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

Abstract Background 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-rec...

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Main Authors: Feten Fekih-Romdhane, Youssef Boukadida, Majda Cheour, Souheil Hallit
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Journal of Eating Disorders
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Online Access:https://doi.org/10.1186/s40337-025-01210-4
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author Feten Fekih-Romdhane
Youssef Boukadida
Majda Cheour
Souheil Hallit
author_facet Feten Fekih-Romdhane
Youssef Boukadida
Majda Cheour
Souheil Hallit
author_sort Feten Fekih-Romdhane
collection DOAJ
description Abstract Background 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. Methods 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). Results 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. Conclusion 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.
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spelling doaj-art-2a2b38da7716465db5be20273e0fa7f62025-02-09T12:04:05ZengBMCJournal of Eating Disorders2050-29742025-02-011311910.1186/s40337-025-01210-4Validation of the shortest version of the eating attitude test (EAT-7) as a screening tool for disordered eating in patients with first-episode schizophreniaFeten Fekih-Romdhane0Youssef Boukadida1Majda Cheour2Souheil Hallit3The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi hospitalFaculty of Medicine of Sousse, University of SousseThe Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi hospitalSchool of Medicine and Medical Sciences, Holy Spirit University of KaslikAbstract Background 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. Methods 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). Results 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. Conclusion 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.https://doi.org/10.1186/s40337-025-01210-4Disordered eatingEating attitude testShort formSchizophreniaPsychometric properties
spellingShingle Feten Fekih-Romdhane
Youssef Boukadida
Majda Cheour
Souheil Hallit
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
Journal of Eating Disorders
Disordered eating
Eating attitude test
Short form
Schizophrenia
Psychometric properties
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Disordered eating
Eating attitude test
Short form
Schizophrenia
Psychometric properties
url https://doi.org/10.1186/s40337-025-01210-4
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AT majdacheour validationoftheshortestversionoftheeatingattitudetesteat7asascreeningtoolfordisorderedeatinginpatientswithfirstepisodeschizophrenia
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