Eating disorders and schizophrenia in male patients: A review

OBJECTIVE: To understand the comorbidity of schizophrenia and eating disorders (ED) in male patients. METHOD: A review of the published literature was made via Med-Line using the following terms: “schizophrenia” or “psychosis” in association with “eating disorders”, “anorexia nervosa”, “binge eating” or “bulimia nervosa”, in association with the terms “comorbidity” or “comorbidities” and finally in association with the term “male”, “man” or “men”. RESULTS: Groups of male patients known to suffer from schizophrenia and screened for ED suffer essentially from anorexia nervosa (0.81%). Groups of male patients screened for anorexia nervosa and then for schizophrenia demonstrate high comorbidity prevalence (36%). In general, ED symptoms diminish with psychotic episodes and recur when the psychotic episode remits. A man with an ED has a 3.6 times more risk than a woman with an ED to have comorbid schizophrenia. In men, ED present atypical features so that ED not otherwise specified (EDNOS) is relatively frequent. DISCUSSION AND CONCLUSION: Male patients described in the literature as suffering from schizophrenia and ED fall under one of four categories: a) acute psychotic episode related to organic causes due to malnutrition; b) male patients presenting with an ED who later develops schizophrenia; c) male patients known to suffer from schizophrenia and who develops distorted eating cognitions and disordered behaviors; d) male patients suffering from schizophrenia and developing a medication-induced ED.