Table_1_Is Obesity in Young People With Psychosis a Foregone Conclusion? Markedly Excessive Energy Intake Is Evident Soon After Antipsychotic Initiation.DOCX

Introduction: Antipsychotic medication (APM) initiation is associated with rapid and substantial weight-gain and high rates of obesity. Obesity leads to premature onset of cardiometabolic diseases and contributes to the 15–20 year shortfall in life expectancy in those experiencing severe mental illness. Dietary energy intake excess is critical to weight management but is yet to be quantified in youth with first episode psychosis (FEP) receiving APM. This study aimed to describe the degree of energy overconsumption and the food sources contributing to this in youth with FEP.
Materials and Methods: People aged 15–30 years with FEP receiving APM completed diet histories through qualified dietitians to assess energy imbalance and food sources. Outcome measures were: (i) energy balance; and (ii) intake of core and discretionary foods.
Results: Participants (n = 93) were aged 15–29 years (mean = 21.4 ± 2.9 years) and exposed to APMs for a median for 8 months (Interquartile Range (IQR) 11 months). Energy balance was exceeded by 26%, by a median 1,837 kJ per day (IQR 5,365 kJ). APM polypharmacy and olanzapine were linked to larger excesses in dietary energy intake. The greatest contributors to energy intake were refined grain foods (33%) and discretionary foods (31%).
Conclusion: Young people with FEP receiving APMs appear to have markedly excessive energy consumption, likely contributing to rapid weight-gain, and thereby seeding future poor physical health. Larger, prospective studies are needed to gain a greater understanding of dietary intake, and its effects on health, in people with FEP.

引言：抗精神病药物（Antipsychotic Medication, APM）的启用与快速显著的体重增加及高肥胖发生率密切相关。肥胖可引发心血管代谢疾病早发，并导致严重精神疾病患者的预期寿命缩短15至20年。膳食能量摄入过剩是体重管理的关键影响因素，但在接受抗精神病药物治疗的首发精神病（First Episode Psychosis, FEP）青年群体中，该指标尚未得到量化分析。本研究旨在明确首发精神病青年群体的能量过度摄入程度及其主要食物来源。

材料与方法：招募15至30岁、接受抗精神病药物治疗的首发精神病患者，由合格营养师通过膳食史调查法评估其能量失衡情况与食物来源。本研究的主要结局指标包括：(1) 能量平衡状态；(2) 核心食品与随意摄入食品（discretionary foods）的摄入量。

结果：本研究共纳入93名受试者，年龄15至29岁，平均年龄为21.4±2.9岁，接受抗精神病药物治疗的中位时长为8个月（四分位距（IQR）为11个月）。受试者的能量摄入超出能量平衡阈值26%，日均超额能量摄入中位数为1837千焦（四分位距为5365千焦）。抗精神病药物联合用药及奥氮平（olanzapine）的使用与更高的膳食能量摄入过剩程度相关。能量摄入的主要来源为精制谷物食品（33%）与随意摄入食品（31%）。

结论：接受抗精神病药物治疗的首发精神病青年群体存在显著的能量摄入过剩情况，这可能是导致其快速体重增加的原因，并为未来的身体健康埋下隐患。未来需开展更大样本量的前瞻性研究，以深入了解首发精神病患者的膳食摄入情况及其对健康的影响。