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Abstract
Objectives
The aims of this study were to examine the relationship between obesity and psychopathology of inpatients with schizophrenia.
Methods
Eighty four inpatients with schizophrenia and 81 control subjects were recruited. Height and weight were measured for calculation of body mass index (BMI). Symptom severity scales [Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale] and Global Assessment of Functioning Scale (GAF) were conducted in all patients. Comorbid medical conditions, years of education, smoking status, age of onset, duration of illness, and medication history were collected.
Results
Patients with schizophrenia had significantly higher BMI and ratio of obesity than control subjects. Among patients, obese patients scored lower on symptom severity scales and better on functional assessment than not obese patients. Multiple regression analysis revealed an association of late onset and being obese with lower PANSS total score and better GAF score in patients. Late onset and being female were inversely related with negative symptom score. The type and dose of antipsychotics showed no association with obesity.
Conclusion
The results of this study indicate that patients with schizophrenia are likely to be more obese. Some characteristics of patients with less severe psychopathology, such as late onset, being obese, were coincident with the result of previous studies. In addition, the result showing that the heavier the weight of patients, the lower severity of symptoms was repeatedly reported in previous studies. The type and dose of antipsychotics were not associated with obesity. These results prompt further investigation of the relationship among schizophrenia, antipsychotics, and weight gain.
Figures and Tables
Fig. 1
Comparisons of weight status on PANSS scores, BPRS score, and GAF (between obese and not obese patients). P : PANSS positive scale, P3 : hallucinatory behavior (Z=-2.036 p=0.042), P6 : suspiciousness/persecution (Z=-2.611, p=0.009), Positive scale : PANSS positive scale total (Z=-2.141, p=0.032), N : PANSS negative scale, N4 : passive/apathetic social withdrawal (Z=-2.262, p=0.024), PANSS : PANSS total score (Z=-2.056, p=0.040), GAF : (Z=-2.649, p=0.008), BPRS score : (Z=-1.952, p=0.051). PANSS : Positive and Negative Syndrome Scale, GAF : Global Assessment of Functioning Scale, BPRS : Brief Psychiatric Rating Scale.
Fig. 2
In male patients : comparisons of weight status on PANSS scores, BPRS score, and GAF (between obese and not obese male patients). In female patients, no differences observed between obese and not obese female patients. P : PANSS positive scale, P6 : suspiciousness/persecution (Z=-2.172, p=0.030), N : PANSS negative scale, N2 : emotional withdrawal (Z=-2.027, p=0.021), N3 : poor rapport (Z=-2.624, p=0.004), N4 : passive/apathetic social withdrawal (Z=-2.551, p=0.005), N5 : difficulty in abstract thinking (Z=-1.840, p=0.033), G : general psychopathology, G1 : somatic concern (Z=-1.697, p=0.045), G3 : guilt feelings (Z=-1.804, p=0.037), G4 : tension (Z=-1.735, p=0.042), G15 : preoccupation (Z=-2.253, p=0.012), G16 : active social avoidance (Z=-1.662, p=0.049), Negative scale : PANSS negative scale total (Z=-2.444, p=0.015), PANSS : PANSS total score (Z=-2.794, p=0.005), GAF : (Z=-2.646, p=0.008), BPRS score : (Z=-2.049, p=0.040). PANSS : Positive and Negative Syndrome Scale, GAF : Global Assessment of Functioning Scale, BPRS : Brief Psychiatric Rating Scale.
Table 1
Demographic and clinical characteristics of the patients and control subjects
Values are mean±SD or n (%). Polytherapy : Atypical antipsychotics+atypical antipsychotics or typical antipsychotics. * : Independent t-test for continuous variables and chi-square or Fisher's exact test for categorical variables, † : Analysis of covariance test, ‡ : p-value<0.05. AP : Antipsychotics, CPZ : Chlorpromazine, BMI : Body mass index, SD : Standard deviation, RR : Relative risk
Table 2
Clinical characteristics and psychopathology of schizophrenia patients
Values are mean±SD or n (%). * : Nonparametric test (Mann-Whitney U test) for ordinal variables, chi-square or Fisher's exact test for categorical variables, † : p-value<0.05. PANSS : Positive and Negative Syndrome Scale, GAF : Global Assessment of Functioning Scale, BPRS : Brief Psychiatric Rating Scale, DM : Diabetes mellitus, HTN : Hypertension, SD : Standard deviation
Table 3
Demographic and clinical characteristics of the obese patients and not obese patients
Values are mean±SD or n (%). Polytherapy : atypical antipsychotics+atypical antipsychotics or typical antipsychotics. * : Independent t-test for continuous variables and chi-square or Fisher's exact test for categorical variables, † : p-value<0.05. AP : Antipsychotics, CPZ : Chlorpromazine, SD : Standard deviation
Table 4
Multiple regressions modeling for psychopathology
Stepwise method used. * : R2=0.126, Adjusted R2=0.103, df=2, 76, F=5.478, Sig=0.006, † : R2=0.131, Adjusted R2=0.109, df=2, 76, F=5.750, Sig=0.005, ‡ : R2=0.138, Adjusted R2=0.113, df=2, 76, F=5.968, Sig=0.004. Std.Error : Standard error, VIF : Variance inflation factor, PANSS : Positive and Negative Syndrome Scale, GAF : Global Assessment of Functioning Scale
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