In predominantly medication-naïve schizophrenic patients, those exhibiting partial metabolic disorders have significantly worse sleep quality and sleep onset time; poor sleep predicted metabolic dysregulation even after controlling for confounding factors. Mental health, sleep, and eating behavior interact in ways that strongly influence the risk of obesity and MetS. Emotional eating (eating in response to emotions rather than hunger) is central to this network and appears to be closely associated with psychiatric illnesses, particularly depression, anxiety, and sleep disorders. There is a continuing need to elucidate the frequency, level, and relationship of emotional eating with other factors in individuals with SMI. Therefore, this study aims to elucidate this complex relationship, thereby shedding light on new ways to reduce metabolic risks in psychiatric patients.

Research Questions

• Is there a relationship between mental status and MetS in individuals with SMI?
• How does diagnosis (schizophrenia or bipolar disorder) and the group of medications used affect MetS in individuals with SMI?
• What is the level of emotional eating in individuals with SMI?
• Do emotional eating and sleep quality affect MetS in relation to mental status in individuals with SMI?

Hypotheses

H1 The group of psychotropic medications routinely used significantly affects MetS levels.

H2 Individuals with SMI have high levels of emotional eating.

H3 As mental status deteriorates, the level of emotional eating increases.

H4 Emotional eating mediates the relationship between mental status and MetS.

H5 Sleep quality mediates the relationship between mental status and MetS.

H6 Emotional eating and sleep quality mediate the relationship between mental status and MetS (multiple mediation model).

H7 As sleep quality decreases, emotional eating increases.

H8 As the level of emotional eating increases, sleep quality deteriorates, which increases the risk of metabolic syndrome.

Inclusion Criteria:

• Being registered with the Bolu İzzet Baysal Mental Health and Diseases Hospital Community Mental Health Center,
• Having a severe chronic psychiatric illness (Schizophrenia Spectrum and Other Psychotic Disorders and Bipolar Disorder) followed by the Bolu İzzet Baysal Mental Health and Diseases Hospital Community Mental Health Center for at least 6 months,
• Being in remission (Complete Remission (Pre-Remission): Symptoms remaining below threshold values for at least 2 months (8 weeks). A state of improvement lasting more than 2 months is generally referred to as "remission"),
• Schizophrenia remission definition: 8 diagnostically significant symptoms were selected from the Positive and Negative Syndrome Scale.
• Bipolar disorder remission definition: Complete remission is defined as the absence of acute attacks and the presence of minimal/very mild symptoms.
• Being between 18-65 years of age,
• Being able to understand what is read and give written consent.

Exclusion Criteria:

• Having a diagnosis of mental retardation,
• Having other neurocognitive disorders, primarily dementia, according to DSM-V (as it can affect the ability to make decisions and give correct answers),
• Not being able to speak or understand Turkish.

Individuals being followed at the Community Mental Health Center, diagnosed with schizophrenia or bipolar disorder, who volunteered to participate in the study and were able to provide written consent.