Parental Socio-economic Class and Obesity in Hispanic and non-Hispanic Individuals with First Episode Psychosis

Obesity is a significant public health issue in the United States (U.S.), with rates of obesity increasing for the past few years, particularly in Hispanics. Individuals with schizophrenia have additional risks for obesity due to the metabolic burden associated with antipsychotic (AP) medications, limited physical activity due to negative symptoms, and poor eating habits. There are no published studies that have compared obesity rates between Hispanics and non-Hispanics with first episode psychosis (FEP). We aimed to explore the relationship between ethnicity and obesity in FEP patients prior to the initiation of AP treatment, to eliminate the potential effects of AP treatment on weight.

Baseline data from 145 individuals with FEP enrolled in a FEP research study was used. Demographic, education, occupation and Body Mass Index (BMI) data for FEP participants was stratified by ethnicity (Hispanic vs. non-Hispanic) and BMI (< 25 or ≥ 25). Variables with a p-value < 0.1 were entered into a multivariate linear regression model using a manual backwards elimination approach, using BMI as a continuous measure as the outcome and ethnicity as our predictor of interest.

Twenty-four Hispanics, and 121 non-Hispanics were included. Baseline characteristics were not significantly different between ethnicity groups, except for BMI which was significantly higher in Hispanics (mean = 25.3, SD = 6.0, p = 0.037) than non-Hispanics (mean = 23.0, SD = 4.5). Data stratified by BMI showed that age, ethnicity, mother's occupation, and socioeconomic status (SES) were associated with BMI. Multivariate linear regression showed that Hispanic ethnicity (B = 3.04, SE = 1.32, p = 0.024) and age (B = 0.36, SE = 0.09, p < 0.001) were statistically significantly associated with higher BMI scores while adjusting for sex (B = - 0.67, SE = 1.04, p = 0.521).

Hispanic individuals with FEP present with higher BMI scores compared to non-Hispanics, even before the initiation of antipsychotic treatment. Therefore, in addition to exercise and healthy eating habits, the use of AP medications with less metabolic burden is advisable along with using the lowest effective dose.