Validation of the shortest version of the eating attitude test (EAT-7) as a screening tool for disordered eating in patients with first-episode schizophrenia.
Fekih-Romdhane, Feten Boukadida, Youssef Cheour, Majda Hallit, Souheil
Fekih-Romdhane, Feten
Boukadida, Youssef
Cheour, Majda
Hallit, Souheil
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Date
2025-02-07
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Abstract
Individuals diagnosed with schizophrenia have a two to five-fold higher risk of developing obesity and up to threefold higher risk of developing disordered eating behaviors relative to the general population. Over the past decades, the Eating Attitude Test (EAT) has been well-recognized and widely used in clinical practice. However, only little psychometric information is available on the EAT for researchers and clinicians who deal with patients with schizophrenia, and it is still unclear whether the scale could fulfill measurement needs and help clinical and research decision-making in the context of psychotic disorders. This study aimed to investigate the psychometric properties of the shortest version of the EAT (EAT-7) among newly-diagnosed patients with schizophrenia who had minimal exposure to antipsychotics at the start of the study.
This is an observational, cross-sectional survey that was carried out in the department of psychiatry at Razi Hospital, Manouba, Tunisia. The study took place between January and June 2024, and involved clinically-stabilized outpatients with schizophrenia who have had < 3 months of treatment with antipsychotics (N = 112; mean age of 24.44 ± 5.41 years).
In terms of factor analysis, the EAT-7 presented a one-dimensional structure. All seven items strongly loaded on a single factor, with all indices of the CFA suggesting a good fit to the data. In addition, the EAT-7 yielded excellent reliability coefficients, with both a McDonald's ω and a Cronbach's α of 0.88. Measurement invariance of the EAT-7 across sex groups was tested using multi-group CFA, and established at the configural, scalar, and metric levels. No significant differences in EAT-7 scores between males and females were found. Finally, EAT-7 scores positively correlated with scores of depression and anxiety, supporting concurrent validity of the scale.
The shortness, items' clarity and conciseness of the EAT-7 make it an efficient tool appropriate as a first-step screening tool to detect disordered eating in patients with schizophrenia at low cost and burden. We hope that this study will facilitate the widespread application of the EAT-7 in routine assessment and monitoring of disordered eating in patients with schizophrenia, in both clinical and research practices.
Individuals diagnosed with schizophrenia present higher rates of disordered eating than the general population. Disordered eating behaviors are more pronounced during the early stages of schizophrenia and are associated with a range of negative clinical outcomes. Therefore, valid and reliable screening tools are imperative to improve early identification and optimize clinical outcomes of people with schizophrenia at-risk for eating disorders. The Eating Attitudes Test (EAT) is one of the most widely used screening tools to detect eating disorders in both clinical and non-clinical populations. Our study proposed to test the psychometric properties of the shortest version of the EAT (EAT-7) in newly-diagnosed patients with schizophrenia who had minimal exposure to antipsychotics at the start of the study. The single-factor solution consisting of the seven items of the EAT-7 demonstrated good construct validity, excellent internal consistency reliability, measurement invariance across sex groups, and adequate concurrent validity. Therefore, our results justify the use of the EAT-7 as a screening tool to enable a timely detection of disordered eating symptoms in schizophrenia. The EAT-7 is short, simple to understand and quick-to-answer, minimizing the cognitive load on patients, and is easy to implement in clinical routine.
This is an observational, cross-sectional survey that was carried out in the department of psychiatry at Razi Hospital, Manouba, Tunisia. The study took place between January and June 2024, and involved clinically-stabilized outpatients with schizophrenia who have had < 3 months of treatment with antipsychotics (N = 112; mean age of 24.44 ± 5.41 years).
In terms of factor analysis, the EAT-7 presented a one-dimensional structure. All seven items strongly loaded on a single factor, with all indices of the CFA suggesting a good fit to the data. In addition, the EAT-7 yielded excellent reliability coefficients, with both a McDonald's ω and a Cronbach's α of 0.88. Measurement invariance of the EAT-7 across sex groups was tested using multi-group CFA, and established at the configural, scalar, and metric levels. No significant differences in EAT-7 scores between males and females were found. Finally, EAT-7 scores positively correlated with scores of depression and anxiety, supporting concurrent validity of the scale.
The shortness, items' clarity and conciseness of the EAT-7 make it an efficient tool appropriate as a first-step screening tool to detect disordered eating in patients with schizophrenia at low cost and burden. We hope that this study will facilitate the widespread application of the EAT-7 in routine assessment and monitoring of disordered eating in patients with schizophrenia, in both clinical and research practices.
Individuals diagnosed with schizophrenia present higher rates of disordered eating than the general population. Disordered eating behaviors are more pronounced during the early stages of schizophrenia and are associated with a range of negative clinical outcomes. Therefore, valid and reliable screening tools are imperative to improve early identification and optimize clinical outcomes of people with schizophrenia at-risk for eating disorders. The Eating Attitudes Test (EAT) is one of the most widely used screening tools to detect eating disorders in both clinical and non-clinical populations. Our study proposed to test the psychometric properties of the shortest version of the EAT (EAT-7) in newly-diagnosed patients with schizophrenia who had minimal exposure to antipsychotics at the start of the study. The single-factor solution consisting of the seven items of the EAT-7 demonstrated good construct validity, excellent internal consistency reliability, measurement invariance across sex groups, and adequate concurrent validity. Therefore, our results justify the use of the EAT-7 as a screening tool to enable a timely detection of disordered eating symptoms in schizophrenia. The EAT-7 is short, simple to understand and quick-to-answer, minimizing the cognitive load on patients, and is easy to implement in clinical routine.
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