Prevalence of overweight or underweight among institutionalized patients with schizophrenia: a descriptive cross-sectional study

Background: Schizophrenia is known to be associated with metabolic and or nutritional derangements among institutionalized patients due to multiple reasons that may have a negative impact on the recovery process.

Aims: To determine the prevalence of overweight or underweight and their associated factors among patients diagnosed with schizophrenia at the long-stay facilities of the National Institute of Mental Health (NIMH) and the Halfway Home, Mulleriyawa, Sri Lanka.

Methods: A descriptive cross-sectional study was carried out among patients of the long-stay units of the NIMH and the Halfway Home, Mulleriyawa, Sri Lanka. Patients with an ICD 10 diagnosis of schizophrenia for more than five years were recruited. The sociodemographic and clinical details were obtained from the patients and their medical records using a prepiloted questionnaire. The body mass index (BMI), the mid-upper arm circumference (MUAC), the waist circumference (WC), and the waist/hip ratio were measured using standard techniques.

Results: Out of the 218 participants who consented, 65% were females who were more likely to be on two or more antipsychotics than males (P=0.01). The male participants were significantly more likely to be diagnosed with a comorbid medical condition than the females (P=0.01).

Of the sample, 33% of the males and 14% of the females were underweight, while 35% of the females and 5% of the males were overweight and these differences were statistically significant (P<0.001). The prevalence of android (apple-shaped) obesity was 97% in those who were overweight (P<0.001). Strong correlations were observed between the BMI and the MUAC (r =0.808, P< 0.001) and between the BMI and the WC (r=0.849, P< 0.001).

Conclusions: A considerable proportion of males and females with long-standing schizophrenia were underweight and overweight, respectively. Clinicians must pay attention to nutritional status of institutionalised patients as it has an impact on the recovery process.