Mental disorders in adults with malnutrition: Prevalence and association with nutritional outcomes: A retrospective cohort study

Abstract Background Despite often coexisting, the association between mental disorders and malnutrition is not well characterized. This study aimed to describe the prevalence of mental disorders and their association with malnutrition, nutritional interventions, and clinical outcomes. Methods A retrospective cohort study was conducted on 431 patients in a specialized malnutrition clinic. Nutritional status was classified using the Global Leadership Initiative on Malnutrition (GLIM) criteria as well‐nourished (GLIM 0) or malnourished (GLIM 1–2). The primary outcome was to determine the prevalence of pre‐existing mental disorders, including mood, anxiety, psychotic, substance use‐related, and eating disorders. Secondary outcomes included differences in anthropometrics, micronutrient levels, nutritional interventions, follow‐up status, and mortality between patients with and without mental disorders. Categorical variables were compared using Pearson's chi‐square test and continuous variables using Welch's t ‐test or Mann‐Whitney U test. Results A total of 363 patients (84.2%) were malnourished (GLIM 1–2), and 272 patients (63.1%) had a pre‐existing mental disorder. Mental disorders were more prevalent among malnourished patients compared with well‐nourished patients (65.6% vs 50.0%, P = 0.02). Patients with mental disorders were more likely to receive nutritional interventions: oral nutrition supplementation (34.6% vs 22.0%, P = 0.01), enteral nutrition (16.5% vs 9.4%, P = 0.04), and mirtazapine for appetite (28.3% vs 0.6%, P < 0.001). Lastly, patients with mental disorders were more likely lost to follow‐up (15.1% vs 12.0%, P = 0.04). Conclusion Mental disorders, particularly for mood and anxiety, are highly prevalent in this cohort and are associated with increased nutritional interventions and loss to follow‐up. These findings emphasize the importance of a multidisciplinary approach to managing patients with malnutrition and mental disorders.