Volume 6, Issue 3, September 2018, Page: 86-94
Long-Term Weight Gain and Prevalence of Obesity in General Adult Psychiatric Inpatients
Carlo Lazzari, Department of General Adult Psychiatry, Essex Partnership University NHS Foundation Trust (EPUT), Colchester, United Kingdom; Department of Statistical Modelling, International Centre for Healthcare and Medical Education (ICHME), Bristol, United Kingdom
Ahmed Shoka, Department of General Adult Psychiatry, Essex Partnership University NHS Foundation Trust (EPUT), Colchester, United Kingdom
Basavaraja Papanna, Department of General Adult Psychiatry, Essex Partnership University NHS Foundation Trust (EPUT), Colchester, United Kingdom
Marco Rabottini, Department of Statistical Modelling, International Centre for Healthcare and Medical Education (ICHME), Bristol, United Kingdom
Received: Jul. 25, 2018;       Accepted: Aug. 27, 2018;       Published: Oct. 6, 2018
DOI: 10.11648/j.ajpn.20180603.16      View  285      Downloads  25
Abstract
Weight gain is a common concern in general adult psychiatry. However, there are no extensive and longitudinal studies to show how weight gain variates and if it does so in the inpatient population. We collected the electronic data of the weights from a sample of 186 psychiatric and non-forensic inpatients hospitalized in Essex, United Kingdom, these data being relative to a period from one to ten years. Statistical methods included the coefficient of determination R2 for progressive measures of weight, Cohen’s d for R2, and meta-analysis to calculate the coefficient of heterogeneity I2 of individual R2 and mean weights. Subsequently, the body weights were compared with the national Body Mass Index (BMI = Kg/m2). The results showed that the time variation of body weight was low to medium for male patients (R2 = 0.17; d = 0.44), and medium to high for female patients (R2 = 0.27; d = 0.74). Additionally, the average BMI for female patients was 31.21 (SD = ±7.73) corresponding to the WHO Class I Obesity spectrum while for males it was 27.05 (SD = ±5.92) corresponding to the WHO Overweight Class spectrum. In conclusion, overweight in males and obesity in females are commonly found in psychiatric non-forensic inpatients. However, in our study, only 27% of the females’ and 17% of the males’ variation in body weight was explained by the time variable. Consequently, one conclusion is that increased BMI might be comorbid with psychiatric disorders although the direction of the reciprocal influence should be investigated.
Keywords
Psychiatry, Inpatients, Body Mass Index, Obesity, Weight-Gain, Meta-Analysis, Borderline Personality Disorder
To cite this article
Carlo Lazzari, Ahmed Shoka, Basavaraja Papanna, Marco Rabottini, Long-Term Weight Gain and Prevalence of Obesity in General Adult Psychiatric Inpatients, American Journal of Psychiatry and Neuroscience. Vol. 6, No. 3, 2018, pp. 86-94. doi: 10.11648/j.ajpn.20180603.16
Copyright
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Lin HY, Huang CK, Tai CM, Lin HY, Kao YH, Tsai CC, Hsuan CF, Lee SL, Chi SC, Yen YC. Psychiatric disorders of patients seeking obesity treatment. BMC Psychiatry, 2013, 13(1):1-8.
[2]
Long C, Rowell A, Gayton A, Hodgson E, Dolley O. Tackling obesity and its complications in secure settings. Mental Health Review Journal, 2014; 19(1):37-46.
[3]
Day M, Maxine J. Working together to address obesity in adult mental health secure units. A systematic review of the evidence and a summary of the implications for practice. London: Public Health England, 2017. Available: https://www.gov.uk/government/publications/obesity-in-mental-health-secure-units.
[4]
Gatineau M., Dent M. Obesity and mental health. Oxford: National Obesity Observatory and National Health Service (NHS) 2011. Available: https://www.scie-socialcareonline.org.uk/obesity-and-mental-health/r/a11G00000017trJIAQ
[5]
Lopresti AL, Drummond PD. Obesity and psychiatric disorders: Commonalities in dysregulated biological pathways and their implications for treatment. Prog Neuropsychopharmacol Biol Psychiatry, 2013; 45:92-99.
[6]
Hilton NZ, Ham E, Lang C, Harris TG. Weight gain and its correlates among forensic inpatients. CJP, 2015; 60(5):232-238.
[7]
Gebhardt S, Haberhausen M, Heinzel-Gutenbrunner M, Gebhardt N, Remschmidt H, Krieg JC, Hebebrand J, Theisen FM. Antipsychotic-induced body weight gain: Predictors and a systematic categorization of the long-term weight course. Antipsychotic-induced body weight gain: Predictors and a systematic categorization of the long-term weight course. J Psychiatr Res, 2009; 43(6):620-626.
[8]
Uguz F, Sahingoz M, Gungor B, Aksoy F, Askin R. Weight gain and associated factors in patients using newer antidepressant drugs. Gen Hosp Psychiatry, 2015; 37(1):46-48.
[9]
Küçük L, Kaya H, Çömez T, Kaçar S, Kutlu Y, Zülfikar H. Eating behaviors and related factors in psychiatric patients. Arch Psychiatr Nurs, 2018; 32(2):194-199.
[10]
Sánchez-Villegas A, Toledo E, de Irala J, Ruiz-Canela M, Pla-Vidal J, and Martínez-González. Fast-food and commercial baked goods consumption and the risk of depression. Public Health Nutr, 2012; 15(3):424-432.
[11]
Bruce-Keller AJ, Salbaum MJ, Luo M, Blanchard IV E, Taylor CM, Welsh DA, Berthoud H-R. Reply to: High-fat diet-induced dysbiosis as a cause of neuroinflammation. Biol Psychiatry, 2016; 80: e5–e6.
[12]
Sholtz S, Morgan JF. Obesity and psychiatry. Psychiatry, 2009; 8(6):198-202.
[13]
Dickerson FB, Brown CH, Kreyenbuhl JA, Fang L, Goldberg RW, Wohlheiter K, Dixon LB. Obesity among individuals with serious mental illness. Acta Psychiatr Scand, 2006; 113(4): 306-313.
[14]
Lazzari C, Shoka A, Papanna B, Kulkarni K. Predominant diagnoses, gender, and admission duration in an adult psychiatric inpatient hospital in United Kingdom. OJPAS, 2017; 9(1):37-40.
[15]
Sansone RA, and Sansone LA. The relationship between borderline personality and obesity. Innov Clin Neurosci, 2013; 10(4):36–40.
[16]
Rajan TM, and Menon V. Psychiatric disorders and obesity: A review of association studies. JPGM, 2017; 63(3):182-190.
[17]
Udtha M, Nomie K, Yu E, Sanner J. Novel and emerging strategies for longitudinal data collection. J Nurs Scholarsh, 2015; 47(2):152–160.
[18]
Perlis RH, Iosifescu DV, Castro VM, Murphy N, Gainer VS, Minnier J, et al. Using electronic medical records to enable large-scale studies in psychiatry: treatment resistant depression as a model. Psychol Med, 2012; 42(1):41–50.
[19]
Lazzari C, Shoka A, Mousailidis G, Papanna B. Meta-analysis of long-term weight gain in general adult psychiatric inpatients [version 1; not peer reviewed]. F1000Res, 2017; 6:2014 (slides) (doi: 10.7490/f1000research.1115085.1).
[20]
Lazzari C., Shoka A., Papanna B, Mousalidis G. Long-Term weight gain in psychiatric inpatients: A Meta-Analysis. Proceedings of the 27th European Congress of Psychiatry (EPA), Nice, 2018, Eur Psychiat, 2018; 48:PW0847.
[21]
Hidese S, Ota M, Matsuo J, Ishida I, Hirashi M, Yoshida S, et al. Association of obesity with cognitive function and brain structure in patients with major depressive disorder. J Affect Disorders, 2018; 225:188-194.
[22]
Monda V, La Marra M, Perrella R, Caviglia G, Iavarone A, et al. Obesity and brain illness: from cognitive and psychological evidences to obesity paradox. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2017; 10:473–479.
[23]
Guo X, Zhang Z, Wei Q, Lv H, Wu R, Zhao J. The relationship between obesity and neurocognitive function in Chinese patients with schizophrenia. BMC Psychiatry, 2013; 13(109):1-6.
[24]
Prickett C, Brennan L, Stolwyk R. Examining the relationship between obesity and cognitive function: A systematic literature review. Obes Res Clin Pract, 2015; 9:93-113.
[25]
Huthwaite M, Elmslie J, Every-Palmer S, Grant E, Sarah Romans SE. Obesity in a forensic and rehabilitation psychiatric service: a missed opportunity? Journal of Forensic Practice, 2017; 19(4):269-267.
[26]
Haw C, and Jean Stubbs J. What are we doing about weight management in forensic psychiatry? A survey of forensic psychiatrists. The British Journal of Forensic Practice, 2011; 13(3):183-190.
[27]
Deux N, Schlarb AA, Martin F, Holtmann M, Hebebrand J, Legenbauer T. Overweight in adolescent, psychiatric inpatients: A problem of general or food-specific impulsivity. Appetite, 2017; 112: 157-166.
[28]
Kisely S, Cox M, Campbell LA, Cooke C, Gardner D. An epidemiologic study of psychotropic medication and obesity-related chronic illnesses in older psychiatric patients. CJP, 2009; 54(4):269-274.
[29]
Kisely S, Cox M, Campbel LA, Cooke C, Gardner D. An epidemiologic study of psychotropic medication and obesity-related chronic illnesses in older psychiatric patients. Can J Psychiatry, 2009; 54(4):269–274.
[30]
Hirsch L, Yang J, Bresee L, Jette N, Patten S, Pringsheim T. Second-generation antipsychotics and metabolic side effects: A systematic review of population-based studies. Drug Saf. 2017; 40(9):771-781.
[31]
Raben AT, Marshe VS, Chintoh A, Gorbovskaya I, Müller DJ, Hahn MK. The complex relationship between antipsychotic-induced weight gain and therapeutic benefits: A systematic review and implications for treatment. Front. Neurosci., 2018; 11:Art 741.
[32]
Hussain T, Margoob MA, Shoib S, Shafat M, Chandel KR. Prevalence of metabolic syndrome among psychiatric inpatients: A hospital-based study from Kashmir. Journal of Clinical and Diagnostic Research, 2017; 11(6):VC05-VC08
[33]
Santini I, Stratta P, D’onofrio S, De Laurentis I, Santarelli V, Pacitti F, Rossi A. The metabolic syndrome in an Italian psychiatric sample: a retrospective chart review of inpatients treated with antipsychotics. Riv Psichiatr 2016; 51(1):37-42.
[34]
Følling IS, Kulseng B., HelviK A-S. Overweight, obesity and related conditions: a cross-sectional study of adult inpatients at a Novergian hospital. BMC Research Notes 2014, 7(115):1-6.
[35]
National Health Service Digital (NHS Digital). Statistics on obesity, physical activity and diet. 2017. Available: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/613532/obes-phys-acti-diet-eng-2017-rep.pdf.
[36]
Powers AD, Oltmanns TF. Borderline Personality pathology and chronic health problems in later adulthood: The mediating role of obesity. Personal Disord, 2013; 4(2):152-159.
[37]
Danese A, Tan M. Childhood maltreatment and obesity: systematic review and meta-analysis. Mol Psychiatr, 2014, 19:544–554.
[38]
Nemiari D, Shim R, Mattox G, Holden K. The relationship between obesity and depression among adolescents. Psychiatr Ann, 2012; 42(8):305-308.
[39]
Polanka BM, Vrany EA, Patel J, Stewart JC. Depressive disorder subtypes as predictors of incident obesity in US adults: Moderation by race/ethnicity. Am J Epidemiol. 2017; 185(9):734–742.
[40]
Nigatu YT, Bültmann U, Reijneveld SA. The progressive association between obesity and major depression in the general population: does single or recurrent episode matter? BMC Public Health, 2015; 15(350):1-8.
[41]
Orešič M. Obesity and psychotic disorders: uncovering common mechanisms through metabolomics. Dis Model Mech 2012; 5(5):614–620.
[42]
Kolenic M, Frankec K, Hlinka J, Matejka M, Capkova J, Pausova Z, Uher R, Alda M, Spaniel F, Hajek T. Obesity, dyslipidemia and brain age in first-episode psychosis. J Psychiat Res, 2018; 99:151-158.
[43]
Spangaro M, Mazza E, Poletti S, Cavallaro R, Benedetti F. Obesity influences white matter integrity in schizophrenia. Psychoneuroendocrino 2018; 97:135-142.
[44]
Zhao Z, Okusaga OO, Quevedo J, Soares JC, Teixeira AL. The potential association between obesity and bipolar disorder: A meta-analysis. J Affect Disorders, 2016; 202:120-123.
[45]
Islam AH, Metcalfe AWS, MacIntosh BJ; Korczak DJ, Goldstein, BI. Greater body mass index is associated with reduced frontal cortical volumes among adolescents with bipolar disorder. J Psychiatry Neurosci 2018; 43(2):120-130.
[46]
Chouinard V-A, Pingali SM, Chouinard G, Henderson CD, Mallya SG, Cypess AM, Cohen BM, Öngür D. Factors associated with overweight and obesity in schizophrenia, schizoaffective and bipolar disorders. Psychiatry Research, 2016; 237:304-310.
[47]
British Broadcasting Corporation (BBC). Statistics reveal Britain’s ‘Mr and Mrs Average. 3 October 2010, Available at: https://www.bbc.co.uk/news/uk-11534042.
[48]
Medcalc. Significance of one proportion. 2018 [Online] Available: https://www.medcalc.org/calc/test_one_proportion.php
[49]
Brown School of Public Health. Open Meta-Analyst. 2018; [Online] Available: http://www.cebm.brown.edu/openmeta/download.html.
[50]
National Health Service. BMI Calculator. 2018 [Online] Available: https://www.nhs.uk/Tools/Pages/Healthyweightcalculator.aspx
[51]
Moorse JM, and Niehaus L. Mixed method design: Principles and procedures. London and New York: Routledge; 2009.
[52]
Tashakkori A, Teddlie C. (Eds.) (2003). Handbook of mixed methods in social and behavioural research. Thousand Oaks, California: SAGE; 2003.
[53]
Schifferdecker KE, Reed VA. Using mixed methods research in medical education: Basic guidelines for researchers. Med Educ, 2009; 43:637–644.
[54]
Haidich AB. Meta-analysis in medical research. Hyppokratia, 2010; 14 (1):29–37.
[55]
Nordmann AJ, Kasenda B, Briel M. Meta-analyses: What they can and cannot do. Swiss Medical Weekly, 2012; 142.
[56]
Rosendaal FR, Reitsma PH (2014). Meta-analysis. Journal of Thrombosis and Hemostasis, 2014; 12:1009.
[57]
Fernandes J, Ferreira-Santos F, Miller K, Torres S. Emotional processing in obesity: a systematic review and exploratory meta-analysis. Obes Rev, 2018; 19:111-120.
[58]
Eggerm M (1997). Meta-analysis: principles and procedures. BMJ, 1997; 315:1533.
[59]
Cook DA. Randomized controlled trials and meta-analysis in medical education.: What role do they play? Med Teach, 2012; 34:468–473.
[60]
Ishak KJ, Platta RW, Joseph L, Hanley JA, Caroa JJ. Meta-analysis of longitudinal studies. Clin Trials, 2007; 4:525–539.
[61]
Zhang D. A coefficient of determination for generalized linear models. Am Stat, 2017; 71(4):310-316.
[62]
Magnusoon K. Interpreting correlations: An interactive visualization. 2018 [Online]. Available: http://rpsychologist.com/d3/cohend/
[63]
Lenhard W, Lenhard A (2016). Calculation of effect sizes. Psychometrica, 2016; Available: https://www.psychometrica.de/effect_size.html.
[64]
Lyons-Morris AM. Meta-Analysis. 2018 [Online]. Available: http://www.lyonsmorris.com/ma1/
[65]
Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Erlbaum; 1988.
[66]
Magnusoon K. Interpreting Cohen’s d effect size: An interactive visualization. 2018. [Online] Available: http://rpsychologist.com/d3/cohend/
[67]
World Health Organisation. Physical status: the use and interpretation of anthropometry – report of a WHO Expert Committee. WHO Technical Report Series No. 854, World Health Organisation, Geneva; 1995.
[68]
Raben AT, Marshe VS, Chintoh A, Gorbovskaya I, Daniel Müller DJ, Hahn MK. The complex relationship between antipsychotic-induced weight gain and therapeutic benefits: A systematic review and implications for treatment. Front Neurosci-Switz, 2018; 11: Article 741.
[69]
Lin C-H, Lin S-C, Huang Y-H, Wang F-C, Huang C-J. Early prediction of olanzapine-induced weight gain for schizophrenia patients. Psychiatry Research, 2018; 263:207–211.
[70]
Marques C, Meireles M, Faria A, Calhau C. High-fat diet-induced dysbiosis as a cause of neuroinflammation [Letter to the editor]. Biol Psychiatry, 2016; 80:e3–e4.
[71]
Peet M, Stokes C. Omega-3 fatty acids in the treatment of psychiatric disorders. Drugs, 2005; 65(8):1051-1059.
[72]
Bruce-Keller AJ, Keller JN, Morrison CD. Obesity and vulnerability of CNS. Biochim Biophys Acta, 2009; 1792:395-400.
[73]
Opel N, Redlich R, Grotegerd D, Dohm K, Heindel W, Kugel H, Arolt V, Dannlowski U. Obesity and major depression: Body-mass index (BMI) is associated with a severe course of disease and specific neurostructural alterations. Psychoneuroendocrino, 2015; 219-226.
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