Positive Symptoms in Antipsychotic-naïve Schizophrenia are Associated with Increased BMI after Treatment
Shih-Hsien Lin 1, 2, Huai-Hsuan Tseng 1, 2, Hsin Chun Tsai 1, 3, Mei Hung Chi 1, I Hui Lee 1, Po See Chen 1, 2, 3, Kao Chin Chen 1, Yen Kuang Yang 1, 2, 4*
1Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, 2Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, 3Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan, 4Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
Received: September 25, 2019; Revised: May 4, 2020; Accepted: May 26, 2020; Published online: May 26, 2020.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Objective: Weight gain is an important risk factor for morbidity and mortality among patients with schizophrenia. We speculated that positive symptoms, related to dopaminergic hyperactivity and altered mesolimbic function, are associated with weight gain.
Methods: Twenty-two antipsychotic-naïve, first-episode patients with schizophrenia were enrolled. The Positive and Negative Syndrome Scale was completed at enrollment and follow-up. Body mass index (BMI) was also measured.
Results: The increase in BMI, after 6.04 ± 2.16 years of follow-up, was associated with positive symptoms, but not negative symptoms, before treatment with antipsychotics in antipsychotic-naïve patients with schizophrenia.
Conclusions: This finding implied that dopaminergic hyperactivity could be an important factor to predict the treatment outcome. Body weight control is important for the health management of patients with schizophrenia with more severe positive symptoms.
Keywords: mesolimbic pathway, metabolic syndrome, positive syndrome, schizophrenia, weight gain