Schizophrénie et troubles du comportement alimentaire : synthèse de la littérature

Abstract

IntroductionSchizophrenia is a severe disorder with an estimated global prevalence of one percent. In France, it represents approximately 600,000 individuals. Beyond the suffering caused by this disorder, schizophrenia requires significant financial and human resources, due to repeated hospitalizations for many patients. The presence of addictive comorbidities, with or without substance, including eating disorders, further increases the frequency of hospitalizations. ObjectivesThis article aims to present the current state of knowledge on the expression of eating disorders listed in the 5th DSM, in the schizophrenic disorder. We studied the public health issues and economic challenges that are magnified by the presence of comorbidities, the different eating disorders that can occur in patients with schizophrenia and the joint depressed mood phenomenon of eating disorders and schizophrenia, while introducing the notion of schizoaffective disorder. Materials and methodsThis study's patients suffered from schizophrenia and were diagnosed according to the 4th DSM's direct or indirect criteria, for example with SCID (Structured Clinical Interview for DSM Disorders). In most studies, no distinction is made between schizophrenia and schizoaffective disorder. Articles in this literature review came from referenced databases, such as PsycInfo, PubMed and Web of Science and were selected with the following keywords: schizophrenia, eating disorders, night eating syndrome, binge eating disorder, anorexia nervosa and bulimia nervosa. The search for articles was carried out between December 2015 and March 2016. ResultsThis literature review brings to the forefront the cooccurrence between schizophrenia, night eating syndrome and binge eating disorder. However, studies investigating this topic are scarce and it is difficult to know the real prevalence of each eating disorder in schizophrenia. Presumably, the presence of eating disorders in schizophrenia or schizoaffective patients may have specific functions, such as feeling the limits of their body, relieving internal tensions or stresses or trying to control sensations caused by the disease. ConclusionsAlthough clinically observed, the entanglement of these two disorders has received little attention in the literature. This literature review aims to identify future directions for research, in order to understand the role of eating disorders in the evolution of schizophrenia and their global treatment. From a clinical point of view, the joint assessment of these comorbidities in the schizophrenic disorder (and the schizoaffective disorder) could eventually bring professionals from different health fields to reflect on a comprehensive care model, more appropriate for individuals with a dual diagnosis.