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Stogios N, Smith E, Asgariroozbehani R, Hamel L, Gdanski A, Selby P, Sockalingam S, Graff-Guerrero A, Taylor VH, Agarwal SM, Hahn MK. Exploring Patterns of Disturbed Eating in Psychosis: A Scoping Review. Nutrients 2020; 12:E3883. [PMID: 33353080 PMCID: PMC7768542 DOI: 10.3390/nu12123883] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 12/03/2020] [Accepted: 12/09/2020] [Indexed: 12/19/2022] Open
Abstract
Disturbed eating behaviours have been widely reported in psychotic disorders since the early 19th century. There is also evidence that antipsychotic (AP) treatment may induce binge eating or other related compulsive eating behaviours. It is therefore possible that abnormal eating patterns may contribute to the significant weight gain and other metabolic disturbances observed in patients with psychosis. In this scoping review, we aimed to explore the underlying psychopathological and neurobiological mechanisms of disrupted eating behaviours in psychosis spectrum disorders and the role of APs in this relationship. A systematic search identified 35 studies that met our eligibility criteria and were included in our qualitative synthesis. Synthesizing evidence from self-report questionnaires and food surveys, we found that patients with psychosis exhibit increased appetite and craving for fatty food, as well as increased caloric intake and snacking, which may be associated with increased disinhibition. Limited evidence from neuroimaging studies suggested that AP-naïve first episode patients exhibit similar neural processing of food to healthy controls, while chronic AP exposure may lead to decreased activity in satiety areas and increased activity in areas associated with reward anticipation. Overall, this review supports the notion that AP use can lead to disturbed eating patterns in patients, which may contribute to AP-induced weight gain. However, intrinsic illness-related effects on eating behaviors remain less well elucidated, and many confounding factors as well as variability in study designs limits interpretation of existing literature in this field and precludes firm conclusions from being made.
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Affiliation(s)
- Nicolette Stogios
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Emily Smith
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Roshanak Asgariroozbehani
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Laurie Hamel
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
| | - Alexander Gdanski
- Department of Human Biology, University of Toronto, Toronto, ON M5S 3J6, Canada;
| | - Peter Selby
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Sanjeev Sockalingam
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Bariatric Surgery Program, University Health Network, Toronto, ON M5T 2S8, Canada
| | - Ariel Graff-Guerrero
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Valerie H. Taylor
- Department of Psychiatry, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Sri Mahavir Agarwal
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Margaret K. Hahn
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
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A meta-analysis of craving studies in schizophrenia spectrum disorders. Schizophr Res 2020; 222:49-57. [PMID: 32553432 DOI: 10.1016/j.schres.2020.05.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 03/30/2020] [Accepted: 05/18/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE DSM-5 Substance Use Disorders (SUD) are frequent and debilitating comorbidities displayed by patients with schizophrenia spectrum disorders (SZ). One crucial feature of SUD is drug craving, an intense desire to consume a substance, commonly divided into reward and relief dimensions. Here, we conducted a meta-analysis of studies investigating craving in individuals with both SUD and SZ in order to examine whether these patients exhibit a distinct pattern of craving as compared to patients with SUD without SZ. METHOD Meta-analysis based on the PRISMA guidelines. RESULTS Sixteen relevant publications were identified by a systematic search of databases, which included 1219 individuals (589 SUD-SZ and 630 SUD-without-SZ). Of the 16 studies, 11 focused on tobacco, 3 on cannabis and 2 on cocaine. When considered across all studies, SUD-SZ had significantly higher scores than SUD-without-SZ for global craving with medium effect size (knumber of studies = 16, Zr = 0.20 [0.15, 0.26], equivalent d = 0.41, P < 0.001). Discrete patterns emerged for reward (k = 7, Zr = 0.10 [0.02, 0.17], equivalent d = 0.20, P < 0.05) and relief (k = 7, Zr = 0.25 [0.17, 0.33], d = 0.52, P < 0.001) craving, and the direct comparison revealed a significantly greater effect for relief than reward (χ2(1) = 7.40 P = 0.007). CONCLUSION These results suggest that SUD-SZ cases experience higher craving, more specifically for relief, in comparison to patients with SUD-without-SZ. These clinical findings can foster the development of tailored addiction therapies for this specific comorbid population.
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Borgan F, O’Daly O, Hoang K, Veronese M, Withers D, Batterham R, Howes O. Neural Responsivity to Food Cues in Patients With Unmedicated First-Episode Psychosis. JAMA Netw Open 2019; 2:e186893. [PMID: 30646204 PMCID: PMC6420094 DOI: 10.1001/jamanetworkopen.2018.6893] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
IMPORTANCE Schizophrenia is associated with a reduced life expectancy of 15 to 20 years owing to a high prevalence of cardiometabolic disorders. Obesity, a key risk factor for the development of cardiometabolic alterations, is more prevalent in individuals with schizophrenia. Although obesity is linked to the altered reward processing of food cues, no studies have investigated this link in schizophrenia without the confounds of antipsychotics and illness chronicity. OBJECTIVE To investigate neural responsivity to food cues in first-episode psychosis without the confounds of antipsychotic medication or illness chronicity. DESIGN, SETTING, AND PARTICIPANTS A case-control study was conducted from January 31, 2015, to September 30, 2018, in London, United Kingdom, of 29 patients with first-episode psychosis who were not taking antipsychotic medication and 28 matched controls. MAIN OUTCOMES AND MEASURES Participants completed a food cue paradigm while undergoing a functional magnetic resonance imaging scan. Neural activation was indexed using the blood oxygen level-dependent hemodynamic response. The Dietary Instrument for Nutrition Education was used to measure diet, and the International Physical Activity Questionnaire was used to measure exercise. RESULTS There were no significant differences in age, sex, or body mass index between the 29 patients (25 men and 4 women; mean [SD] age, 26.1 [4.8] years) and 28 controls (22 men and 6 women; mean [SD] age, 26.4 [5.5] years). Relative to controls, patients consumed more saturated fat (t46 = -3.046; P = .004) and undertook less high-intensity (U = 304.0; P = .01) and low-intensity (U = 299.5; P = .005) weekly exercise. There were no group differences in neural responses to food vs nonfood cues in whole-brain or region-of-interest analyses of the nucleus accumbens, insula, or hypothalamus. Body mass index was inversely correlated with the mean blood oxygen level-dependent signal in the nucleus accumbens in response to food vs nonfood cues in controls (R = -0.499; P = .01) but not patients (R = 0.082; P = .70). CONCLUSIONS AND RELEVANCE Relative to controls, patients with first-episode psychosis who were not taking antipsychotic medication consumed more saturated fat and showed an altered association between body mass index and neural response to food cues in the absence of differences in neural responses to food cues. These findings highlight how maladaptive eating patterns and alterations in the association between body mass index and neural responses to food cues are established early in the course of schizophrenia.
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Affiliation(s)
- Faith Borgan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Psychiatric Imaging Group, Faculty of Medicine, Medical Research Council London Institute of Medical Sciences, Imperial College London, London, United Kingdom
| | - Owen O’Daly
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Karen Hoang
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Mattia Veronese
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Dominic Withers
- Metabolic Signalling Group, Medical Research Council London Institute of Medical Sciences, Imperial College London, London, United Kingdom
- Institute of Clinical Sciences, Imperial College London, London, United Kingdom
| | - Rachel Batterham
- Centre for Obesity Research, University College London, London, United Kingdom
- University College London Hospitals Bariatric Centre for Weight Management and Metabolic Surgery, London, United Kingdom
- National Institute of Health Research University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Oliver Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Psychiatric Imaging Group, Faculty of Medicine, Medical Research Council London Institute of Medical Sciences, Imperial College London, London, United Kingdom
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Kumar JR, Rajkumar R, Jayakody T, Marwari S, Hong JM, Ma S, Gundlach AL, Lai MKP, Dawe GS. Relaxin' the brain: a case for targeting the nucleus incertus network and relaxin-3/RXFP3 system in neuropsychiatric disorders. Br J Pharmacol 2016; 174:1061-1076. [PMID: 27597467 PMCID: PMC5406295 DOI: 10.1111/bph.13564] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 07/15/2016] [Indexed: 12/14/2022] Open
Abstract
Relaxin‐3 has been proposed to modulate emotional–behavioural functions such as arousal and behavioural activation, appetite regulation, stress responses, anxiety, memory, sleep and circadian rhythm. The nucleus incertus (NI), in the midline tegmentum close to the fourth ventricle, projects widely throughout the brain and is the primary site of relaxin‐3 neurons. Over recent years, a number of preclinical studies have explored the function of the NI and relaxin‐3 signalling, including reports of mRNA or peptide expression changes in the NI in response to behavioural or pharmacological manipulations, effects of lesions or electrical or pharmacological manipulations of the NI, effects of central microinfusions of relaxin‐3 or related agonist or antagonist ligands on physiology and behaviour, and the impact of relaxin‐3 gene deletion or knockdown. Although these individual studies reveal facets of the likely functional relevance of the NI and relaxin‐3 systems for human physiology and behaviour, the differences observed in responses between species (e.g. rat vs. mouse), the clearly identified heterogeneity of NI neurons and procedural differences between laboratories are some of the factors that have prevented a precise understanding of their function. This review aims to draw attention to the current preclinical evidence available that suggests the relevance of the NI/relaxin‐3 system to the pathology and/or symptoms of certain neuropsychiatric disorders and to provide cognizant directions for future research to effectively and efficiently uncover its therapeutic potential. Linked Articles This article is part of a themed section on Recent Progress in the Understanding of Relaxin Family Peptides and their Receptors. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.10/issuetoc
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Affiliation(s)
- Jigna Rajesh Kumar
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Neurobiology and Ageing Programme, Life Sciences Institute, National University of Singapore, Singapore.,Singapore Institute for Neurotechnology (SINAPSE), Singapore.,NUS Graduate School for Integrative Sciences and Engineering (NGS), National University of Singapore, Singapore
| | - Ramamoorthy Rajkumar
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Neurobiology and Ageing Programme, Life Sciences Institute, National University of Singapore, Singapore.,Singapore Institute for Neurotechnology (SINAPSE), Singapore
| | - Tharindunee Jayakody
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Neurobiology and Ageing Programme, Life Sciences Institute, National University of Singapore, Singapore.,Singapore Institute for Neurotechnology (SINAPSE), Singapore
| | - Subhi Marwari
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Neurobiology and Ageing Programme, Life Sciences Institute, National University of Singapore, Singapore.,Singapore Institute for Neurotechnology (SINAPSE), Singapore
| | - Jia Mei Hong
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Neurobiology and Ageing Programme, Life Sciences Institute, National University of Singapore, Singapore.,Singapore Institute for Neurotechnology (SINAPSE), Singapore.,NUS Graduate School for Integrative Sciences and Engineering (NGS), National University of Singapore, Singapore
| | - Sherie Ma
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Andrew L Gundlach
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia.,Department of Anatomy and Neuroscience, The University of Melbourne, Parkville, Victoria, Australia
| | - Mitchell K P Lai
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gavin S Dawe
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Neurobiology and Ageing Programme, Life Sciences Institute, National University of Singapore, Singapore.,Singapore Institute for Neurotechnology (SINAPSE), Singapore.,NUS Graduate School for Integrative Sciences and Engineering (NGS), National University of Singapore, Singapore
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Stip E, Lungu OV, Anselmo K, Letourneau G, Mendrek A, Stip B, Lipp O, Lalonde P, Bentaleb LA. Neural changes associated with appetite information processing in schizophrenic patients after 16 weeks of olanzapine treatment. Transl Psychiatry 2012; 2:e128. [PMID: 22714121 PMCID: PMC3384221 DOI: 10.1038/tp.2012.53] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
There is evidence that some atypical antipsychotics, including olanzapine, can produce unwanted metabolic side effects, weight gain and diabetes. However, neuronal correlates of change related to food information processing have not been investigated with these medications. We studied the effect of a pharmacological manipulation with an antipsychotic known to cause weight gain on metabolites, cognitive tasks and neural correlates related to food regulation. We used functional magnetic resonance imaging in conjunction with a task requiring visual processing of appetitive stimuli in schizophrenic patients and healthy controls before and after 16 weeks of antipsychotic medication with olanzapine. In patients, the psychological and neuronal changes associated following the treatment correlated with appetite control measures and metabolite levels in fasting blood samples. After 16 weeks of olanzapine treatment, the patients gained weight, increased their waist circumference, had fewer positive schizophrenia symptoms, a reduced ghrelin plasma concentration and an increased concentration of triglycerides, insulin and leptin. In premotor area, somatosensory cortices as well as bilaterally in the fusiform gyri, the olanzapine treatment increased the neural activity related to appetitive information in schizophrenic patients to similar levels relative to healthy individuals. However, a higher increase in sensitivity to appetitive stimuli after the treatment was observed in insular cortices, amygdala and cerebellum in schizophrenic patients as compared with healthy controls. Furthermore, these changes in neuronal activity correlated with changes in some metabolites and cognitive measurements related to appetite regulation.
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Affiliation(s)
- E Stip
- Department of Psychiatry, Université de Montréal, Montréal, QC, Canada.
| | - O V Lungu
- Department of Psychiatry, Université de Montréal, Montréal, QC, Canada,Centre de Recherche de l′Institut Universitaire de gériatrie de Montréal, Université de Montréal, Montréal, QC, Canada,Department of Research, Donald Berman Maimonides Geriatric Center, Montréal, QC, Canada
| | - K Anselmo
- Department of Psychiatry, Université de Montréal, Montréal, QC, Canada,CHUM, Centre de Recherche Fernand Seguin, Université de Montréal, Notre Dame Hospital, Montréal, QC, Canada
| | - G Letourneau
- Department of Psychiatry, Université de Montréal, Montréal, QC, Canada,CHUM, Centre de Recherche Fernand Seguin, Université de Montréal, Notre Dame Hospital, Montréal, QC, Canada
| | - A Mendrek
- Department of Psychiatry, Université de Montréal, Montréal, QC, Canada,CHUM, Centre de Recherche Fernand Seguin, Université de Montréal, Notre Dame Hospital, Montréal, QC, Canada
| | - B Stip
- École Polytechnique de Montréal, Montréal, QC, Canada
| | - O Lipp
- Department of Psychiatry, Université de Montréal, Montréal, QC, Canada,Centre de Recherche de l′Institut Universitaire de gériatrie de Montréal, Université de Montréal, Montréal, QC, Canada
| | - P Lalonde
- Department of Psychiatry, Université de Montréal, Montréal, QC, Canada,CHUM, Centre de Recherche Fernand Seguin, Université de Montréal, Notre Dame Hospital, Montréal, QC, Canada
| | - L A Bentaleb
- Department of Psychiatry, Université de Montréal, Montréal, QC, Canada,CHUM, Centre de Recherche Fernand Seguin, Université de Montréal, Notre Dame Hospital, Montréal, QC, Canada
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