Preventing antipsychotic-induced weight gain in first-episode psychosis: Transitioning dietitians into routine care

AbstractPatients with schizophrenia have a lower than average life span, largely due to the increased prevalence of cardiometabolic co-morbidities. Identification of individuals with psychotic disorders with a high risk of rapid weight gain, and the associated development of metabolic complications, is an unmet need as regards public health. Here, we applied mass spectrometry-based lipidomics in a prospective study comprising 48 controls (CTR), 44 first-episode psychosis (FEP) patients and 22 individuals at clinical-high-risk (CHR) for psychosis, from two study centers (Turku/Finland and London/UK). Baseline serum samples were analyzed by lipidomics, while body mass index (BMI) was assessed at baseline and after 12 months. We found that baseline triacylglycerols with low double bond counts and carbon numbers were positively associated with the change in BMI at follow-up. In addition, a molecular signature comprised of two triacylglycerols (TG(48:0) and TG(45:0)), was predictive of weight gain in individuals with a psychotic disorder, with an area under the receiver operating characteristic curve (AUROC) of 0.74 (95% CI: 0.60–0.85). When independently tested in the CHR group, this molecular signature predicted said weight change with AUROC = 0.73 (95% CI: 0.61–0.83). We conclude that molecular lipids may serve as a predictor of weight gain in psychotic disorders in at-risk individuals, and may thus provide a useful marker for identifying individuals who are most prone to developing cardiometabolic co-morbidities.

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Polymorphisms of the 5-HT2C receptor and leptin genes are associated with antipsychotic drug-induced weight gain in Caucasian subjects with a first-episode psychosis

Pharmacogenetics and Genomics ◽

10.1097/01213011-200504000-00002 ◽

2005 ◽

Vol 15 (4) ◽

pp. 195-200 ◽

Cited By ~ 199

Author(s):

Lucy A. Templeman ◽

Gavin P. Reynolds ◽

Belen Arranz ◽

Luis San

Keyword(s):

Weight Gain ◽

Antipsychotic Drug ◽

First Episode Psychosis ◽

First Episode ◽

Drug Induced ◽

Episode Psychosis

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The Psychology of Food Cravings in Patients With First-Episode Psychosis

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.587486 ◽

2020 ◽

Vol 11 ◽

Author(s):

Young-Hyuk Kim ◽

Seunghyong Ryu ◽

Hee-Jung Nam ◽

Mina Kim ◽

Min Jhon ◽

...

Keyword(s):

Body Weight ◽

Weight Gain ◽

Perceived Stress ◽

First Episode Psychosis ◽

Psychological Characteristics ◽

First Episode ◽

Loss Of Control ◽

Food Cravings ◽

Significant Weight Gain ◽

Episode Psychosis

Objectives: Food cravings may cause weight gain in patients with schizophrenia. This study investigated psychological characteristics associated with food cravings in patients with first-episode psychosis.Methods: This study analyzed data from a clinical cohort of first-episode psychosis patients taking antipsychotics for 3 months or less. The strength of food cravings was measured using the General Food Cravings Questionnaire-Trait (G-FCQ-T). Psychological characteristics and psychiatric symptoms were investigated with the Positive and Negative Symptom Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Social and Occupational Functioning Assessment Scale, Rosenberg Self-Esteem Scale (RSES), and Perceived Stress Scale (PSS). Clinical characteristics were compared according to significant weight gain (≥10% increase in body weight compared to baseline) over 3 months. Associations between the G-FCQ-T and other psychiatric scales were investigated. We conducted sex-stratified analyses.Results: In total, 182 patients (78 males and 104 females) with first-episode psychosis were enrolled in this study. In females, the G-FCQ-T total score at baseline was associated with baseline body weight and significant weight gain over 3 months. The PSS scales were significantly associated the G-FCQ-T total and all subscale scores in female participants. Scores on the RSES and CDSS were significantly associated with the G-FCQ-T total score and with the preoccupation and loss of control subscale scores. The PANSS negative and general subscales were significantly associated with the positive outcome expectancy and loss of control subscales of the G-FCQ-T, respectively. In males, the only significant association was between the loss of control subscale and RSES scores. Linear regression analysis showed significant associations of PSS scores with the total and all subscale scores of the G-FCQ-T despite the loss of significance for other variables.Conclusion: These results indicate that the food cravings in patients with first-episode psychosis, which were associated with weight gain, were influenced by perceived stress in females. To reduce food cravings in female patients with schizophrenia, interventions aimed at perceived stress should be considered.

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Clinical correlates of weight gain in first episode psychosis patients treated with olanzapine

Schizophrenia Research ◽

10.1016/s0920-9964(03)80215-3 ◽

2003 ◽

Vol 60 (1) ◽

pp. 372 ◽

Cited By ~ 5

Author(s):

R. Zipursky ◽

H. Gu ◽

A.I. Green ◽

F. Centorrina ◽

I. Glick ◽

...

Keyword(s):

Weight Gain ◽

First Episode Psychosis ◽

First Episode ◽

Clinical Correlates ◽

Episode Psychosis

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Association Between Circulating Lipids and Future Weight Gain in Individuals With an At-Risk Mental State and in First-Episode Psychosis

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa087 ◽

2020 ◽

Cited By ~ 1

Author(s):

Santosh Lamichhane ◽

Alex M Dickens ◽

Partho Sen ◽

Heikki Laurikainen ◽

Faith Borgan ◽

...

Keyword(s):

At Risk ◽

Weight Gain ◽

High Risk ◽

Psychotic Disorders ◽

First Episode Psychosis ◽

Molecular Signature ◽

First Episode ◽

Baseline Serum ◽

Average Life Span ◽

Episode Psychosis

Abstract Patients with schizophrenia have a lower than average life span, largely due to the increased prevalence of cardiometabolic comorbidities. There is an unmet public health need to identify individuals with psychotic disorders who have a high risk of rapid weight gain and who are at risk of developing metabolic complications. Here, we applied mass spectrometry-based lipidomics in a prospective study comprising 48 healthy controls (CTR), 44 first-episode psychosis (FEP) patients, and 22 individuals at clinical high risk (CHR) for psychosis, from 2 study centers (Turku, Finland and London, UK). Baseline serum samples were analyzed using lipidomics, and body mass index (BMI) was assessed at baseline and after 12 months. We found that baseline triacylglycerols (TGs) with low double-bond counts and carbon numbers were positively associated with the change in BMI at follow-up. In addition, a molecular signature comprised of 2 TGs (TG[48:0] and TG[45:0]) was predictive of weight gain in individuals with a psychotic disorder, with an area under the receiver operating characteristic curve (AUROC) of 0.74 (95% CI: 0.60–0.85). When independently tested in the CHR group, this molecular signature predicted said weight change with AUROC = 0.73 (95% CI: 0.61–0.83). We conclude that molecular lipids may serve as a predictor of weight gain in psychotic disorders in at-risk individuals and may thus provide a useful marker for identifying individuals who are most prone to developing cardiometabolic comorbidities.

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Weight gain in first-episode psychosis over three years

Schizophrenia Research ◽

10.1016/j.schres.2006.06.035 ◽

2006 ◽

Vol 86 (1-3) ◽

pp. 335-336 ◽

Cited By ~ 7

Author(s):

Jean Addington ◽

Huma Saeedi ◽

Donald Addington

Keyword(s):

Weight Gain ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis

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Weight Gain in First-Episode Psychosis

The Canadian Journal of Psychiatry ◽

10.1177/070674370304800412 ◽

2003 ◽

Vol 48 (4) ◽

pp. 272-276 ◽

Cited By ~ 29

Author(s):

Jean Addington ◽

Chrystal Mansley ◽

Donald Addington

Keyword(s):

Body Mass Index ◽

Weight Gain ◽

Body Mass ◽

First Episode Psychosis ◽

First Episode ◽

First Year ◽

Optimum Treatment ◽

Episode Psychosis ◽

Second Generation Antipsychotics ◽

Potential Weight

Objective: To examine the extent of weight gain in the first year of treatment in an early psychosis program. Method: Subjects were 114 individuals who had experienced a first episode of psychosis and had completed 1 year in a comprehensive first-episode program. Weight and body mass index were calculated on entry to the program and at 6 and 12 months. Most of the subjects were all being prescribed second-generation antipsychotics. Results: Significant increases in mean weight were observed in these young individuals over the course of the first year of treatment. Conclusions: If we are to work toward optimum treatment for first-episode subjects then potential weight gain needs to be addressed at the beginning of treatment and monitored during treatment.

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