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


Mutwalli H., Keeler J. L., Bektas S., Dhopatkar N., Treasure J., Himmerich H.

Journal of Psychiatric Research, vol.160, pp.137-162, 2023 (SCI-Expanded, SSCI, Scopus) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 160
  • Publication Date: 2023
  • Doi Number: 10.1016/j.jpsychires.2023.02.006
  • Journal Name: Journal of Psychiatric Research
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, Academic Search Premier, ASSIA, PASCAL, BIOSIS, EMBASE, MEDLINE, Psycinfo
  • Page Numbers: pp.137-162
  • Keywords: Eating behaviour, Appetite, Food craving, Food addiction, Atypical antipsychotic, Second generation antipsychotic
  • Hacettepe University Affiliated: No

Abstract

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.