The link between psychosis and malnutrition

By Annie Harrison-Dunn contact

- Last updated on GMT

Acutely psychotic individuals may fail to eat meals as a consequence of the chaos of psychotic symptoms and antipsychotic medication can cause obsessive overeating
Acutely psychotic individuals may fail to eat meals as a consequence of the chaos of psychotic symptoms and antipsychotic medication can cause obsessive overeating

Related tags: Nutrition

First-time psychosis sufferers are far more likely to be deficient in micronutrients and protein than the general population – and more intervention studies are needed to explore strategies against this, say UK researchers.

Researchers from Sheffield Hallam University and the UK’s National Health Service (NHS) Rotherham Early Intervention in Psychosis Service looked at nutritional data from 143 individuals aged 19 to 64 years receiving treatment for first-episode psychosis.

The nutritional statuses of the patients, who lived within the wider community and had autonomy over their own diets, were compared with that of the general population according to data from the Food Standards Agency (FSA). 

The results showed average total energy intake was lower for males and higher for females in the cohort than the corresponding subgroups of the general national sample. 

Psychosis is a mental health problem that causes people to perceive or interpret things differently from those around them and can include things like hallucinations and delusions.

It is not a condition in itself but triggered by other conditions for example schizophrenia, bipolar disorder, severe depression or by traumatic experiences or drug use.

The NHS estimates about one in 100 people will experience schizophrenia at some point in their lifetime, with the same figure calculated for bipolar disorder. 

Females in the study cohort consumed 12.9 g more total fat per day, whilst males consumed 7.7 g less protein per day than the national sample.

Males in the study also showed significantly lower average intakes of folate, iron, selenium, vitamin D and zinc, but not vitamin C.

The proportion of individuals not meeting the lower reference nutrient intakes, particularly for selenium (males 54.0% and females 57.1%) and for iron among females (29.6%) was cause for concern, the researchers wrote in the Journal of Nutritional Science​. 

Severe mental illness like schizophrenia increases the risk of cardiovascular disease, obesity and type 2 diabetes and reduces life expectancy.

Different food consumption patterns in those affected could be due to socio-economic status, an illness-induced lack of motivation and a sedentary lifestyle compared to the wider population. 

Antipsychotic medication is also known to cause carbohydrate craving and hyperphagia – an excessive desire to eat.

Despite this knowledge, few studies have looked at nutritional status and the first incidence of psychosis and where this was addressed, it was unclear whether the individuals had control over their own diet.

Autonomy over dietary choice is important because acutely psychotic individuals in the community may fail to eat meals as a consequence of the chaos of psychotic symptoms, and could help determine which aspects of the diet would benefit from dietary change intervention.”  

They said dietary intervention studies on first-episode psychosis and physical and mental health and wellbeing were needed.

Source: Journal of Nutritional Science
Volume 4, e28, Pages 1-8, doi: 10.1017/jns.2015.18
“A comparison of the nutrient intake of a community-dwelling first-episode psychosis cohort, aged 19–64 years, with data from the UK population”
Authors: K. Williamson, K. Kilner and N. Clibbens 

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