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

INTRODUCTION: Weight gain and metabolic disturbances are frequent in people treated with second generation antipsychotics (SGA). OBJECTIVES: We aimed to investigate the effect of SGAs on eating behaviors, cognitions and emotions, as a possible contributor to weight gain and metabolic disturbances. METHODS: A systematic review and meta-analysis was 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. RESULTS: 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)(see Figure 1.). 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 (See figure 2 and 3). There were few studies examining other eating-related outcomes such as food addiction, satiety, fullness, caloric intake and dietary quality and habits. Image: Image 2: Image 3: CONCLUSIONS: 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. DISCLOSURE OF INTEREST: H. Mutwalli Grant / Research support from: The Saudi Arabian Government Educational Sponsorship for PhD, J. Keeler Grant / Research support from: The Medical Research Council, S. Bektas Grant / Research support from: The Turkish Ministry of National Education for PhD training, N. Dhopatkar Employee of: South London and Maudsley NHS Foundation Trust (SLaM), J. Treasure Grant / Research support from: The National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust (SLaM), Employee of: King’s College London, H. Himmerich Grant / Research support from: The National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust (SLaM), Employee of: King’s College London.