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

TY - JOUR

T1 - Eating cognitions, emotions and behaviour under treatment with second generation antipsychotics: A systematic review and meta-analysis

AU - Mutwalli, Hiba

AU - Keeler, Johanna

AU - Bektas, Sevgi

AU - Dhopatkar, Namrata

AU - Treasure, Janet

AU - Himmerich, Hubertus

N1 - Funding Information: H.M. acknowledges financial support from the Saudi Arabian Government Educational Sponsorship for PhD training, Saudi Arabia. J.K. received a PhD stipend from the Medical Research Council (reference number: MR/N013700/1), United Kingdom. S.B. acknowledges financial support from the Turkish Ministry of National Education for PhD training, Turkey. N.D. recieves salary support from South London and Maudsley NHS Foundation Trust. H.H. and J.T. received salary support from the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust (SLaM) and KCL, United Kingdom. The views expressed are those of the author(s) and not necessarily those of the Saudi Arabian Government, the MRC or the NIHR BRC. Funding Information: H.M. acknowledges financial support from the Saudi Arabian Government Educational Sponsorship for PhD training, Saudi Arabia. J.K. received a PhD stipend from the Medical Research Council (reference number: MR/N013700/1 ), United Kingdom. S.B. acknowledges financial support from the Turkish Ministry of National Education for PhD training, Turkey. N.D. recieves salary support from South London and Maudsley NHS Foundation Trust . H.H. and J.T. received salary support from the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust (SLaM) and KCL, United Kingdom . The views expressed are those of the author(s) and not necessarily those of the Saudi Arabian Government, the MRC or the NIHR BRC. Publisher Copyright: © 2023 The Authors

PY - 2023/2/8

Y1 - 2023/2/8

N2 - Weight gain and metabolic disturbances are frequent in people treated with second generation antipsychotics (SGA). We aimed to investigate the effect of SGAs on eating behaviors, cognitions and emotions, as a possible contributor to this adverse effect. A systematic review and a meta-analysis were 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. 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). 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. There were few studies examining other eating-related outcomes such as food addiction, satiety, fullness, caloric intake and dietary quality and habits. 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.

AB - Weight gain and metabolic disturbances are frequent in people treated with second generation antipsychotics (SGA). We aimed to investigate the effect of SGAs on eating behaviors, cognitions and emotions, as a possible contributor to this adverse effect. A systematic review and a meta-analysis were 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. 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). 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. There were few studies examining other eating-related outcomes such as food addiction, satiety, fullness, caloric intake and dietary quality and habits. 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.

UR - http://www.scopus.com/inward/record.url?scp=85150079263&partnerID=8YFLogxK

U2 - 10.1016/j.jpsychires.2023.02.006

DO - 10.1016/j.jpsychires.2023.02.006

M3 - Review article

SN - 0022-3956

VL - 160

SP - 137

EP - 162

JO - Journal of psychiatric research

JF - Journal of psychiatric research

ER -