| Summary: | Statement of the problem : Subjects with psychosis are at risk for metabolic syndrome, mainly secondary to antipsychotic treatment although overeating also plays a role. The hypothalamic–pituitary–adrenal axis, which is involved in visceral obesity, may also affect energy balance through affecting energy intake and the risk for stress-induced hyperphagia. The main aim of the study was to study the association between salivary cortisol, overeating, and obesity in a sample of subjects with early psychosis. Methods : We evaluated 53 participants (mean age: 23.5 years, 42% females) who were attending to the Early Psychosis Program from Reus (HPU Institut Pere Mata, Tarragona, Spain). All participants met criteria for a psychotic disorder or were considered at risk mental states after administration of the Schedules of Clinical Assessment in Neuropsychiatry (SCAN) or the Comprehensive Assessment of At Risk Mental States (CAARMS). Dietary habits were assessed by a dietician who administered the Eating Disorders module of the SCAN to explore two types of overeating: (1) Grazing, defined as repeatedly eating small amounts of food between mean meals (2) Binging, defined as consuming large quantities of food in a very short period of time. As grazing and binging can coexist in the same patient, we recoded overeating in four categories: (1) no overeating, (2) only grazing, (3) only binging and (4) grazing and binging. BMI and waist circumference were registered. A fasting morning saliva sample (9 h) was obtained. Salivary cortisol levels were determined by ELISA. Statistical analyses were performed with SPSS v.17.0. Kruskal–Wallis test was used to test differences between groups in continuous variables. Chi-squared tests were used to test differences between groups in categorical data. Results : Of 53 participants, 37 (69.8%) reported grazing and/or binging. Salivary cortisol was not associated with BMI or waist circumference. Of all participants, the group reporting both grazing and binging showed increased salivary cortisol levels (p = 0.004) and greater BMI (p=0.035). Conclusions : In young participants with early psychosis, overeating (coexistence of grazing and binging episodes) is associated with greater BMI and increased morning salivary cortisol levels.
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