Original Research

Double burden of malnutrition amongst patients with first-episode schizophrenia in a psychiatric hospital: A 1-year follow-up study

Justus U. Onu, Portia N. Osuji
South African Journal of Psychiatry | Vol 26 | a1564 | DOI: https://doi.org/10.4102/sajpsychiatry.v26i0.1564 | © 2020 Justus U. Onu, Portia N. Osuji | This work is licensed under CC Attribution 4.0
Submitted: 19 May 2020 | Published: 10 November 2020

About the author(s)

Justus U. Onu, Department of Mental Health, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
Portia N. Osuji, Department of Neurosurgery, University College Hospital, Ibadan, Nigeria


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Abstract

Background: Despite the burgeoning data on the double burden of malnutrition (DBM) in sub-Saharan Africa, longitudinal studies to examine malnutrition amongst first-episode schizophrenia are uncommon in the modern literature.

Aim: To determine the extent of nutritional variations amongst persons with schizophrenia at intervals of 1-year treatment follow-up.

Setting: This study was conducted at the Federal Neuropsychiatric Hospital, Enugu, Nigeria.

Methods: Consecutive incident cases that fulfilled the criteria for schizophrenia were recruited into the study. After a baseline assessment, 206 incident cases of schizophrenia were followed up at 4th, 8th, 12th weeks, 6 months and 1 year for indicators of nutritional outcome. The body mass index (BMI) was used to measure the nutritional status amongst the study participants. Changes in the BMI across intervals of follow-up were examined using repeated measures analysis of variance, whereas the socio-demographic and clinical variables were evaluated as predictors of outcome using multiple regression analysis.

Results: After 1 year of treatment with antipsychotics, the prevalence of underweight decreased from 19.9% (95% CI, 19.8% – 20.0%) at baseline to 16.0% (95% CI, 15.9% – 16.1%) at 1 year, but the prevalence of overweight/obesity increased from 29.1% (95% CI, 29.0% – 29.2%) at baseline to 43.2% (95% CI, 43.0% – 43.3%) at 1 year of follow-up. The predictors of BMI at 1 year were antipsychotic medication (32.7% variance), duration of vagrancy (24.0%) and age at onset (20.0%).

Conclusion: The finding of coexistence of undernutrition and overnutrition across the intervals of treatment follow-up underscores the need for comprehensive interventions to address both extremes of malnutrition amongst patients with schizophrenia.


Keywords

burden; double; malnutrition; first-episode; schizophrenia

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