Prevalence of Eating Disorders in Individuals With Schizophrenia Spectrum Disorder: A Systematic Review and Meta-Analysis

BackgroundEating disorders (EDs) are significant comorbidities in individuals with schizophrenia spectrum disorders (SSDs), yet they are often under recognized. This systematic review and meta-analysis aimed to synthesise existing evidence on the prevalence of EDs in SSD populations and to explore potential moderators such as geographical location and diagnostic tools.MethodsWe conducted a systematic search of PubMed, Embase and Web of Science for studies reporting the prevalence of EDs in individuals with SSDs. Subgroup analyses examined the influence of geographical location and screening tools on prevalence estimates. Sensitivity analyses and a funnel plot were used to assess the robustness of the findings and potential publication bias.ResultsA total of 13 studies, comprising 1135 participants, were included in the review, with 12 studies contributing to the meta-analysis using R v4.4. The pooled prevalence of EDs in individuals with SSDs was 15.65% (95% CI: 8.04-28.26), with a prediction interval ranging from 1.62% to 67.66%. Subgroup analysis by geographical location revealed substantial variability, with prevalence estimates ranging from 5.88% in Southern Europe to 28.99% in the Middle East and North Africa. Studies using questionnaire-based tools reported a higher pooled prevalence (19.25%) compared to those employing DSM-based diagnostic criteria (11.90%). Significant heterogeneity was observed across studies (I2 = 87%).ConclusionsThis study highlights the considerable prevalence of EDs in SSD populations, emphasising the need for early identification and integrated care. The variability in prevalence estimates suggests that geographical, cultural and methodological factors play an important role in the findings. Future research should focus on longitudinal studies, the development of standardized diagnostic tools, and the inclusion of underrepresented regions to enhance understanding and improve care for this vulnerable population.