Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nußbaumstraße 7, 80336, Munich, Germany.
Eur Arch Psychiatry Clin Neurosci. 2023 Jun;273(4):839-851. doi: 10.1007/s00406-022-01442-4. Epub 2022 Jul 1.
Many psychiatric patients suffer from overweight/obesity and subsequent metabolic disturbances, where psychotropic medication is one of the main contributors. However, the magnitude of weight gain ranges individually, which leads to questioning the role of other contributors like lifestyle factors. The present study investigated several lifestyle factors among psychiatric inpatients, their relation to biological factors, and their predictive capability for weight gain during treatment. Using a naturalistic observational study design, psychiatric inpatients of all diagnoses were followed for 4 weeks from the start of treatment with weight gain-associated medication. N = 163 participants entered the study. Lifestyle factors were assessed by patient self-report questionnaires. Body weight change over time was calculated relative to baseline body weight. Our study provides three main findings: (1) Obesity and/or metabolic syndrome (metSy) were associated with emotional eating (disinhibition), craving for fast food and sweets, and weight cycling. (2) Patients without metSy and normal BMI experienced increased sweets craving (also for women), a more positive attitude towards drugs, and an improvement of affect (also for men). (3) Sex, presence of metSy and/or drug dosage interacted with disinhibition change, sweets craving change (trend), and fast food craving change to predict weight change over time. Furthermore, drug attitude change interacted with BMI, drug dosage, and presence of metSy to predict weight change. Lifestyle factors, especially eating behaviors, are related to metabolic disturbances and predict weight gain in interaction with clinical parameters.
许多精神科患者患有超重/肥胖症和随后的代谢紊乱，而精神药物是主要原因之一。然而，体重增加的幅度因人而异，这导致人们质疑其他因素（如生活方式因素）的作用。本研究调查了精神科住院患者的几种生活方式因素、它们与生物学因素的关系，以及它们在治疗期间预测体重增加的能力。本研究采用自然观察研究设计，对开始服用与体重增加相关的药物治疗的所有诊断的精神科住院患者进行了 4 周的随访。共有 163 名参与者入组本研究。生活方式因素通过患者自我报告问卷进行评估。体重随时间的变化相对于基线体重进行计算。我们的研究提供了三个主要发现：（1）肥胖和/或代谢综合征（metSy）与情绪性进食（抑制障碍）、对快餐和甜食的渴望以及体重循环有关。（2）无 metSy 和正常 BMI 的患者经历了甜食渴望增加（也适用于女性）、对药物的更积极态度以及情绪改善（也适用于男性）。（3）性别、metSy 的存在与否以及/或药物剂量与抑制障碍变化、甜食渴望变化（趋势）以及快餐渴望变化相互作用，可预测随时间的体重变化。此外，药物态度的变化与 BMI、药物剂量和 metSy 的存在相互作用，可预测体重的变化。生活方式因素，尤其是饮食行为，与代谢紊乱有关，并与临床参数相互作用预测体重增加。
