Comparative study of eating behavior between patients with mental illness and healthy controls using the Japanese version of the Dutch Eating Behavior Questionnaire.

Background and objectives: To examine the reliability and validity of the Japanese version of the Dutch Eating Behavior Questionnaire (DEBQ-J) for patients with mental illness, and to determine the characteristics of eating behavior among these patients when compared with healthy controls.

Methods and study design: In May 2018, 120 outpatients with mental illness and 132 healthy controls were surveyed. First, exploratory factor analysis was conducted on the DEBQ-J statement responses for both patients and healthy controls. Next, reliability coefficients were calculated for the eating behavior scale scores (emotional, restrained, and external eating) extracted from the factor analysis. The association between BMI and eating behavior was examined using Student's t-test and Pearson's correlation coefficient.

Results: The DEBQ-J had a similar factor structure to that of the original DEBQ for healthy controls, with a cumulative contribution of 52.4% for the three factors, and alpha coefficients ranging from 0.87 to 0.91. For patients, factor analysis showed that four statements classified as emotional eating items in the original DEBQ were recategorized as external eating items, and the percentage of patients with obesity (BMI≥25) was 57.5%, compared with only 25.4% among the healthy controls. The patients with obesity tended to score higher on the external eating scale than did those with BMI<25.

Conclusions: Patients tended to blur the distinction between emotional feelings of mental irritability or anxiety and feelings in response to external stimuli. Monitoring of the DEBQ-J external eating score and appropriate intervention among patients living with mental illness may help to prevent obesity.