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Eating cognitions, emotions and behaviour under treatment with second generation antipsychotics: A systematic review and meta-analysis

Published online by Cambridge University Press:  19 July 2023

H. Mutwalli ,
J. L. Keeler ,
S. Bektas ,
N. Dhopatkar ,
J. Treasure  and
H. Himmerich
H. Mutwalli*
Affiliation:
Institute of Psychiatry, Psychology and Neurosciences, King’s College London, London, United Kingdom Department of Clinical Nutrition, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
J. L. Keeler
Affiliation:
Institute of Psychiatry, Psychology and Neurosciences, King’s College London, London, United Kingdom
S. Bektas
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King’s College London
N. Dhopatkar
Affiliation:
Eating Disorders Unit, South London and Maudsley NHS Foundation Trust (SLaM), London, United Kingdom
J. Treasure
Affiliation:
Institute of Psychiatry, Psychology and Neurosciences, King’s College London, London, United Kingdom Eating Disorders Unit, South London and Maudsley NHS Foundation Trust (SLaM), London, United Kingdom
H. Himmerich
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King’s College London Eating Disorders Unit, South London and Maudsley NHS Foundation Trust (SLaM), London, United Kingdom
*
*Corresponding author.

Abstract

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Introduction

Weight gain and metabolic disturbances are frequent in people treated with second generation antipsychotics (SGA).

Objectives

We aimed to investigate the effect of SGAs on eating behaviors, cognitions and emotions, as a possible contributor to weight gain and metabolic disturbances.

Methods

A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Original articles measuring outcomes relating to eating cognitions, behaviours and emotions, during treatment with SGAs were included in this review. A total of 92 papers with 11,274 participants were included from three scientific databases (PubMed, Web of Science and PsycInfo). Results were synthesized descriptively except for the continuous data where meta-analyses were performed and for the binary data where odds ratios were calculated.

Results

Hunger was increased in participants treated with SGAs with an odds ratio for appetite increase of 1.51 (95% CI [1.04, 1.97]; z=6.40; p<0.001)(see Figure 1.). Compared to controls, our results showed that craving for fat and carbohydrates are the highest among other craving subscales. There was a small increase in dietary disinhibition (SMD=0.40) and restrained eating (SMD=0.43) in participants treated with SGAs compared to controls and substantial heterogeneity across studies reporting these eating traits (See figure 2 and 3). There were few studies examining other eating-related outcomes such as food addiction, satiety, fullness, caloric intake and dietary quality and habits.

Image:

Image 2:

Image 3:

Conclusions

Understanding the mechanisms associated with appetite and eating-related psychopathology changes in patients treated with antipsychotics is needed to reliably inform the development of effective preventative strategies.

Disclosure of Interest

H. Mutwalli Grant / Research support from: The Saudi Arabian Government Educational Sponsorship for PhD, J. Keeler Grant / Research support from: The Medical Research Council, S. Bektas Grant / Research support from: The Turkish Ministry of National Education for PhD training, N. Dhopatkar Employee of: South London and Maudsley NHS Foundation Trust (SLaM), J. Treasure Grant / Research support from: The National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust (SLaM), Employee of: King’s College London, H. Himmerich Grant / Research support from: The National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust (SLaM), Employee of: King’s College London.

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S71 - S72
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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