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Originalarbeit/Original article

Subjective and Biological Weight-Related Parameters

in Adolescents and Young Adults with Schizophrenia Spectrum Disorder under Clozapine or Olanzapine Treatment

Published Online:April 27, 2012https://doi.org/10.1024/1422-4917/a000165

Abstract

Objective: Administration of atypical antipsychotics often induces significant weight gain and metabolic changes. Little is known about subjective weight-related parameters in adolescent patients. Therefore, this cross-sectional, explorative study aimed to assess these parameters and their relationship with biological weight-related parameters. Method: 74 patients (mean age: 19.9 [SD ± 2.3] years; 66.2% male) with schizophrenia under clozapine or olanzapine treatment were examined. Subjective well-being, eating behavior, body perception and social functioning were assessed, using the Three-Factor-Eating-Questionnaire, FKB-20 Body Perception Questionnaire, Subjective Well-being under Neuroleptics, Short Form and Global Assessment of Functioning. Patients’ biological weight-related parameters were measured as well. Gender differences as well as associations between subjective and biological weight-related parameters were evaluated. Results: Female patients reported significantly worse negative body appraisal and physical functioning than males. An elevated BMI was associated with impaired physical functioning in females and with negative body appraisal and hunger in males. Conclusions: In our sample of young patients with schizophrenia unter treatment with atypical antipsychotics, an elevated BMI was associated with impaired physical functioning and negative body appraisal, respectively. Bearing in mind the high risk of obesity in this population, the mentioned impairments should be accounted for, especially in terms of compliance and quality of life.


Subjektive und biologische gewichtsbezogene Parameter bei Jugendlichen und jungen Erwachsenen mit Schizophrenie unter Therapie mit Clozapin oder Olanzapin

Fragestellung: Die Behandlung mit atypischen Antipsychotika führt häufig zu Gewichtszunahme und metabolischen Veränderungen. Für Jugendliche und junge Erwachsene liegen bisher nur wenige Daten zu subjektiven körpergewichtsbezogenen Parametern unter Therapie mit atypischen Antipsychotika vor. Die vorliegende explorative Querschnittsstudie zielt deshalb auf die Untersuchung dieser subjektiven Parameter und ihrer Beziehung zu biologischen körpergewichtsbezogenen Parametern. Methodik: Es wurden 74 Patienten mit Schizophrenie unter Behandlung mit Clozapin oder Olanzapin untersucht (Alter: 19,9 [SD ± 2,3] Jahre; 66,2% männlich). Subjektives Wohlbefinden, Essverhalten, Körperbild und soziales Funktionsniveau wurden mit folgenden Verfahren erfasst: Subjektives Wohlbefinden unter Neuroleptika (Kurzform), Fragebogen zum Essverhalten, Fragebogen zum Körperbild und Global Assessment of Functioning. Ergänzend wurden biologische körpergewichtsbezogene Parameter erfasst. Zudem wurden geschlechtsabhängige Unterschiede sowie Beziehungen zwischen subjektiven und biologischen körpergewichtsbezogenen Parametern untersucht. Ergebnisse: Im Vergleich zu männlichen Patienten zeigten weibliche Patientinnen eine stärker ausgeprägte ablehnende Körperbewertung und schlechteres physisches Wohlbefinden. Ein erhöhter BMI war bei Frauen signifikant mit verringertem physischen Wohlbefinden und bei Männern mit ablehnender Körperbewertung und Hunger assoziiert. Schlussfolgerungen: In der untersuchten Stichprobe junger schizophrener Patienten unter Therapie mit atypischen Antipsychotika ging ein erhöhter BMI mit ablehnender Körperbewertung bzw. verringertem physischen Wohlbefinden einher. Dieser Befund sollte besonders im Hinblick auf Compliance und Lebensqualität in dieser stark adipositas-gefährdeten Population berücksichtigt werden.

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