Research

Eating and weight related cognitions in people with Schizophrenia : A case control study

Yasser Khazaal¹, Emmanuelle Frésard¹, Grégoire Zimmermann^2,3, Nathalie Morinière Trombert⁴, Valentino Pomini¹, François Grasset¹, François Borgeat¹ and Daniele Zullino⁵

¹  Department of Psychiatry – CHUV, University of Lausanne, Site de Cery, 1008 Prilly, Switzerland

²  Institut Universitaire de Psychothérapie, Département de Psychiatrie-CHUV, Université de Lausanne, Site de Cery, 1008 Prilly, Switzerland

³  Chaire de psychologie clinique, Département de Psychologie, Université de Fribourg, Fribourg, Switzerland

⁴  Fondation Edith Seltzer, Médical Center Chantoiseau, Briançon, France

⁵  University Hospitals of Geneva, Division of Substance Abuse, Rue Verte 2, 1205 Geneva, Switzerland

Clinical Practice and Epidemiology in Mental Health 2006, 2:29doi:10.1186/1745-0179-2-29

Published:	31 October 2006

Abstract

Background

Patients with antipsychotic-induced weight gain (WG) regularly report on unsuccessful dietary trials, which suggests strong biological weight gain drive that is extremely hard to overcome with thoughts, such that behaviour doesn't change despite some intent to change. The purpose of the present study was to assess cognitions specifically related to restrained eating in severely overweight patients with schizophrenia treated with antipsychotic drugs.

Methods

Forty outpatients with schizophrenia and 40 controls without psychiatric disability were included. Both groups were composed of one subgroup severely overweight (defined as a BMI > 28), and a comparison sample (BMI<28). The revised version of the Mizes Anorectic cognitive questionnaire (MAC-R) was used in this cross-sectional case-control study.

Results

Gender was significantly related to eating disorders cognition, women scoring higher than men. Patients with schizophrenia in general scored higher on the MAC-R total scale and on the MAC-R subscale 2, the latter score representing rigid weight regulation and fear of weight gain. When comparing the two groups of subjects with BMI < 28, it appeared that patients with schizophrenia also scored higher on MAC-R total scale, the subscales 2 and 3, the latter subscale 3, indicating altered self control and self-esteem.

Conclusion

As is the case in weight gain of subjects without schizophrenia, the present results suggest that the cognitive distortions, as assessed by the MAC-R, may play an important role in weight gain also in patients with schizophrenia, and in weight gain associated with antipsychotic pharmacotherapy. Particular attention to these processes may help to improve the management of antipsychotic drugs induced weight gain.