Food addiction and associated factors in newly diagnosed patients with schizophrenia: a cross-sectional comparison with siblings and healthy controls

Abstract

Despite the potential clinical and treatment relevance of food addiction (FA) among individuals with schizophrenia, the scientific literature on its characteristics and correlates within this population is sparse. Limited knowledge on FA in patients with schizophrenia may impede progress in developing effective treatments for pathological eating patterns and the common obesity and metabolic syndrome problems in this population. Considering these research gaps, the present study aimed to compare the nature and prevalence of FA symptoms among patients with first-episode schizophrenia, their siblings, and healthy controls. As a secondary objective, this study sought to examine the psychopathological correlates of FA in the patients’ group. A cross-sectional study was conducted in Razi Hospital, Tunis, Tunisia, from January to June 2024. A total of 112 newly diagnosed, clinically stabilized patients with first-episode schizophrenia, 77 of their unaffected siblings and 78 healthy controls were included. FA was assessed using the modified version of the Yale Food Addiction Scale (mYFAS 2.0). The Metacognitions Questionnaire (MCQ-30) and the Emotion Regulation Questionnaire were administered to the patients’ group. Findings showed a higher prevalence of FA in the patient group (32.1%) compared to both siblings (13.0%) and controls (9.0%). Siblings had higher FA scores compared to controls (16.12 ± 4.95 versus 15.00 ± 6.09; p < 0.001). After Bonferroni correction for multiple testing, higher FA scores were significantly associated with less cognitive self-consciousness (Beta = − 0.54), older age (Beta = 0.45), and higher psychological distress (Beta = 0.63). Our findings suggest that people with first-episode schizophrenia are likely to present with co-occurring FA, and experience associated distress. Findings also provide initial support for a possible connection between dysfunctional metacognitive beliefs and FA in patients with schizophrenia, suggesting that cognitive self-consciousness may be a fundamental cognitive process in FA in this population. This may lend some theoretical and clinical implications for alleviating FA symptoms in schizophrenia. There is some evidence to support that food addiction is highly comorbid with schizophrenia. Food addiction might explain the unhealthy eating habits, the poor nutrient intake profile, as well as the high rates of obesity and metabolic syndrome often observed in schizophrenia since the very early stages. However, the co-occurrence of food addiction with schizophrenia remains largely misunderstood and understudied. Such as limited knowledge on the topic is concerning, as it may impede progress in developing effective treatments for pathological eating patterns and addressing the common obesity and metabolic syndrome problems in this population. This study proposed to explore the nature and prevalence of food addiction symptoms in patients with first-episode schizophrenia who have limited exposure to antipsychotic drugs, their siblings, and healthy controls. As a secondary objective, this study sought to examine the psychopathological correlates of food addiction in the patients’ group. Findings showed a higher prevalence of food addiction in the patient group relative to both siblings and controls. No significant differences in food addiction severity were found between siblings and controls. Multivariable analyses showed that older age, more psychological distress, and lower “cognitive self-consciousness” metacognitive beliefs were significantly associated with greater food addiction.