Eder Julia, Glocker Catherine, Barton Barbara, Sarisik Elif, Popovic David, Lämmermann Jana, Knaf Alexandra, Beqiri-Zagler Anja, Engl Katharina, Rihs Leonie, Pfeiffer Lisa, Schmitt Andrea, Falkai Peter, Simon Maria S, Musil Richard
Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU, Munich, Germany.
Graduate Program "POKAL - Predictors and Outcomes in Primary Care" (DFG-GrK 2621), Munich, Germany.
Acta Psychiatr Scand. 2025 Mar;151(3):231-244. doi: 10.1111/acps.13684. Epub 2024 Apr 1.
Weight gain is a common side effect in psychopharmacology; however, targeted therapeutic interventions and prevention strategies are currently absent in day-to-day clinical practice. To promote the development of such strategies, the identification of factors indicative of patients at risk is essential.
In this study, we developed a transdiagnostic model using and comparing decision tree classifiers, logistic regression, XGboost, and a support vector machine to predict weight gain of ≥5% of body weight during the first 4 weeks of treatment with psychotropic drugs associated with weight gain in 103 psychiatric inpatients. We included established variables from the literature as well as an extended set with additional clinical variables and questionnaires.
Baseline BMI, premorbid BMI, and age are known risk factors and were confirmed by our models. Additionally, waist circumference has emerged as a new and significant risk factor. Eating behavior next to blood glucose were found as additional potential predictor that may underlie therapeutic interventions and could be used for preventive strategies in a cohort at risk for psychotropics induced weight gain (PIWG).
Our models validate existing findings and further uncover previously unknown modifiable factors, such as eating behavior and blood glucose, which can be used as targets for preventive strategies. These findings underscore the imperative for continued research in this domain to establish effective preventive measures for individuals undergoing psychotropic drug treatments.
体重增加是精神药理学中常见的副作用;然而,在日常临床实践中目前缺乏针对性的治疗干预措施和预防策略。为了促进此类策略的发展,识别有风险的患者的指示因素至关重要。
在本研究中,我们开发了一种跨诊断模型,使用并比较决策树分类器、逻辑回归、极端梯度提升(XGboost)和支持向量机,以预测103名精神科住院患者在使用与体重增加相关的精神药物治疗的前4周内体重增加≥5%的情况。我们纳入了文献中已有的变量以及一组包含额外临床变量和问卷的扩展变量。
基线体重指数(BMI)、病前BMI和年龄是已知的风险因素,并且得到了我们模型的证实。此外,腰围已成为一个新的重要风险因素。除血糖外,饮食行为被发现是另一个潜在的预测因素,可能是治疗干预的基础,并且可用于有精神药物所致体重增加(PIWG)风险的队列中的预防策略。
我们的模型验证了现有发现,并进一步揭示了以前未知的可改变因素,如饮食行为和血糖,这些因素可作为预防策略的目标。这些发现强调了在该领域持续研究的必要性,以便为接受精神药物治疗的个体建立有效的预防措施。