = .027). Comparison between schizophrenia patients with and without disordered eating showed no significant differences in demographic and a number of clinical variables, but they differed in their scores on lifestyle characteristics and anthropometric measures. The group of patients with disordered eating had also higher scores on total and all scale factors but not on the negative symptom scale.
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 and a number of clinical characteristics 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.
本研究旨在检验在埃及初诊抗精神病药物治疗的精神分裂症患者样本中，以下两个假设的合理性：其一，饮食障碍与精神分裂症的共病发生率高于普通人群中的预期值；其二，饮食障碍共病与更严重的精神分裂症病理表现相关。既往研究大多关注抗精神病药物的影响，而缺乏将异常进食行为与精神分裂症病理表现而非其治疗相关联的研究。
在这项病例对照的横断面研究中，对 50 例连续就诊于埃及扎加齐格大学医院精神科门诊、初诊接受抗精神病药物治疗的精神分裂症患者（采用《精神障碍诊断与统计手册（第四版）》进行诊断）进行了评估，评估工具包括阳性与阴性症状量表（Positive and Negative Syndrome Scale）和饮食态度量表（Eating Attitudes Test，EAT40）。将这些患者与 50 例非精神科对照组进行比较。
精神分裂症患者的 EAT40 平均得分为（23.4 ± 7.8），高于对照组的（19.7 ± 7.2）（P =.015）。这些患者中饮食障碍的患病率（EAT40 评分≥30）高于对照组（30%比 12%，P =.027）。有和无饮食障碍的精神分裂症患者在人口统计学和一些临床变量上没有显著差异，但在生活方式特征和人体测量指标上存在差异。有饮食障碍的患者在总分和所有分量表因子上的得分更高，但在阴性症状量表上的得分没有差异。
本研究的数据首次表明，在埃及精神分裂症患者中，EAT40 所测量的“紊乱”饮食态度比对照组更高。然而，有和无饮食障碍的患者在人口统计学和一些临床特征方面没有差异，这使得精神分裂症伴饮食障碍是精神分裂症的一个特殊亚型的假说难以成立。另一方面，数据表明，精神分裂症患者存在饮食障碍行为与更活跃的精神病症状表现相关。
