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Knaus S, Steininger J, Klinger D, Riedl S. Body Mass Index Distributions and Obesity Prevalence in a Transgender Youth Cohort - A Retrospective Analysis. J Adolesc Health 2024; 75:127-132. [PMID: 38752964 DOI: 10.1016/j.jadohealth.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/20/2024] [Accepted: 03/04/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE To evaluate differences in auxological parameters between transgender and cisgender adolescents. METHODS Retrospective analysis of auxological data of 269 transgender and gender diverse patients (75% assigned female at birth or AFAB, 25% assigned male at birth or AMAB) at the outpatient clinic for Pediatric Endocrinology at the Vienna General Hospital. All were treatment naïve at initial measurement. Height and weight data were compared to current World Health Organization (WHO) standards, defining a standard deviation score (SDS) of ≥ 1 ≤ 2 as overweight and > 2 as obese. RESULTS In our untreated transgender population (mean age 15.7 years), 20% were overweight and 17% obese. Mean BMI was 0.64 SDS above the WHO average (p < .001). This result was more pronounced in the AFAB subgroup (+0.73 SDS, p < .001) than in the AMAB group (+0.37 SDS, p = .07). The AMAB group showed markedly higher BMI variance compared to WHO standards (p < .001) and to the AFAB group (p = .03), due to a higher relative number of underweight observations. When correcting for psychiatric diagnosis, transgender patients were still significantly overweight (p < .001). In patients for whom data both pregender-affirming hormone therapy and during gender-affirming hormone therapy was available (n = 133), BMI SDS did not change significantly over time (p = .22). DISCUSSION We observed significantly higher rates of overweight and obesity in our adolescent transgender cohort. The reasons are likely complex and multifactorial. This makes eating and exercise behaviors central in both transgender care and future research.
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Affiliation(s)
- Sarah Knaus
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
| | - Johanna Steininger
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Diana Klinger
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Stefan Riedl
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria; St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
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2
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Echeveste-Navarrete J, Zavaleta-Ramírez P, Castilla-Peon MF. Trajectory of the body mass index of children and adolescents attending a reference mental health center. J Pediatr Endocrinol Metab 2024; 37:559-568. [PMID: 38634616 DOI: 10.1515/jpem-2024-0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/29/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVES The primary objective was to describe the standardized body mass index (z-BMI) trajectory of children and adolescents admitted to a psychiatric reference center in Mexico City according to their diagnosis and medication use. The secondary objective was to compare z-BMI between antipsychotic users and non-users. METHODS This is a retrospective cohort study. The psychiatric diagnosis, prescribed medications, serial heights, and weights were collected from the medical records. RESULTS The median baseline z-BMI of the 129 analyzed cases was 0.88 (interquartile range [IQR]: 0-1.92), and the prevalence of excessive weight (obesity or overweight) was 46.8 %. At the end of follow-up (median 50.3 weeks), the median change in z-BMI was -0.09 (IQR: -0.68 to 0.42). New long-term users of antipsychotics (n=29) had an increase in their z-BMI, in contrast to never-users (median difference 0.73, p=0.01) and to previous users (median difference 0.92, p=0.047). The 59 subjects with excessive weight at admission had a median z-BMI change of -0.39 (IQR: -0.81 to -0.04). Among patients with excessive weight and depression, there was a greater decrease in z-BMI in sertraline users (n=13) compared with fluoxetine users (n=15) (median -0.65 vs. 0.21, p<0.001). CONCLUSIONS New long-term users of antipsychotics showed a significant increase in their z-BMI. Patients with depressive disorders and obesity on sertraline therapy tended to show a decrease in their z-BMI.
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Affiliation(s)
- Juliana Echeveste-Navarrete
- Pharmacist, Hospital Psiquiátrico Infantil 'Dr. Juan N. Navarro', Servicios de Atención Psiquiátrica, Mexico City, Mexico
| | - Patricia Zavaleta-Ramírez
- Child and Adolescent Psychiatrist, Research Division Director, Hospital Psiquiátrico Infantil 'Dr. Juan N. Navarro', Servicios de Atención Psiquiátrica, Mexico City, Mexico
| | - Maria Fernanda Castilla-Peon
- Pediatric Endocrinologist, Researcher at Hospital Psiquiátrico Infantil 'Dr. Juan N. Navarro', Comisión Nacional de Salud Mental y Adicciones, Mexico City, México
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Richardson KA, Punke ELA, Dabrowski BS, Teply AL, Walker J, McKibbin CL. Parent Intention to Participate in an Online Intervention to Enhance Health Behavior Change Among Youth Treated with Psychotropic Medication Who are Overweight or Obese: An Application of the Theory of Planned Behavior. JOURNAL OF PREVENTION (2022) 2024; 45:431-450. [PMID: 38446270 DOI: 10.1007/s10935-024-00773-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 03/07/2024]
Abstract
Youth with mental health disorders (MHD), particularly those who take psychotropic medications, are at increased risk of being overweight or obese (OW/OB) when compared to typical youth. Parents are important resources for interventions addressing OW/OB. However, parents of youth with MHD may face challenges that require interventions designed to address their needs. Prior to investing research funding in the development of interventions for this group, research is needed to understand factors associated with parents' decisions to enroll in these programs. The theory of planned behavior (TPB) provided a framework for examining parents' salient beliefs, direct attitudes, and intention to enroll in a hypothetical online healthy lifestyle intervention for their youth (ages 11-17) with OW/OB and treated with psychotropic medication. Parents who were enrolled in the study (n = 84) completed demographic questionnaires and a TPB questionnaire which was constructed for this study. A confirmatory factor analysis (CFA) of the direct attitude (i.e., attitude toward the behavior, subjective norm, perceived behavioral control) questions generally supported the three-factor model (i.e., RMSEA = .07, 90% CI .03-.11, p = .18; CFI = .96, SRMR = .06). Results from a multiple regression analysis demonstrated that direct attitudes predicted parent intention to participate in an online healthy lifestyle intervention for this sample of youth accounting for 84% of variance. In this preliminary study, the TPB appears to be a promising framework for understanding direct attitudes associated with parent intentions toward intervention participation in this population of youth. Interventions for parents of youth with OW/OB who are prescribed psychotropic medication should consider addressing these direct attitudes to improve intention.
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Affiliation(s)
| | | | | | - Abby L Teply
- Department of Psychology, University of Wyoming, Laramie, WY, 82072, USA
| | - Johnathan Walker
- Department of Psychology, University of Wyoming, Laramie, WY, 82072, USA
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Carvalho LML, Jorge AADL, Bertola DR, Krepischi ACV, Rosenberg C. A Comprehensive Review of Syndromic Forms of Obesity: Genetic Etiology, Clinical Features and Molecular Diagnosis. Curr Obes Rep 2024; 13:313-337. [PMID: 38277088 DOI: 10.1007/s13679-023-00543-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 01/27/2024]
Abstract
Syndromic obesity refers to obesity occurring with additional clinical findings, such as intellectual disability/developmental delay, dysmorphic features, and congenital malformations. PURPOSE OF REVIEW: To present a narrative review regarding the genetic etiology, clinical description, and molecular diagnosis of syndromic obesity, which is a rare condition with high phenotypic variability and genetic heterogeneity. The following syndromes are presented in this review: Prader-Willi, Bardet-Biedl, Pseudohypoparathyroidism, Alström, Smith-Magenis, Cohen, Temple, 1p36 deletion, 16p11.2 microdeletion, Kleefstra, SIM1-related, Börjeson-Forssman-Lehmann, WAGRO, Carpenter, MORM, and MYT1L-related syndromes. RECENT FINDINGS: There are three main groups of mechanisms for syndromic obesity: imprinting, transcriptional activity regulation, and cellular cilia function. For molecular diagnostic, methods of genome-wide investigation should be prioritized over sequencing of panels of syndromic obesity genes. In addition, we present novel syndromic conditions that need further delineation, but evidences suggest they have a higher frequency of obesity. The etiology of syndromic obesity tends to be linked to disrupted neurodevelopment (central) and is associated with a diversity of genes and biological pathways. In the genetic investigation of individuals with syndromic obesity, the possibility that the etiology of the syndromic condition is independent of obesity should be considered. The accurate genetic diagnosis impacts medical management, treatment, and prognosis, and allows proper genetic counseling.
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Affiliation(s)
- Laura Machado Lara Carvalho
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Laboratory of Human Genetics - LGH, Institute of Biosciences, University of São Paulo (USP), Matão Street 277 - Room 350, São Paulo, SP, Brazil
| | - Alexander Augusto de Lima Jorge
- Genetic Endocrinology Unit, Cellular and Molecular Endocrinology Laboratory (LIM/25), Faculty of Medicine, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Débora Romeo Bertola
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Laboratory of Human Genetics - LGH, Institute of Biosciences, University of São Paulo (USP), Matão Street 277 - Room 350, São Paulo, SP, Brazil
- Genetics Unit of Instituto da Criança, Faculty of Medicine, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Ana Cristina Victorino Krepischi
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Laboratory of Human Genetics - LGH, Institute of Biosciences, University of São Paulo (USP), Matão Street 277 - Room 350, São Paulo, SP, Brazil
| | - Carla Rosenberg
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Laboratory of Human Genetics - LGH, Institute of Biosciences, University of São Paulo (USP), Matão Street 277 - Room 350, São Paulo, SP, Brazil.
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Borger O, Perl L, Yackobovitch-Gavan M, Sides R, Brener A, Segev-Becker A, Sheppes T, Weinstein G, Oren A, Lebenthal Y. Body Composition and Metabolic Syndrome Components in Transgender/Gender Diverse Adolescents and Young Adults. LGBT Health 2024. [PMID: 38557208 DOI: 10.1089/lgbt.2023.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Purpose: The objective of this study was to examine the association of designated sex at birth, body composition, and gender-affirming hormone treatment (GAHT) with the components of metabolic syndrome (MetS) (overweight/obesity, elevated blood pressure [BP], altered glucose metabolism, and dyslipidemia) in transgender/gender diverse (TGD) adolescents and young adults. Methods: TGD individuals underwent body composition studies by bioelectrical impedance analysis according to designated sex at birth, and their muscle-to-fat ratio (MFR) z-scores were calculated. Generalized estimating equations with binary logistic models (n = 326) were used to explore associations while adjusting for potential confounders. Results: A total of 55 TGD females and 111 TGD males, with mean age of 18 ± 1.9 years and median duration of GAHT of 1.4 years (interquartile range = 0.6-2.5), were enrolled. Overall, 118/166 (71%) of the TGD cohort showed evidence of at least one MetS component, with a significantly higher rate among TGD males compared with TGD females (91.1% vs. 50.9%, p < 0.001). TGD males were at increased odds for overweight/obesity, elevated/hypertensive BP, elevated triglycerides (TGs), and an atherogenic dyslipidemia index (TG/high-density lipoprotein cholesterol [HDL-c], TG:HDL-c). The odds of overweight/obesity increased by 44.9 for each standard deviation decrease in the MFR z-score, while the odds for an elevated TG:HDL-c index increased by 3.7. Psychiatric morbidity increased the odds for overweight/obesity by 2.89. Conclusions: After considering confounding variables, the TGD males on GAHT were found to be at an increased risk for cardiometabolic disease. Our observations support the importance of targeted medical nutrition intervention in this group of individuals.
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Affiliation(s)
- Ophir Borger
- The Institute of Pediatric Endocrinology and Diabetes, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- The Nutrition and Dietetics Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Liat Perl
- The Institute of Pediatric Endocrinology and Diabetes, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Yackobovitch-Gavan
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roni Sides
- The Nutrition and Dietetics Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Avivit Brener
- The Institute of Pediatric Endocrinology and Diabetes, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Segev-Becker
- The Institute of Pediatric Endocrinology and Diabetes, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamar Sheppes
- The Institute of Pediatric Endocrinology and Diabetes, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Psychological Services, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - Asaf Oren
- The Institute of Pediatric Endocrinology and Diabetes, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- The Nutrition and Dietetics Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yael Lebenthal
- The Institute of Pediatric Endocrinology and Diabetes, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- The Nutrition and Dietetics Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Lu P, Gao CX, Luo FJ, Huang YT, Gao MM, Long YS. Hippocampal proteomic changes in high-fat diet-induced obese mice associated with memory decline. J Nutr Biochem 2024; 125:109554. [PMID: 38142716 DOI: 10.1016/j.jnutbio.2023.109554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/24/2023] [Accepted: 12/19/2023] [Indexed: 12/26/2023]
Abstract
Substantial evidence suggest that chronic consumption of high-fat diets (HFDs) can lead to obesity, abnormal metabolism, as well as cognitive impairment. Molecular and cellular changes regarding hippocampal dysfunctions have been identified in multiple HFD animal models. Therefore, in-depth identification of expression changes of hippocampal proteins is critical for understanding the mechanism of HFD-induced cognitive deficits. In this study, we fed 3-week-old male mice with HFD for 3 months to generate obese mice who exhibit systemic metabolic abnormality and learning and memory decline. Using an iTRAQ-labeled proteomic analysis, we identified a total of 82 differentially expressed proteins (DEPs) in the hippocampus upon HFD with 35 up-regulated proteins and 47 down-regulated proteins. Functional enrichment indicated that these DEPs were predominantly enriched in regulation of catabolic process, dendritic shaft, neuron projection morphogenesis and GTPase regulator activity. Protein-protein interaction enrichment showed that the DEPs are mostly enriched in postsynaptic functions; and of them, six proteins (i.e., DLG3, SYNGAP1, DCLK1, GRIA4, GRIP1, and ARHGAP32) were involved in several functional assemblies of the postsynaptic density including G-protein signaling, scaffolding and adaptor, kinase and AMPA signaling, respectively. Collectively, our findings suggest that these DEPs upon HFD might contribute to memory decline by disturbing neuronal and postsynaptic functions in the hippocampus.
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Affiliation(s)
- Ping Lu
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Cun-Xiu Gao
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Fei-Jian Luo
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Yu-Ting Huang
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Mei-Mei Gao
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Yue-Sheng Long
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China.
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7
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Chen W, Feng J, Jiang S, Guo J, Zhang X, Zhang X, Wang C, Ma Y, Dong Z. Mendelian randomization analyses identify bidirectional causal relationships of obesity with psychiatric disorders. J Affect Disord 2023; 339:807-814. [PMID: 37474010 DOI: 10.1016/j.jad.2023.07.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/25/2023] [Accepted: 07/08/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Obesity have been showed to be strongly associated with psychiatric disorders, but the exact causality and the direction of the relationship remain inconclusive. Thus, we aimed to identify the causal associations between obesity and psychiatric disorders using two-sample Mendelian randomization (MR). METHODS Single-nucleotide polymorphisms associated with obesity, including body mass index (BMI), waist-hip ratio (WHR), and waist-hip ratio adjusted for BMI (WHRadjBMI), were extracted from a genome-wide association study of 694,649 European ancestry from the GIANT consortium. Summary level data for 10 psychiatric disorders were obtained from the Psychiatric Genomics Consortium. Inverse-variance weighted (IVW) method was used as the primary analysis, while several sensitivity analyses were applied to evaluate heterogeneity and pleiotropy. RESULTS The main MR results suggested higher BMI or WHR was positively causally associated with an increased risk of attention deficit hyperactivity disorder (ADHD), anorexia nervosa (AN), post-traumatic stress disorder (PTSD), major depressive disorder (MDD) and Alzheimer's disease (ALZ), but negatively causally associated with an increased risk of obsessive-compulsive disorder (OCD) and schizophrenia. For the reverse direction, ADHD and MDD were associated with an increased risk of obesity, but schizophrenia and ALZ were associated with a decreased risk of obesity. CONCLUSION Our findings support evidence of causal relationships between obesity and ADHD, MDD, PTSD, ALZ, SCZ, AN, and OCD, and confirmed the bidirectional causal relationships between obesity and ADHD, MDD, SCZ, and ALZ.
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Affiliation(s)
- Wenhui Chen
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou 510632, China
| | - Jia Feng
- Institute of Biomedicine, Department of Cellular Biology, Jinan University, Guangzhou 510632, China
| | - Shuwen Jiang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou 510632, China
| | - Jie Guo
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou 510632, China
| | - XiaoLin Zhang
- Department of General Surgery, The Fifth Affiliated Hospital of Jinnan University (Shenhe People's Hospital), Heyuan 517300, China
| | - Xiaoguan Zhang
- Department of General Surgery, Dalang Hospital of Dongguan, Dongguan 523000, China
| | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou 510632, China
| | - Yi Ma
- Institute of Biomedicine, Department of Cellular Biology, Jinan University, Guangzhou 510632, China.
| | - Zhiyong Dong
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou 510632, China.
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Moursi N, Tanofsky-Kraff M, Parker M, Loch L, Bloomer B, Te-Vazquez J, Nwosu E, Lazareva J, Yang SB, Turner S, Brady S, Yanovski J. Changes in Food Consumption, BMI, and Body Composition in Youth in the US during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6796. [PMID: 37754655 PMCID: PMC10531233 DOI: 10.3390/ijerph20186796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 09/28/2023]
Abstract
Rates of childhood overweight/obesity have risen for decades; however, data show the prevalence increased at a faster rate during the COVID-19 pandemic. Pandemic-associated increases in youth's body mass index (BMI; kg/m2) have been attributed to decreases in reported physical activity; few studies have examined changes in food intake. We therefore examined changes in total energy, nutrient consumption, BMI, BMIz, and adiposity longitudinally over 3 years, comparing healthy youth aged 8-17 years assessed twice prior to the pandemic, to youth seen once before and once during the pandemic. The total energy intake and percent macronutrient consumption were assessed using a standardized, laboratory-based, buffet-style meal. Height and weight were measured and adiposity was collected via dual energy X-ray absorptiometry. Generalized linear model univariate analyses investigated differences between groups. One-hundred-fifteen youth (15.6 + 2.8 years 47.8% female; 54.8% White) from the Washington D.C., Maryland, and Virginia greater metropolitan area participated. In this secondary analysis, neither changes in total energy intake (p = 0.52) nor changes in nutrient consumption were significantly different between the two groups (ps = 0.23-0.83). Likewise, changes in BMI, BMIz, and adiposity (ps = 0.95-0.25) did not differ by group. Further research should investigate food intake and body composition, comparing youth with and without overweight/obesity to better identify those at greatest risk of excess weight gain during the pandemic.
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Affiliation(s)
- Nasreen Moursi
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; (N.M.); (M.P.); (L.L.); (B.B.); (J.T.-V.); (E.N.); (J.L.); (S.B.); (J.Y.)
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD 20814, USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; (N.M.); (M.P.); (L.L.); (B.B.); (J.T.-V.); (E.N.); (J.L.); (S.B.); (J.Y.)
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD 20814, USA
| | - Megan Parker
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; (N.M.); (M.P.); (L.L.); (B.B.); (J.T.-V.); (E.N.); (J.L.); (S.B.); (J.Y.)
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD 20814, USA
| | - Lucy Loch
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; (N.M.); (M.P.); (L.L.); (B.B.); (J.T.-V.); (E.N.); (J.L.); (S.B.); (J.Y.)
| | - Bess Bloomer
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; (N.M.); (M.P.); (L.L.); (B.B.); (J.T.-V.); (E.N.); (J.L.); (S.B.); (J.Y.)
| | - Jennifer Te-Vazquez
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; (N.M.); (M.P.); (L.L.); (B.B.); (J.T.-V.); (E.N.); (J.L.); (S.B.); (J.Y.)
| | - Ejike Nwosu
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; (N.M.); (M.P.); (L.L.); (B.B.); (J.T.-V.); (E.N.); (J.L.); (S.B.); (J.Y.)
| | - Julia Lazareva
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; (N.M.); (M.P.); (L.L.); (B.B.); (J.T.-V.); (E.N.); (J.L.); (S.B.); (J.Y.)
| | - Shanna B. Yang
- Nutrition Department, NIH Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA; (S.B.Y.); (S.T.)
| | - Sara Turner
- Nutrition Department, NIH Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA; (S.B.Y.); (S.T.)
| | - Sheila Brady
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; (N.M.); (M.P.); (L.L.); (B.B.); (J.T.-V.); (E.N.); (J.L.); (S.B.); (J.Y.)
| | - Jack Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; (N.M.); (M.P.); (L.L.); (B.B.); (J.T.-V.); (E.N.); (J.L.); (S.B.); (J.Y.)
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Muskens JB, Ester WA, Klip H, Zinkstok J, van Dongen-Boomsma M, Staal WG. Novel Insights into Somatic Comorbidities in Children and Adolescents Across Psychiatric Diagnoses: An Explorative Study. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01587-w. [PMID: 37656290 DOI: 10.1007/s10578-023-01587-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/02/2023]
Abstract
Many children with psychiatric disorders display somatic symptoms, although these are frequently overlooked. As somatic morbidity early in life negatively influences long-term outcomes, it is relevant to assess comorbidity. However, studies of simultaneous psychiatric and somatic assessment in children are lacking. The aim of this study was to assess the prevalence of somatic comorbidities in a clinical sample of children and adolescents with psychiatric disorders in a naturalistic design. Data were assessed from 276 children with various psychiatric disorders (neurodevelopmental disorders, affective disorders, eating disorders and psychosis) aged 6-18 years. These data were collected as part of routine clinical assessment, including physical examination and retrospectively analyzed. For a subsample (n = 97), blood testing on vitamin D3, lipid spectrum, glucose and prolactin was available. Results of this cross-sectional study revealed that food intake problems (43%) and insomnia (66%) were common. On physical examination, 20% of the children were overweight, 12% displayed obesity and 38% had minor physical anomalies. Blood testing (n = 97) highlighted vitamin D3 deficiency (< 50 nmol/L) in 73% of the children. None of the predefined variables (gender, age, medication and socioeconomic factors) contributed significantly to the prevalence of somatic comorbidities. The main somatic comorbidities in this broad child- and adolescent psychiatric population consisted of (1) problems associated with food intake, including obesity and vitamin D3 deficiency and (2) sleeping problems, mainly insomnia. Child and adolescent psychiatrists need to be aware of potential somatic comorbidities and may promote a healthy lifestyle.
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Affiliation(s)
- Jet B Muskens
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands.
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands.
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands.
| | - Wietske A Ester
- Sarr Autism Rotterdam, Youz Child and Adolescence Psychiatry, Dynamostraat 18, Rotterdam, 3083 AK, The Netherlands
- Parnassia Psychiatric Institute, Kiwistraat 30, The Hague, 2552 DH, The Netherlands
- Department of Child and Adolescent Psychiatry, Curium-LUMC, Leiden University Medical Center, Endegeesterstraatweg 27, Oegstgeest, 2342 AK, The Netherlands
| | - Helen Klip
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
| | - Janneke Zinkstok
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martine van Dongen-Boomsma
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Wouter G Staal
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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10
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Wilson CE, Carpenter JS, Crouse JJ, Park S, Koethe D, Scott EM, Hickie IB. Cross-sectional and longitudinal associations between cardiometabolic measures and clinical stage in young people accessing early intervention mental health services. Early Interv Psychiatry 2023; 17:893-900. [PMID: 36682384 PMCID: PMC10946614 DOI: 10.1111/eip.13381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 09/13/2022] [Accepted: 01/02/2023] [Indexed: 01/24/2023]
Abstract
AIM This retrospective cohort study aimed to identify the cardiometabolic characteristics, cross-sectionally and longitudinally, associated with clinical stage in youth accessing early intervention mental health services. METHODS Cardiometabolic data we collected in 511 young people (aged 12-25 years at entry) receiving mental health care at the early intervention services in Sydney, Australia. RESULTS The majority of young people (N = 448, 87.67%) were classified in stage 1a or 1b at entry. At entry to care, there was no cross-sectional relationship between clinical stage and age, gender, fasting insulin, fasting glucose, updated homeostatic model assessment for insulin resistance (HOMA2-IR) score, BMI or waist circumference. Of the 111 (21.7%) young people initially classified at stage 1a ('non-specific symptoms') and the 337 (65.9%) classified in stage 1b ('attenuated syndromes'), 40 individuals transitioned to stage 2+ (7.8%) ("full-threshold disorders") longitudinally. No cardiometabolic factors predicted clinical stage transitions. However, those with an increase in BMI over the course of care (n = 54) were 1.46 (OR; 95% CI: 1.02-2.17) times more likely to progress to stage 2+ at follow up. CONCLUSIONS Whilst no relationships were found between demographic or cardiometabolic variables and clinical stage at entry to care, an increased BMI over time was associated with clinical stage transition longitudinally. Further longitudinal research is needed to understand the demographic, clinical, illness progression or treatment factors associated with changes in cardiometabolic status.
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Affiliation(s)
- Chloe E. Wilson
- Brain and Mind Centre, Youth Mental Health and Technology TeamThe University of SydneyCamperdownAustralia
| | - Joanne S. Carpenter
- Brain and Mind Centre, Youth Mental Health and Technology TeamThe University of SydneyCamperdownAustralia
| | - Jacob J. Crouse
- Brain and Mind Centre, Youth Mental Health and Technology TeamThe University of SydneyCamperdownAustralia
| | - Shin Park
- Brain and Mind Centre, Youth Mental Health and Technology TeamThe University of SydneyCamperdownAustralia
| | - Dagmar Koethe
- Brain and Mind Centre, Youth Mental Health and Technology TeamThe University of SydneyCamperdownAustralia
| | - Elizabeth M. Scott
- Brain and Mind Centre, Youth Mental Health and Technology TeamThe University of SydneyCamperdownAustralia
| | - Ian B. Hickie
- Brain and Mind Centre, Youth Mental Health and Technology TeamThe University of SydneyCamperdownAustralia
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11
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Liu XF, Zhao SW, Cui JJ, Gu YW, Fan JW, Fu YF, Zhang YH, Yin H, Chen K, Cui LB. Differential expression of diacylglycerol kinase ζ is involved in inferior parietal lobule-related dysfunction in schizophrenia with cognitive impairments. BMC Psychiatry 2023; 23:526. [PMID: 37479996 PMCID: PMC10362743 DOI: 10.1186/s12888-023-04955-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/13/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Cognitive impairment is the main factor in the poor prognosis of schizophrenia, but its mechanism remains unclear. The inferior parietal lobule (IPL) is related to various clinical symptoms and cognitive impairment in schizophrenia. We aimed to explore the relationship between IPL-related functions and cognitive impairment in schizophrenia. METHODS 136 schizophrenia patients and 146 demographically matched healthy controls were enrolled for a cross-sectional study. High-spatial-resolution structural and resting-state functional images were acquired to demonstrate the alternations of brain structure and function. At the same time, the digit span and digit symbol coding tasks of the Chinese Wechsler Adult Intelligence Test Revised (WAIS-RC) were utilized in assessing the subjects' cognitive function. Patients were divided into cognitive impairment and normal cognitive groups according to their cognitive score and then compared whether there were differences between the three groups in fractional amplitude of low-frequency fluctuation (fALFF). In addition, we did a correlation analysis between cognitive function and the fALFF for the left IPL of patients and healthy controls. Based on the Allen Human Brain Atlas, we obtained genes expressed in the left IPL, which were then intersected with the transcriptome-wide association study results and differentially expressed genes in schizophrenia. RESULTS Grouping of patients by the backward digit span task and the digit symbol coding task showed differences in fALFF values between healthy controls and cognitive impairment patients (P < 0.05). We found a negative correlation between the backward digit span task score and fALFF of the left IPL in healthy controls (r = - 0.388, P = 0.003), which was not seen in patients (r = 0.203, P = 0.020). In addition, none of the other analyses were statistically significant (P > 0.017). In addition, we found that diacylglycerol kinase ζ (DGKζ) is differentially expressed in the left IPL and associated with schizophrenia. CONCLUSION Our study demonstrates that the left IPL plays a vital role in cognitive impairment in schizophrenia. DGKζ may act as an essential regulator in the left IPL of schizophrenia patients with cognitive impairment.
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Affiliation(s)
- Xiao-Fan Liu
- Department of Radiology, Xi'an People's Hospital, Xi'an, China
- Schizophrenia Imaging Lab, Fourth Military Medical University, Xi'an, China
| | - Shu-Wan Zhao
- Schizophrenia Imaging Lab, Fourth Military Medical University, Xi'an, China
| | - Jin-Jin Cui
- Department of Radiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yue-Wen Gu
- Schizophrenia Imaging Lab, Fourth Military Medical University, Xi'an, China
| | - Jing-Wen Fan
- Schizophrenia Imaging Lab, Fourth Military Medical University, Xi'an, China
| | - Yu-Fei Fu
- Schizophrenia Imaging Lab, Fourth Military Medical University, Xi'an, China
| | - Ya-Hong Zhang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Hong Yin
- Department of Radiology, Xi'an People's Hospital, Xi'an, China.
| | - Kun Chen
- Department of Human Anatomy and K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, China.
- Shaanxi Provincial Key Laboratory of Clinic Genetics, Fourth Military Medical University, Xi'an, China.
| | - Long-Biao Cui
- Schizophrenia Imaging Lab, Fourth Military Medical University, Xi'an, China.
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
- Shaanxi Provincial Key Laboratory of Clinic Genetics, Fourth Military Medical University, Xi'an, China.
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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12
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Catalan A, Aymerich C, Bilbao A, Pedruzo B, Pérez JL, Aranguren N, Salazar de Pablo G, Hedges E, Gil P, Segarra R, González-Pinto A, Fernández-Rivas A, Inchausti L, McGuire P, Fusar-Poli P, González-Torres MÁ. Psychosis and substance abuse increase the COVID-19 mortality risk. Psychol Med 2023; 53:4236-4244. [PMID: 35410632 PMCID: PMC9114752 DOI: 10.1017/s0033291722000976] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has been a global challenge. High mortality rates have been reported in some risk groups, including patients with pre-existing mental disorders. METHODS We used electronic health records to retrospectively identify people infected due to COVID-19 (between March 2020 and March 2021) in the three territories of the Basque Country. COVID-19 cases were defined as individuals who had tested positive on a reverse transcription-polymerase chain reaction (PCR) test. Univariate and multivariate logistic regression models and multilevel analyses with generalized estimated equations were used to determine factors associated with COVID-19-related mortality and hospital admission. RESULTS The COVID-19 mortality rate was increased for patients with psychotic disorders [odds ratio (OR) adjusted: 1.45, 95% confidence interval (CI) (1.09-1.94), p = 0.0114] and patients with substance abuse [OR adjusted: 1.88, 95% CI (1.13-3.14, p < 0.0152)]. The mortality rate was lower for patients with affective disorders [OR adjusted: 0.80, 95% CI (0.61-0.99), p = 0.0407]. Hospital admission rates due to COVID-19 were higher in psychosis [OR adjusted: 2.90, 95% CI (2.36-3.56), p < 0.0001] and anxiety disorder groups [OR adjusted: 1.54, 95% CI (1.37-1.72), p < 0.0001]. Among admitted patients, COVID-19 mortality rate was decreased for those with affective disorders rate [OR adjusted: 0.72, 95% CI (0.55-0.95), p = 0.0194]. CONCLUSIONS COVID-19-related mortality and hospitalizations rates were higher for patients with a pre-existing psychotic disorder.
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Affiliation(s)
- Ana Catalan
- Osakidetza Basque Health Service, Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Claudia Aymerich
- Osakidetza Basque Health Service, Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Amaia Bilbao
- Osakidetza Basque Health Service, Basurto University Hospital, Research Unit, Bilbao, Bizkaia, Spain
- Health Service Research Network on Chronic Diseases (REDISSEC), Madrid, Spain
- Kronikgune Institute for Health Services Research, Barakaldo, Spain
| | - Borja Pedruzo
- Osakidetza Basque Health Service, Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - José Luis Pérez
- Osakidetza Basque Health Service, Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | | | - Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health. Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Emily Hedges
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Patxi Gil
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Bizkaia Mental Health Network, Programa Lehenak, Bilbao, Spain
| | - Rafael Segarra
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
- Psychiatry Department, Cruces University Hospital, Barakaldo, Spain
| | - Ana González-Pinto
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
- Bioaraba. CIBERSAM. Psychiatry Department, Hospital Universitario de Alava, Vitoria-Gasteiz, Spain
| | - Aranzazu Fernández-Rivas
- Osakidetza Basque Health Service, Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Lucía Inchausti
- Osakidetza Basque Health Service, Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Outreach and Support in South London Service, South London and Maudsley National Health Service Foundation Trust, London, UK
- National Institute for Health Research Biomedical Research Centre, London, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Kronikgune Institute for Health Services Research, Barakaldo, Spain
- National Institute for Health Research Biomedical Research Centre, London, UK
| | - Miguel Ángel González-Torres
- Osakidetza Basque Health Service, Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
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Liu Z, Sun L, Zhang Y, Wang J, Sun F, Zhang Z, Sun G, Sun L, Yang R. The prevalence of underweight and obesity in Chinese children and adolescents with major depressive disorder and relationship with suicidal ideation and attempted suicide. Front Psychiatry 2023; 14:1130437. [PMID: 37215666 PMCID: PMC10196048 DOI: 10.3389/fpsyt.2023.1130437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/17/2023] [Indexed: 05/24/2023] Open
Abstract
Background The high rates of obesity and suicide have become serious public health problems worldwide, especially in children and adolescents with major depressive disorder (MDD). This research aimed to explore the rates of underweight, overweight or obesity, suicidal ideation and attempted suicide in hospitalized children and adolescents with MDD. Then, we analyzed the correlation between underweight or obesity and suicidal ideation and attempted suicide, and finally obtained the independent influencing factors of underweight or obesity. Methods A total of 757 subjects in the Third People's Hospital of Fuyang from January 2020 to December 2021 were enrolled in this study. According to the underweight, overweight and obesity screening table for school-age children and adolescents published and implemented by the health industry standard of China, all subjects were divided into different body mass index (BMI) categories. We measured fasting blood glucose (FBG) and lipid levels in all subjects and assessed suicidal ideation, attempted suicide, and the severity of depressive symptoms. The socio-demographic and clinical data were collected and analyzed by SPSS 22.0. Results The rates of underweight, overweight, obesity, suicidal ideation and attempted suicide were 8.2% (62/757), 15.5% (117/757), 10.4% (79/757), 17.2% (130/757), and 9.9% (75/757), respectively. Correlation analysis indicated that BMIs level was positively correlated with age, age of first hospitalization, total duration of disease, number of hospitalizations, FBG, TG (triglyceride), TC (total cholesterol), LDL (low density lipoprotein), and negatively correlated with HDL (high density lipoprotein). Binary logistic regression analysis showed that male and high level of HDL were risk factors for MDD inpatients with underweight, while high level of TG was a protective factor. Meanwhile, higher levels of FBG, TG and CGI-S were risk factors and suicidal ideation and high dose of antidepressant drugs were protective factors for obesity in children and adolescents with MDD. Conclusion The prevalence of underweight, obesity, suicidal ideation and attempted suicide were high in children and adolescents with MDD, and severe depressive symptoms are independent risk factors for obesity, while suicidal ideation and high dose of antidepressants may be protective factors for obesity.
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Affiliation(s)
- Zhiwei Liu
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Liang Sun
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Yulong Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Juan Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Department of Psychiatry, The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Feng Sun
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Zhaokun Zhang
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Guangying Sun
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Longlong Sun
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Rongchun Yang
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
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14
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Witte MA, Weber CH, Lebow J, LeMahieu A, Geske J, Witte N, Whiteside S, Loth K, Sim L. Lifetime Prevalence of Psychiatric Disorders in Adolescents with Unexplained Weight Loss, Underweight, or Poor Appetite. J Dev Behav Pediatr 2023; 44:e277-e283. [PMID: 37020320 PMCID: PMC10691667 DOI: 10.1097/dbp.0000000000001173] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/31/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND When adolescents present with symptoms of unexplained weight loss, underweight, or poor appetite, eating disorders (EDs) are commonly on the list of differential diagnoses. However, the relationship of these symptoms to other psychiatric disorders is often less clear. METHODS Using the Rochester Epidemiology Project database, a retrospective cohort study of adolescents (13-18 years) with billing diagnoses of weight loss, underweight, or loss of appetite was conducted between January 2005 and December 2017. Patients who presented with conditions commonly associated with weight loss, underweight, or poor appetite (e.g., cancer) were excluded. This study sought to examine the proportion of patients who received ED and psychiatric diagnoses within 5 years of the index visit and patient characteristics associated with these diagnoses. RESULTS Of 884 patients diagnosed with symptoms of unexplained weight loss, underweight, or poor appetite, 662 patients ( M age = 15.8; SD = 1.6; 66.0% female) met study criteria. Within 5 years of the index visit, the lifetime prevalence of all psychiatric disorders was 70% (n = 461) and of EDs was 21% (n = 141). For both psychiatric disorders and EDs, sex and race were significantly associated with receiving a diagnosis within 5 years. Decrease in body mass index (BMI) percentile was associated with receiving an ED diagnosis, whereas the highest historical BMI percentile was associated with receiving a psychiatric diagnosis. CONCLUSION Patients presenting with symptoms of unexplained weight loss, underweight, or poor appetite are at risk not only for EDs but also for other psychiatric disorders that may require further assessment and follow-up.
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Affiliation(s)
| | | | - Jocelyn Lebow
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Allison LeMahieu
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Jennifer Geske
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Nathaniel Witte
- Mayo Clinic Strategy Department, Mayo Clinic, Rochester, MN, USA
| | - Stephen Whiteside
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Katie Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Leslie Sim
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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15
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Wilson C, Carpenter JS, Nichles A, Zmicerevska N, Song YJC, McHugh C, Hamilton B, Hockey S, Crouse J, Koethe D, Scott EM, Hickie IB. Double-blind, randomised placebo-controlled clinical trial of metformin as an adjunct to a sleep-wake, activity and metabolically focused behavioural intervention to improve cardiometabolic outcomes and mood symptoms in youth with major mood syndromes: study protocol. BMJ Open 2023; 13:e064682. [PMID: 36810174 PMCID: PMC9945047 DOI: 10.1136/bmjopen-2022-064682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
INTRODUCTION Metformin is a medication likely to improve measures of cardiometabolic disturbance in young people with mental illness. Evidence also suggests metformin may improve depressive symptoms. This 52-week double-blind randomised control trial (RCT) aims to investigate the efficacy of metformin pharmacotherapy as an adjunct to a healthy lifestyle behavioural intervention in improving cardiometabolic outcomes, and depressive, anxiety and psychotic symptoms in youth with clinically diagnosed major mood syndromes. METHODS AND ANALYSIS At least 266 young people aged 16-25 presenting for mental healthcare for major mood syndromes who are also at risk for poor cardiometabolic outcomes will be invited to participate in this study. All participants will engage in a 12-week sleep-wake, activity and metabolically focused behavioural intervention programme. As an adjunctive intervention, participants will receive either metformin (500-1000 mg) or placebo pharmacotherapy for 52 weeks.Participants will undergo a series of assessments including: (1) self-report and clinician-administered assessments; (2) blood tests; (3) anthropometric assessments (height, weight, waist circumference and blood pressure); and (4) actigraphy. Univariate and multivariate tests (generalised mixed-effects models) will be used to examine changes in primary and secondary outcomes (and associations with predetermined predictor variables). ETHICS AND DISSEMINATION This study has been approved by the Sydney Local Health District Research Ethics and Governance Office (X22-0017). The results of this double-blind RCT will be disseminated into the scientific and broader community through peer-reviewed journals, conference presentations, social media and university websites. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ANZCTR) Number: ACTRN12619001559101p, 12 November 2019.
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Affiliation(s)
- Chloe Wilson
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | | | - Alissa Nichles
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Natalia Zmicerevska
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Yun Ju Christine Song
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Catherine McHugh
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Blake Hamilton
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Samuel Hockey
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Jacob Crouse
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Dagmar Koethe
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Elizabeth M Scott
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
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16
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Töbelmann L, Hahne I, Schulze T, Bergmann N, Fuchs L, Zierhut M, Hahn E, Böge K. Mechanisms of action and processes of yoga-based group intervention for inpatients with schizophrenia spectrum disorders-A longitudinal qualitative study. Front Psychiatry 2023; 14:1086468. [PMID: 36824673 PMCID: PMC9941680 DOI: 10.3389/fpsyt.2023.1086468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/16/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Research exploring the effects of yoga therapy (YT) on individuals with schizophrenia spectrum disorders (SSD) is scarce. Therefore, the current study aimed to explore possible mechanisms of actions and processes, as well as adverse effects of a novel yoga-based group intervention (YoGI) for in-patients with SSD in a German university hospital setting. MATERIAL AND METHODS A longitudinal qualitative study was integrated into a rater-blinded randomized controlled trial, exploring the impact of a 4-week YoGI as add-on treatment. In-depth interviews were conducted with participants receiving YoGI (n = 19) in addition to treatment as usual (TAU) and a control group (n = 14) which only received TAU. Interviews were conducted at baseline (n = 33) and 4 weeks post-intervention (N = 28) to assess the participant's experiences and how they changed over time. The interviews (N = 61) were audio-taped, translated, coded, and analyzed by means of inductive thematic analysis. Separate case summaries were prepared for each participant to analyze longitudinal changes within subjects. The research team members collaboratively discussed the final list of themes and subcodes. Rater-based questionnaires, such as the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Personal and Social Performance Scale (PSP) were administered at baseline to assess clinical outcomes. RESULTS At baseline, participants reported a desire to improve their stress- and symptom management. A minority of participants expressed reservations toward yoga, and several psychosocial barriers were named, including worries about symptom exacerbation. At post-intervention, four mechanisms of change became evident from the interviews: (1) acquiring competence in relaxation, (2) increased interoceptive awareness, (3) feeling connected, and (4) a sense of spiritual wellbeing. A small number of participants reported difficulties with YoGI. CONCLUSION Generally, YoGI positively influenced participants' experiences of their inpatient stay, regarding distress, self- and body awareness, social connectedness, and spiritual wellbeing. However, participants also illuminated necessary adjustments to improve the intervention. YoGI will therefore be adapted and further developed in an iterative process based on a participant involvement approach. The efficacy regarding outcomes and processes needs to be investigated in a future larger-scaled randomized controlled trial.
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Affiliation(s)
- Laura Töbelmann
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Inge Hahne
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Theresa Schulze
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Niklas Bergmann
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Lukas Fuchs
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Marco Zierhut
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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Glucose and Lipid Profiles Predict Anthropometric Changes in Drug-Naïve Adolescents Starting Treatment with Risperidone or Sertraline: A Pilot Study. Biomedicines 2022; 11:biomedicines11010048. [PMID: 36672556 PMCID: PMC9855642 DOI: 10.3390/biomedicines11010048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/15/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022] Open
Abstract
Psychiatric disorders are associated with cardiometabolic diseases, partly due to adverse drug effects with individual risk variabilities. Risperidone and sertraline are widely used for youths. Although they may be exposed to anthropometric changes, few data about this population exist. We evaluated the correlation between several blood parameters and body changes in a very small group of drug-naïve adolescents who had started risperidone or sertraline. We examined weight, waist circumference (WC), WC/height ratio and body mass index (BMI) at baseline (T0) and after at least three months of therapy (T1), and blood glucose and lipid profiles at T0. Here, we show significant increases in several anthropometric parameters in both groups, a negative correlation between HDL and ΔWC in the risperidone group and positive correlations between insulin and ΔBMI and between HOMA-IR and ΔBMI in the sertraline group. Despite the sample size, these results are important because it is difficult to study adolescents who are long-term-compliant with psychotropic drugs. This pilot study supports the importance of future large-scale investigations to understand the metabolic risk profiles of psychotropic drugs, their individual vulnerabilities and their underlying mechanisms. Simultaneous guideline-based psychiatric and metabolic interventions should be part of daily practice.
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Cuda S, Censani M, Kharofa R, O'Hara V, Conroy R, Williams DR, Paisley J, Browne AF, Karjoo S, Browne NT. Medication-induced weight gain and advanced therapies for the child with overweight and obesity: An Obesity Medicine Association (OMA) Clinical Practice Statement 2022. OBESITY PILLARS (ONLINE) 2022; 4:100048. [PMID: 37990664 PMCID: PMC10662101 DOI: 10.1016/j.obpill.2022.100048] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 11/30/2022] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) details medication-induced weight gain and advanced therapies for the child with overweight or obesity. Methods The scientific information and clinical guidance in this CPS are based on scientific evidence, supported by the medical literature, and derived from the clinical perspectives of the authors. Results This OMA Clinical Practice Statement addresses medication-induced weight gain and advanced therapies for the child with overweight or obesity. Conclusions This OMA Clinical Practice Statement on medication induced-weight gain and advanced therapies for the child with overweight or obesity is an overview of current recommendations. These recommendations provide a roadmap to the improvement of the health of children and adolescents with obesity, especially those with metabolic, physiological, and psychological complications. This CPS also addresses treatment recommendations. This section is designed to help the provider with clinical decision making.
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Affiliation(s)
- Suzanne Cuda
- Alamo City Healthy Kids and Families, 1919 Oakwell Farms Parkway, Ste 145, San Antonio, TX, 78218, USA
| | - Marisa Censani
- Division of Pediatric Endocrinology, Department of Pediatrics, New York Presbyterian Hospital, Weill Cornell Medicine, 525 East 68th Street, Box 103, New York, NY, 10021, USA
| | - Roohi Kharofa
- Department of Pediatrics, University of Cincinnati College of Medicine Center for Better Health & Nutrition, The Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | | | - Rushika Conroy
- Division of Pediatric Endocrinology, Baystate Children's Hospital Subspecialty Center, 50 Wason AvenueSpringfield, MA, 01107, USA
| | - Dominique R Williams
- The Ohio State University College of Medicine Center for Healthy Weight and Nutrition, Nationwide Children's Hospital 700 Children's Drive LA, Suite 5F, Columbus, OH, 43215, USA
| | - Jennifer Paisley
- St Elizabeth Physician's Group Primary Care, 98 Elm Street Lawrenceburg, IN, 47025-2048, USA
| | | | - Sara Karjoo
- Johns Hopkins All Children's Hospital Pediatric Gastroenterology 501 6th Ave S St. Petersburg, FL, 33701, USA
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Gangopadhyay A, Ibrahim R, Theberge K, May M, Houseknecht KL. Non-alcoholic fatty liver disease (NAFLD) and mental illness: Mechanisms linking mood, metabolism and medicines. Front Neurosci 2022; 16:1042442. [PMID: 36458039 PMCID: PMC9707801 DOI: 10.3389/fnins.2022.1042442] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/21/2022] [Indexed: 09/26/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the world and one of the leading indications for liver transplantation. It is one of the many manifestations of insulin resistance and metabolic syndrome as well as an independent risk factor for cardiovascular disease. There is growing evidence linking the incidence of NAFLD with psychiatric illnesses such as schizophrenia, bipolar disorder and depression mechanistically via genetic, metabolic, inflammatory and environmental factors including smoking and psychiatric medications. Indeed, patients prescribed antipsychotic medications, regardless of diagnosis, have higher incidence of NAFLD than population norms. The mechanistic pharmacology of antipsychotic-associated NAFLD is beginning to emerge. In this review, we aim to discuss the pathophysiology of NAFLD including its risk factors, insulin resistance and systemic inflammation as well as its intersection with psychiatric illnesses.
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Affiliation(s)
| | | | | | | | - Karen L. Houseknecht
- Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME, United States
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20
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Zhang Q, Jin K, Chen B, Liu R, Cheng S, Zhang Y, Lu J. Overnutrition Induced Cognitive Impairment: Insulin Resistance, Gut-Brain Axis, and Neuroinflammation. Front Neurosci 2022; 16:884579. [PMID: 35873818 PMCID: PMC9298971 DOI: 10.3389/fnins.2022.884579] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 06/02/2022] [Indexed: 12/11/2022] Open
Abstract
Overnutrition-related obesity has become a worldwide epidemic, and its prevalence is expected to steadily rise in the future. It is widely recognized that obesity exerts negative impacts on metabolic disorders such as type 2 diabetes mellitus (T2DM) and cardiovascular diseases. However, relatively fewer reports exist on the impairment of brain structure and function, in the form of memory and executive dysfunction, as well as neurogenerative diseases. Emerging evidence indicates that besides obesity, overnutrition diets independently induce cognitive impairments via multiple mechanisms. In this study, we reviewed the clinical and preclinical literature about the detrimental effects of obesity or high-nutrition diets on cognitive performance and cerebral structure. We mainly focused on the role of brain insulin resistance (IR), microbiota-gut-brain axis, and neuroinflammation. We concluded that before the onset of obesity, short-term exposure to high-nutrition diets already blunted central responses to insulin, altered gut microbiome composition, and activated inflammatory mediators. Overnutrition is linked with the changes in protein expression in brain insulin signaling, leading to pathological features in the brain. Microbiome alteration, bacterial endotoxin release, and gut barrier hyperpermeability also occur to trigger mental and neuronal diseases. In addition, obesity or high-nutrition diets cause chronic and low-grade systematic inflammation, which eventually spreads from the peripheral tissue to the central nervous system (CNS). Altogether, a large number of unknown but potential routes interact and contribute to obesity or diet-induced cognitive impairment. The challenge for future research is to identify effective interventions involving dietary shifts and personalized therapy targeting the underlying mechanisms to prevent and improve cognition deficits.
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Affiliation(s)
- Qin Zhang
- First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Kangyu Jin
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Bing Chen
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ripeng Liu
- First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.,Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Shangping Cheng
- School of Life Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuyan Zhang
- School of Life Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jing Lu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou, China
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Richardson KA, McKibbin CL, Dabrowski BS, Punke ELA, Hartung CM. Parent Intention to Enroll in an Online Intervention to Enhance Health Behavior Change among Youth Treated with Psychotropic Medication Who Are Overweight or Obese: An Elicitation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138057. [PMID: 35805722 PMCID: PMC9266077 DOI: 10.3390/ijerph19138057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023]
Abstract
Youth who are prescribed psychotropic medication are disproportionally affected by overweight/obesity (OW/OB), yet few interventions have been tailored to their needs. To develop new interventions, it is important to address the needs, preferences, and intentions of target users. Qualitative methods within the theory of planned behavior (TPB) framework were used in this study to identify salient beliefs which may influence attitudes associated with parents’ intentions to participate in a future online intervention designed to develop behavioral health coaching skills among parents and guardians. Twenty parents and guardians of youth with OW/OB who were taking psychotropic medications, and were eligible for the study, were recruited through TurkPrime. Parents and guardians identified key salient beliefs consistent with the theory of planned behavior including behavioral beliefs (e.g., access and convenience), normative beliefs (e.g., family), and control beliefs (e.g., cost) that may influence their decision to enroll in a future, parent-oriented intervention. The results of this study suggest important salient beliefs which may be included in future research, as well as specific preferences which may be used to guide the development of a future intervention. Future work should focus on the creation of a salient belief quantitative measure and assess the relationships of these beliefs to attitudinal constructs and behaviors.
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22
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Dweik H, Kaur J, Jaka S, Faruki F, Shah RP, Amuk Williams OC, Chalia A, Bachu A. Cardiometabolic Comorbidity Risk in Pediatric Patients With Psychiatric Illnesses: A Case-Control Inpatient Study. Cureus 2022; 14:e26326. [PMID: 35911267 PMCID: PMC9314267 DOI: 10.7759/cureus.26326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives To delineate the differences in the cardiometabolic comorbidities in pediatric patients with medical versus psychiatric illnesses and to determine the risk of association between the spectrum of cardiometabolic comorbidities in pediatric patients with a broad range of psychiatric illnesses. Methods We conducted a case-control study using the nationwide inpatient sample (NIS), the largest hospital database in the United States (US) and included 179,550 pediatric patients (age 10-18 years) that were hospitalized with a primary diagnosis of psychiatric illness (N = 89,775) and pediatric patients that were hospitalized with a primary diagnosis of medical illness (N = 89,775). We used descriptive statistics and Pearson’s chi-square test to delineate the differences between pediatric inpatients with medical versus psychiatric illnesses. Results The majority of pediatric patients with psychiatric illnesses were females (58%) and white (62%), with a mean age of 15 years. Cardiometabolic comorbidities were higher in patients admitted for psychiatric illness, with a higher prevalence of hypothyroidism (1.6%) and obesity (7.1%) than in those hospitalized for medical illnesses. Among all cardiometabolic comorbidities, obesity had the highest prevalence across all psychiatric illnesses, measuring eight percent in patients with disruptive behavior disorders, followed by seven percent each in anxiety, mood, and psychotic disorders. Diabetes had the lowest prevalence hovering between one and two percent for a spectrum of psychiatric illnesses. Conclusion The prevalence of cardiometabolic comorbidities is higher in pediatric inpatients with psychiatric illnesses. This calls for timely monitoring of the routine labs and early diagnosis and management of the cardiometabolic comorbidities in this at-risk population.
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23
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Fornander MJ, Roberts T, Egan AM, Moser CN. Weight Status, Medication Use, and Recreational Activities of Treatment-Naïve Transgender Youth. Child Obes 2022; 18:228-236. [PMID: 34762510 DOI: 10.1089/chi.2021.0155] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background: Studies of transgender/gender diverse (TGD) youth indicate a high prevalence of overweight/obesity and concern for unhealthy weight management behavior. This study describes the association of weight status with medication use and recreational activities among treatment-naïve, pediatric TGD patients. Methods: This study is a chart review of 277 patients [aged 9-18 years, 79.1% female sex assigned at birth (SAB), and 86.3% white] seen at a medical center from 2017 to 2020. BMI was calculated by age and SAB using CDC growth charts. BMI percentile (BMI%) and BMI z-score (BMIz) were used to define weight status. Results: By BMI% category, 3.6% patients were in the underweight range (BMI <5%); 50.5% had BMI >85%; and 30.3% had BMI >95%. Overweight and obesity rates were higher than national norms (χ2 = 15.152, p < 0.01). Female SAB participants had higher BMIz values than male SAB participants. Youth who reported watching/listening to media (t = 3.50, p < 0.01) and parent-reported creative arts involvement (t = 1.97, p = 0.05) were associated with higher BMIz values. Conversely, spending time with friends and family was associated with a lower BMIz. Over half of the patients were prescribed medications, and those patients taking medications had higher BMIz values than those not taking medications (t = -1.96, p < 0.05). Female SAB, involvement in sedentary recreational activities, and taking medications to treat gastrointestinal conditions were associated with elevated BMIz. Conclusions: Overweight/obesity is a common problem among TGD youth. TGD youth should be considered a high-risk group and targeted in obesity prevention and treatment efforts. Interventions to decrease sedentary activities and improve connections with friends and family are promising strategies to address overweight and obesity among TGD youth.
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Affiliation(s)
- Mirae J Fornander
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Timothy Roberts
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Anna M Egan
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Christine N Moser
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
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24
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Fentie D, Derese T. Prevalence and associated factors of overweight/obesity among severely ill psychiatric patients in Eastern Ethiopia: A comparative cross-sectional study. PLoS One 2022; 17:e0264461. [PMID: 35235579 PMCID: PMC8890638 DOI: 10.1371/journal.pone.0264461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/10/2022] [Indexed: 11/19/2022] Open
Abstract
Background Globally, the burden of overweight and obesity is a major cardiovascular disease risk factor and is even higher among patients with psychiatric disorders compared to the general population. This is mainly due to the deleterious lifestyles characterized by physical inactivity, excessive substance use, and unhealthy diets common among patients with psychiatric disorders, as well as the negative metabolic effects of psychotropic medications. Despite these conditions being a high burden among patients with psychiatric illness, little attention is given to them during routine reviews in psychiatric clinics in most African nations, including Ethiopia. Therefore, this study aimed to estimate and compare the prevalence of and associated risk factors for overweight and obesity among patients with psychiatric illnesses. Methods A comparative cross-sectional study was conducted between severely ill psychiatric patients and non-psychiatric patients in Dire Dawa, Eastern Ethiopia. The study included 192 study participants (96 psychiatric patients and 96 non-psychiatric controls). Weight and height were measured for 192 study participants. Baseline demographic and clinical characteristics of psychiatric and non-psychiatric patients were described. The data were cleaned and analyzed using the Statistical Package for Social Sciences, Version 21. The intergroup comparisons were performed using an independent sample t-test and Chi-square tests. Logistic regression analysis was used to identify the association between overweight/obesity and the associated variables. Results The magnitude of overweight/obesity was significantly higher in the severely ill psychiatric groups (43.8%) than in the non-exposed controls (20.80%). The prevalence of overweight/obesity was highest in major depressive disorders (40%), followed by schizophrenia (32%), and bipolar disorder (28%). Conclusions There was a high prevalence of obesity/overweight among psychiatric patients. Educational status, unemployment, and late stages of the disease were significant predictors of overweight/ obesity. Clinicians should be aware of the health consequences of overweight/obesity, and considering screening strategies as a part of routine psychiatric care is strongly recommended.
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Affiliation(s)
- Dilnessa Fentie
- School of Medicine, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
- * E-mail:
| | - Tariku Derese
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
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25
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Clark TD, Crean AJ, Senior AM. Obesogenic diets induce anxiety in rodents: A systematic review and meta-analysis. Obes Rev 2022; 23:e13399. [PMID: 34811885 DOI: 10.1111/obr.13399] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/27/2021] [Accepted: 10/31/2021] [Indexed: 01/04/2023]
Abstract
Obesity and mood disorders have been linked in a positive feedback loop. However, due to the bidirectional relationship between obesity and mental health, it is not clear whether anxiety is correlated with or caused by consumption of obesogenic diets. Here, we present a meta-analysis on the effects of dietary manipulation on rodent behavior in the elevated plus maze and open field test, the most common tests of anxiety-like behavior in animal models. The main dataset examined effects of obesogenic diets on time spent in the open and movement around the mazes. Auxiliary datasets examined effects of caloric restriction and protein restriction. Obesogenic diets had a negative effect on the time spent in the open overall. Effects were stronger in males than females. No effect of diet on locomotion was found, indicating that increases in anxiety-like behavior are not due to altered activity levels. No consistent effect of caloric restriction was observed, whereas protein restriction was associated with an increase in the time spent in the open. We show that obesogenic diets have a causative effect on anxiety-like behaviors in rodents, and not via a change in activity. Further studies are required to determine why obesogenic diets induce these behavioral changes.
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Affiliation(s)
- Thomas D Clark
- Charles Perkins Centre and School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Angela J Crean
- Charles Perkins Centre and School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Alistair M Senior
- Charles Perkins Centre and School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
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Weyand AC, Fitzgerald KD, McGrath M, Gupta V, Braun TM, Quint EH, Choi SW. Depression in Female Adolescents with Heavy Menstrual Bleeding. J Pediatr 2022; 240:171-176. [PMID: 34517012 PMCID: PMC9055780 DOI: 10.1016/j.jpeds.2021.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To assess the degree to which heavy menstrual bleeding is associated with depression, independent of hormonal contraception. STUDY DESIGN We performed a retrospective cohort study of 1168 female adolescents 9-18 years old presenting to general pediatricians for heavy menstrual bleeding or well visits. Depression was the primary outcome and defined as a diagnosis in the health record. Univariable and multivariable regression models were fit to the data to identify factors associated with depression diagnosis. RESULTS In total, 581 adolescents with heavy menstrual bleeding and 587 without heavy menstrual bleeding were included. Depression diagnoses occurred with greater frequency in youth with heavy menstrual bleeding compared with those without heavy menstrual bleeding (50.9% vs 24.2% P < .001; risk ratio 1.67, 95% CI 1.39-2.01) but did not significantly differ between those taking vs not taking hormonal contraception (risk ratio 0.99; 95% CI 0.84-1.17). Most patients with depression and heavy menstrual bleeding developed depression following or concurrent with heavy menstrual bleeding (261/296, 88%). Of these, 199 of 261 (76%) were treated with hormonal contraception, but the majority (168/199; 84%) were diagnosed with depression before initiation. CONCLUSIONS Heavy menstrual bleeding is associated with depression diagnosis in female adolescents. The use of hormonal contraception was not associated with depression diagnosis in multivariable analysis, covarying heavy menstrual bleeding, age, body mass index, anxiety, sexual activity, and substance use. As hormonal contraception is often used to treat heavy menstrual bleeding, heavy menstrual bleeding may be partially driving previous reports of increased depression risk in those taking hormonal contraception.
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Affiliation(s)
- Angela C Weyand
- Department of Pediatrics, Division of Pediatric and Adolescent Gynecology, University of Michigan Medical School, Ann Arbor, MI; Division of Hematology/Oncology, Division of Pediatric and Adolescent Gynecology, University of Michigan Medical School, Ann Arbor, MI.
| | - Kate D Fitzgerald
- Department of Psychiatry, Division of Pediatric and Adolescent Gynecology, University of Michigan Medical School, Ann Arbor, MI
| | - Mary McGrath
- Department of Pediatrics, Division of Pediatric and Adolescent Gynecology, University of Michigan Medical School, Ann Arbor, MI; Division of Hematology/Oncology, Division of Pediatric and Adolescent Gynecology, University of Michigan Medical School, Ann Arbor, MI
| | - Vibhuti Gupta
- Department of Pediatrics, Division of Pediatric and Adolescent Gynecology, University of Michigan Medical School, Ann Arbor, MI
| | - Thomas M Braun
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI
| | - Elisabeth H Quint
- Department of Obstetrics and Gynecology, Division of Pediatric and Adolescent Gynecology, University of Michigan Medical School, Ann Arbor, MI
| | - Sung W Choi
- Department of Pediatrics, Division of Pediatric and Adolescent Gynecology, University of Michigan Medical School, Ann Arbor, MI; Division of Hematology/Oncology, Division of Pediatric and Adolescent Gynecology, University of Michigan Medical School, Ann Arbor, MI
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Abstract
ABSTRACT Bipolar disorder is a diagnosis with immense lifelong implications that affects 1% to 2% of the general population. It typically presents during late adolescence and early adulthood, which often coincides with the age of peak athletic performance and a limited window of opportunity to compete at the highest levels of sport. Understanding the nature and course of the illness, as well as the effects that pharmacological treatment can have on an athlete, can be extremely beneficial for sports medicine physicians, particularly as many young athletes may not yet be diagnosed and/or adequately treated. Bipolar disorder is an incredibly complex and challenging diagnosis, but the ability to identify symptoms and intervene early is invaluable. The aim of this review is to summarize the available evidence and to highlight relevant risk factors, diagnostic features, management, and potential complications pertaining to the athletic population.
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Wykes TL, Worth AS, Richardson KA, Woods T, Longstreth M, McKibbin CL. Examining community mental health providers' delivery of structured weight loss intervention to youth with serious emotional disturbance: An application of the theory of planned behaviour. Health Expect 2021; 25:2056-2064. [PMID: 34585483 PMCID: PMC9615073 DOI: 10.1111/hex.13357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 08/06/2021] [Accepted: 08/10/2021] [Indexed: 11/28/2022] Open
Abstract
Background Rates of overweight and obesity are disproportionately high among youth with serious emotional disturbance (SED). Little is known about community mental health providers' delivery of weight loss interventions to this vulnerable population. Objective This study examined attitudinal predictors of their providers' intentions to deliver weight loss interventions to youth with SED using the theory of planned behaviour. Design This study used a cross‐sectional, single‐time‐point design to examine the relationship of the theory of planned behaviour constructs with behavioural intention. Setting and Participants Community mental health providers (n = 101) serving youth with SED in the United States completed online clinical practice and theory of planned behaviour surveys. Main Variables Studied We examined the relationship of direct attitude constructs (i.e., attitude towards the behaviour, social norms and perceived behavioural control), role beliefs and moral norms with behavioural intention. Analyses included a confirmatory factor analysis and two‐step linear regression. Results The structure of the model and the reliability of the questionnaire were supported. Direct attitude constructs, role beliefs and moral norms predicted behavioural intention to deliver weight loss interventions. Discussion While there is debate about the usefulness of the theory of planned behaviour, our results showed that traditional and newer attitudinal constructs appear to influence provider intentions to deliver weight loss interventions to youth with SED. Findings suggest preliminary strategies to increase provider intentions. Public Contribution This study was designed and the results were interpreted as part of a larger, community‐based participatory research effort that included input from youth, families, providers, administrators and researchers. Collaborative discussions with community mental health providers and administrators particularly contributed to the study question asked as well as interpretation of results.
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Affiliation(s)
- Thomas L Wykes
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| | - Andrea S Worth
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| | | | - Tonja Woods
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| | - Morgan Longstreth
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
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Lopez KE, Salvy SJ, Fink C, Werner J, Wee CP, Hegedus E, Gonzalez J, Fox DS, Vidmar AP. Executive Functioning, Depressive Symptoms, and Intervention Engagement in a Sample of Adolescents Enrolled in a Weight Management Program. Child Obes 2021; 17:281-290. [PMID: 33826861 PMCID: PMC8147508 DOI: 10.1089/chi.2020.0334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purpose: This study examines how baseline demographics, psychosocial characteristics, and intervention delivery predict engagement among adolescents with overweight and obesity seeking treatment. Methods: Data originates from a multisite randomized control trial evaluating the efficacy of an app-based weight loss intervention, compared with standard in-clinic model in adolescents with overweight and obesity. Participants were randomized to one of the three arms: (1) AppCoach, (2) AppAlone, or (3) Control. Demographic, executive functioning (EF), and depression questionnaires were completed at baseline. Percent engagement was compared within and between groups defined by demographics and depressive symptoms. Quantile regression was used to evaluate the association between age and EF on percent engagement. Results: Baseline demographics were not associated with engagement within or between groups. Neither baseline self-reported depressive symptoms (p = 0.244) nor deficits in EF (p = 0.34) were predictors of engagement. Univariate analysis found that the control arm had the highest engagement (83%) compared with AppCoach (63.5%) and AppAlone (22.5%, p = 0.02). Hispanic ethnicity was predictive of higher engagement in the control arm (p = 0.02). On multivariate quartile regression no other baseline characteristics were significant predictors of engagement. Conclusion: Baseline demographics and individual psychosocial characteristics were not related to engagement in this cohort. The intervention arm that required parental involvement resulted in the greatest engagement suggesting that family involvement may overshadow individual behavioral phenotype and thus promote better engagement. Further investigation is needed to understand how program delivery can be leveraged to optimize treatment engagement and outcomes in adolescence. Clinical Trial Registration number: NCT03500835.
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Affiliation(s)
- Kelleen E. Lopez
- Diabetes and Obesity Program, Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA.,Address correspondence to: Kelleen E. Lopez, MPH, Diabetes and Obesity Program, Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #61, Los Angeles, CA 90027, USA
| | - Sarah-Jeanne Salvy
- Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Cassandra Fink
- Diabetes and Obesity Program, Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Julie Werner
- Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Los Angeles, CA, USA.,Division of Pediatric Rehabilitation Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Choo Phei Wee
- Department of Preventive Medicine, Southern California Clinical and Translational Science Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Elizabeth Hegedus
- Diabetes and Obesity Program, Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Janelle Gonzalez
- Diabetes and Obesity Program, Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - D. Steven Fox
- Department of Pharmaceutical and Health Economics, School of Pharmacy of the University of Southern California, Los Angeles, CA, USA
| | - Alaina P. Vidmar
- Diabetes and Obesity Program, Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA.,Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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30
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Walter SM, Dai Z, Wang K. Obesity, Migraine, and Overlapping Comorbidities in a Rural Pediatric Population. J Neurosci Rural Pract 2021; 12:524-529. [PMID: 34295107 PMCID: PMC8289561 DOI: 10.1055/s-0041-1727574] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Objective This study aims to report the prevalence of obesity and overlapping comorbidities in a rural population of children and adolescents with migraine. Design and Methods A cross-sectional, descriptive, secondary data analysis using a comprehensive patient database from the West Virginia University (WVU) Medicine Epic Clarity system will be reported. A review of electronic medical records of 990 children and adolescents, ages 7 to 17 years, evaluated for headache at a rural clinic from December 1, 2009 to December 31, 2017 was completed. The Chi-square test was used to identify any differences in demographic characteristics (age, gender, and race) and distribution of comorbidities (obstructive sleep apnea syndrome [OSAS], depression, and anxiety) among obese versus nonobese adolescents with migraine. Student's t -test was used to identify any differences in the number of comorbidities between the two groups. Results A total of 648 children and adolescents with a diagnosis of migraine were identified. Approximately 26.4% of the children and adolescents diagnosed with migraine ( n = 648) met the criteria for being obese with a mean body mass index (BMI) of 30.6 kg/m 2 (standard deviation [SD] = 6.5), ranging from 20.0 to 58.5 kg/m 2 . There were no significant differences between migraineurs who were categorized as obese versus nonobese in terms of gender ( p = 0.8587), age ( p = 0.1703), race ( p = 0.7655), anxiety ( p = 0.1841), or depression ( p = 0.2793). Obese individuals have more comorbidities than nonobese individuals ( p = 0.015). Additionally, the prevalence of OSAS was significantly higher among obese versus nonobese migraineurs (20 vs. 9.9%, p = 0.0007). Conclusion Given the prevalence of obesity in rural pediatric populations and the reported neurobiological links between migraine and obesity, BMI needs to be monitored and weight management interventions included in plans of care for rural children and adolescents with migraine.
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Affiliation(s)
- Suzy M Walter
- Department of Family and Community Health, West Virginia University School of Nursing, Morgantown, West Virginia, United States
| | - Zheng Dai
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, West Virginia, United States
| | - Kesheng Wang
- Department of Family and Community Health, West Virginia University School of Nursing, Morgantown, West Virginia, United States
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Scholes M, Jensen E, Meier M, Friedman N. Effect of adenotonsillectomy in children with obstructive sleep apnea and major psychiatric disorders on obstructive apnea-hypopnea index and Epworth Sleepiness Scale scores. J Clin Sleep Med 2021; 17:685-689. [PMID: 33206042 DOI: 10.5664/jcsm.9012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES This study evaluates the effectiveness of adenotonsillectomy in the treatment of obstructive sleep apnea in children with major psychiatric disorders as measured by polysomnography and the Epworth Sleepiness Scale (ESS) at a tertiary children's hospital. Adults with major psychiatric disorders often have higher rates of obstructive sleep apnea and decreased response to treatment. The goal was to determine if children with serious mental illness had outcomes similar to their adult counterparts. METHODS A retrospective chart review was undertaken to identify children with obstructive sleep apnea and major psychiatric disorders who underwent adenotonsillectomy as part of their treatment for obstructive sleep apnea and had undergone preoperative and postoperative polysomnography as well as ESS. A multivariable model was run for each of the postoperative outcomes (ESS, obstructive apnea-hypopnea index, or body mass index percentile), adjusting for their respective preoperative value, age, and group. RESULTS There were 34 patients who qualified for this study and who were matched with 66 controls. There was no significant difference between the 2 groups in terms of change in ESS, obstructive apnea-hypopnea index, or body mass index percentile, both before and after adjusting for age. The only significant findings were that preoperative ESS and body mass index percentile were predictive of postoperative ESS and body mass index percentile for both groups. CONCLUSIONS Children with psychiatric disorders in our institution respond to surgical management of obstructive sleep apnea similar to pediatric controls without mental illness despite comorbidities and central-acting medications that may alter sleep.
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Affiliation(s)
- Melissa Scholes
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado.,Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, Colorado
| | - Emily Jensen
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado.,Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, Colorado
| | - Maxene Meier
- Center for Research in Outcomes for Children's Surgery, Center for Children's Surgery, University of Colorado School of Medicine, Aurora, Colorado
| | - Norman Friedman
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado.,Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, Colorado
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32
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Gurka MJ, Siddiqi SU, Filipp SL, Mercado R, Thompson LA, Janicke DM, Shenkman EA. Attention deficit hyperactivity disorder medications and BMI trajectories: The role of medication type, sex and age. Pediatr Obes 2021; 16:e12738. [PMID: 33064373 PMCID: PMC8276278 DOI: 10.1111/ijpo.12738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/17/2020] [Accepted: 09/28/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Attention deficit hyperactivity disorder (ADHD) and the medications used to treat it are associated with obesity. Stimulants lead to weight loss, while antipsychotics and antidepressants lead to weight gain. Little is known, however, how alpha-2-agonists impact weight, or the independent effect on BMI of these four classes of medications, which are often prescribed concurrently. We aimed to estimate the proximal change in BMI associated with start of medication and to assess whether medication-specific departures in BMI varied by age and sex. STUDY DESIGN We analysed longitudinal electronic health records from children (4-19 years) with an ADHD diagnosis seen at one healthcare system (2011-2018). Their BMI z-scores were fit as a cubic function of age via a mixed model, separately by sex and adjusting for race/ethnicity. From this model, we estimated annual changes in BMI-z after medication, allowing changes to vary by age and sex. RESULTS Among the 22 714 children with ADHD (mean initial age = 10.0), 4335 (19.1%) were never prescribed ADHD medication. The others (80.9%) experienced departures in BMI-z after start of all four medication classes, which varied across age and sex (interaction P-values < .01). All medications had larger impacts at younger ages. As expected, decreased BMI-z was observed with stimulants, while antidepressants and antipsychotics led to BMI-z increases; alpha-agonists also were associated with BMI-z increases. CONCLUSIONS This longitudinal study revealed that ADHD medications are independently associated with proximal changes in BMI-z after initiation, significantly varying by sex and age. Future research should study further the interactions of these medications on long-term impacts on obesity.
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Affiliation(s)
- Matthew J. Gurka
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida,Institute for Child Health Policy, University of Florida, Gainesville, Florida,Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida
| | - Siraj U. Siddiqi
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida
| | - Stephanie L. Filipp
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida,Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida
| | - Rebeccah Mercado
- Institute for Child Health Policy, University of Florida, Gainesville, Florida,Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida
| | - Lindsay A. Thompson
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida,Institute for Child Health Policy, University of Florida, Gainesville, Florida,Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida
| | - David M. Janicke
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Elizabeth A. Shenkman
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida,Institute for Child Health Policy, University of Florida, Gainesville, Florida
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Balantekin KN, Grammer AC, Fitzsimmons-Craft EE, Eichen DE, Graham AK, Monterubio GE, Firebaugh ML, Karam AM, Sadeh-Sharvit S, Goel NJ, Flatt RE, Trockel MT, Taylor CB, Wilfley DE. Overweight and obesity are associated with increased eating disorder correlates and general psychopathology in university women with eating disorders. Eat Behav 2021; 41:101482. [PMID: 33609964 PMCID: PMC8131224 DOI: 10.1016/j.eatbeh.2021.101482] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 01/26/2021] [Accepted: 01/31/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Examine how eating disorder (ED) correlates, ED-related clinical impairment, general psychopathology, and ED diagnoses differ across weight statuses in a sample of university women with EDs. METHOD Participants were 690 women from 28 U.S. universities who screened positive for an ED (with the exception of anorexia nervosa [AN]) and participated in the Healthy Body Image Program study. ED correlates, ED-related clinical impairment, general psychopathology (i.e., depression and anxiety), and ED diagnoses were compared across weight statuses (i.e., healthy weight, overweight, obesity) using analyses of variance and chi-square tests. RESULTS Women with EDs and overweight or obesity had higher levels of, perceived benefit of thinness, depressive symptoms, anxiety, and weight/shape concerns (obesity only) than those with healthy weight (ps ≤ .017). Compared to those with healthy weight, those with obesity had higher rates of clinical and sub-clinical binge eating disorder and lower rates of bulimia nervosa (p < .001). DISCUSSION Overweight and obesity in individuals with EDs, excluding AN, are associated with greater severity of ED correlates, ED-related clinical impairment, and co-morbid general psychopathology. The current study highlights the need to consider weight status in ED treatment and for optimization of ED treatments to address shared risk factors between EDs and overweight and obesity.
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Affiliation(s)
| | - Anne Claire Grammer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Dawn E Eichen
- Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Andrea K Graham
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Grace E Monterubio
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Marie-Laure Firebaugh
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Anna M Karam
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Shiri Sadeh-Sharvit
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Center for m(2)Health, Palo Alto University, Palo Alto, CA, USA; Baruch Ivcher School of Psychology, Interdisciplinary Center, Herzliya, Israel
| | - Neha J Goel
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA; Institute for Inclusion, Inquiry and Innovation (iCubed), Virginia Commonwealth University, Richmond, VA, USA
| | - Rachael E Flatt
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mickey T Trockel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - C Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Center for m(2)Health, Palo Alto University, Palo Alto, CA, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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[Overweight/Obesity of Children and Adolescents and its Association with Internalising and Externalising Disorders]. Prax Kinderpsychol Kinderpsychiatr 2021; 70:182-197. [PMID: 33641646 DOI: 10.13109/prkk.2021.70.3.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Overweight/Obesity of Children and Adolescents and its Association with Internalising and Externalising Disorders Research in child and adolescent psychiatry increasingly deals with the association between mental disorder and weight. This paper provides an overview of national and international studies on the relationship between body composition and mental illness in children and adolescents, with a focus on the representation of individual internalizing and externalizing disturbance patterns. The majority of studies in this area are based on the so-called one-compartment model of body composition in terms of the Body Mass Index (BMI) or on the classification as "overweight" or "obese". Associations between mental disorders and body composition were described in two directions: On one hand, both externalising and internalising symptoms are associated with obesity, and on the other hand there are also more psychopathological symptoms among overweight children and adolescents. Longitudinal studies suggest effects in both directions. While externalising symptoms and weight are thought to be related from infancy on, this connection seems to be evident for internalising disorders not earlier than for early school age. It is also known from the literature that psychopharmacological medication affects weight and body growth - especially with psychostimulants, but also with neuroleptics and antidepressants. We found only a few studies describing the relationship between body composition and psyche in more complex models with two or more compartments.
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Kishi T, Okuya M, Sakuma K, Otaka Y, Saitoh E, Iwata N. Body composition in Japanese patients with psychiatric disorders: A cross-sectional study. Neuropsychopharmacol Rep 2021; 41:117-121. [PMID: 33506653 PMCID: PMC8182961 DOI: 10.1002/npr2.12160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 01/27/2023] Open
Abstract
AIM This study aimed to investigate body composition in Japanese patients with psychiatric disorders. METHODS A cross-sectional study was conducted to assess the body composition in Japanese patients with psychiatric disorders and healthy controls. InBody470 was used to measure the body composition of the participants. For the primary analysis, measures of body composition between patients and healthy controls were compared. Moreover, the following patient subgroups were also compared with the healthy controls: (a) patients with psychotic disorders only, (b) patients with mood disorders only, (c) patients receiving antipsychotics, (d) patients receiving conventional mood stabilizers, (e) patients receiving antidepressants only but not any antipsychotics and/or mood stabilizers, and (f) patients receiving hypnotics/anxiolytics. RESULTS This study included 205 individuals (105 patients and 100 healthy controls). It was found that patients had a significantly higher body mass index, waist-hip ratio, body fat mass, and percent body fat compared with the healthy controls. Moreover, significant differences were noted in the waist-hip ratio, body fat mass, and percent body fat between all patient subgroups other than patients receiving conventional mood stabilizers subgroup and healthy controls. CONCLUSION This is the first cross-sectional study to examine body composition in Japanese patients with psychiatric disorders. No difference in the skeletal muscle volume was noted although patients had higher body fat than healthy controls. A longitudinal and large cohort study in the future, controlling for medication and diagnosis, will need to determine why body fat is increased in Japanese patients with psychiatric disorders.
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Affiliation(s)
- Taro Kishi
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Makoto Okuya
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kenji Sakuma
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, Toyoake, Japan
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
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Mood disorders comorbidity in obese bariatric patients: the role of the emotional dysregulation. J Affect Disord 2021; 279:46-52. [PMID: 33038699 DOI: 10.1016/j.jad.2020.09.128] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/25/2020] [Accepted: 09/27/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Obese patients seeking bariatric surgery are known to show high rates of mental disorders, mainly mood and eating disorders. The aim of the present study is to evaluate psychiatric comorbidities, affective temperamental dimensions, emotional dysregulation and impulsivity in a sample of obese bariatric patients, exploring the differences between obese patients with and without mood disorders (MD). METHODS A total of 69 obese patients were consecutively enrolled between March and November 2019 during the presurgical evaluation routinely performed before the bariatric intervention. Sociodemographic and clinical features were collected by psychiatrists during a single consultation. Affective temperaments, emotional dysregulation and impulsivity were also investigated through self-report questionnaires. Epidemiological and clinical variables were compared between patients with and without MD. RESULTS In our sample, almost 3 out of 4 patients presented a lifetime psychiatric disorder, mainly MD (n=33, 48%), binge eating disorder (BED) (n=34, 49%) and anxiety disorders (n=30, 43%). Compared to N-MD patients, those with MD showed higher rates of psychiatric comorbidity with BED, bulimia and panic disorder. In addition, obese patients with MD showed more frequently cyclothymic, depressive and anxious temperaments, and higher mean scores on the psychometric questionnaires assessing emotional dysregulation and impulsivity compared to obese subjects without MD. LIMITATIONS the small sample size, the retrospectively assessment of psychiatric disorders and the self-report questionnaires. CONCLUSIONS A subgroup of obese patients, especially among those with MD, show high emotional dysregulation, affective lability and impulsiveness that could represent suitable substrates for the development of compulsive and addictive eating habits.
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Luçardo JDC, Monk GF, Dias MDS, Martins-Silva T, Fernandes MP, Maia JC, Valle SC, Vaz JDS. Interest in food and triglyceride concentrations in children and adolescents with autistic spectrum disorder. J Pediatr (Rio J) 2021; 97:103-108. [PMID: 32087108 PMCID: PMC9432298 DOI: 10.1016/j.jped.2020.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/31/2019] [Accepted: 01/02/2020] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To investigate eating behavior and serum concentration of triglycerides in children and adolescents with autistic spectrum disorder. METHODS Cross-sectional study conducted in the neurodevelopment nucleus, from October 2018 to April 2019 in a neurodevelopment center in the city of Pelotas/RS. Blood samples were collected, and serum was essayed for triglycerides by colorimetric enzymatic reaction. The Children's Eating Behavior Questionnaire was applied to the parents. The comparison between two or three categories of variables was performed with nonparametric tests. Linear regression was used to access the association between the log triglyceride serum concentration and the score above or below the median score of the food response and emotional overeating subscales. RESULTS Sixty patients were evaluated. The average age was 8.6±3.2 years and most were white (75 %), male (80 %), and overweight (66%). Half of the sample had elevated triglycerides. Triglyceride concentrations were higher among overweight children and adolescents with higher median scores on the "food response" and "emotional overeating" subscales. In the adjusted analysis, the association between triglycerides and higher scores on subscales reflecting interest in food remained significant. CONCLUSION Children and adolescents with autistic spectrum disorder present high triglyceride concentrations associated with a greater interest in food. Knowledge of this eating behavior may provide more effective nutritional intervention in this population.
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Affiliation(s)
- Josiane da Cunha Luçardo
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Nutrição e Alimentação, Pelotas, RS, Brazil.
| | - Giliane Fraga Monk
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Nutrição e Alimentação, Pelotas, RS, Brazil
| | - Mariane da Silva Dias
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil
| | - Thais Martins-Silva
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil
| | - Mayra Pacheco Fernandes
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil
| | - Juliana Costa Maia
- Universidade Federal de Pelotas, Faculdade de Medicina, Neuropediatria, Pelotas, RS, Brazil
| | - Sandra Costa Valle
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Nutrição e Alimentação, Pelotas, RS, Brazil; Universidade Federal de Pelotas, Faculdade de Nutrição, Pelotas, RS, Brazil
| | - Juliana Dos Santos Vaz
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Nutrição e Alimentação, Pelotas, RS, Brazil; Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil; Universidade Federal de Pelotas, Faculdade de Nutrição, Pelotas, RS, Brazil.
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Yu J, Liao X, Zhong Y, Wu Y, Lai X, Jiao H, Yan M, Zhang Y, Ma C, Wang S. The Candidate Schizophrenia Risk Gene Tmem108 Regulates Glucose Metabolism Homeostasis. Front Endocrinol (Lausanne) 2021; 12:770145. [PMID: 34690937 PMCID: PMC8531597 DOI: 10.3389/fendo.2021.770145] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/23/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Schizophrenia (SCZ) is a severe psychiatric disease affected by genetic factors and environmental contributors, and premorbid abnormality of glucose metabolism is one of the SCZ characteristics supposed to contribute to the disease's pathological process. Transmembrane protein 108 (Tmem108) is a susceptible gene associated with multiple psychiatric diseases, including SCZ. Moreover, Tmem108 mutant mice exhibit SCZ-like behaviors in the measurement of sensorimotor gating. However, it is unknown whether Tmem108 regulates glucose metabolism homeostasis while it involves SCZ pathophysiological process. RESULTS In this research, we found that Tmem108 mutant mice exhibited glucose intolerance, insulin resistance, and disturbed metabolic homeostasis. Food and oxygen consumption decreased, and urine production increased, accompanied by weak fatigue resistance in the mutant mice. Simultaneously, the glucose metabolic pathway was enhanced, and lipid metabolism decreased in the mutant mice, consistent with the elevated respiratory exchange ratio (RER). Furthermore, metformin attenuated plasma glucose levels and improved sensorimotor gating in Tmem108 mutant mice. CONCLUSIONS Hyperglycemia occurs more often in SCZ patients than in control, implying that these two diseases share common biological mechanisms, here we demonstrate that the Tmem108 mutant may represent such a comorbid mechanism.
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Affiliation(s)
- Jianbo Yu
- Laboratory of Synaptic Development and Plasticity, Institute of Life Science & School of Life Sciences, Nanchang University, Nanchang, China
| | - Xufeng Liao
- Laboratory of Synaptic Development and Plasticity, Institute of Life Science & School of Life Sciences, Nanchang University, Nanchang, China
| | - Yanzi Zhong
- Laboratory of Synaptic Development and Plasticity, Institute of Life Science & School of Life Sciences, Nanchang University, Nanchang, China
- Department of Biology, Senior Middle School of Yongfeng, Ji’an, China
| | - Yongqiang Wu
- Laboratory of Synaptic Development and Plasticity, Institute of Life Science & School of Life Sciences, Nanchang University, Nanchang, China
| | - Xinsheng Lai
- Laboratory of Synaptic Development and Plasticity, Institute of Life Science & School of Life Sciences, Nanchang University, Nanchang, China
- School of Basic Medical Sciences, Nanchang University, Nanchang, China
| | - Huifeng Jiao
- School of Basic Medical Sciences, Nanchang University, Nanchang, China
| | - Min Yan
- School of Basic Medical Sciences, Nanchang University, Nanchang, China
| | - Yu Zhang
- Laboratory of Synaptic Development and Plasticity, Institute of Life Science & School of Life Sciences, Nanchang University, Nanchang, China
| | - Chaolin Ma
- Laboratory of Synaptic Development and Plasticity, Institute of Life Science & School of Life Sciences, Nanchang University, Nanchang, China
- School of Basic Medical Sciences, Nanchang University, Nanchang, China
- *Correspondence: Chaolin Ma, ; Shunqi Wang,
| | - Shunqi Wang
- Laboratory of Synaptic Development and Plasticity, Institute of Life Science & School of Life Sciences, Nanchang University, Nanchang, China
- School of Basic Medical Sciences, Nanchang University, Nanchang, China
- *Correspondence: Chaolin Ma, ; Shunqi Wang,
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Hampel P, Petermann F, Stachow R. Psychische Auffälligkeiten von Jugendlichen mit Adipositas in der stationären Rehabilitation. KINDHEIT UND ENTWICKLUNG 2020. [DOI: 10.1026/0942-5403/a000322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Es wurden die Geschlechts- und Altersunterschiede in den selbst- und fremdbeurteilten psychischen Auffälligkeiten bei N = 142 Jugendlichen mit Adipositas in der stationären Rehabilitation untersucht. Mädchen wiesen im Selbsturteil höhere Ausprägungen in der Ängstlichkeit/Depressivität sowie den emotionalen und Verhaltensproblemen auf. Die Eltern gaben eine höhere Hyperaktivität ihrer Söhne an. Jüngere schätzten ihre Verhaltensprobleme höher ein als Ältere. Zudem wurde die klinische Stichprobe mit geschlechts- und altersgematchten Kontrollen aus der Normierungsstudie des Screenings psychischer Störungen im Jugendalter (SPS-J-II; Hampel & Petermann, 2012a ) verglichen ( N = 254). Es ergab sich ein 2.43-fach erhöhtes Risiko für auffällige Werte in der Ängstlichkeit/Depressivität bei den Jugendlichen mit Adipositas und ein signifikanter Mittelwertunterschied. Die Befunde sprechen für eine frühzeitige Diagnostik psychischer Auffälligkeiten und bedarfsgerechte Interventionen, um der Entwicklung komorbider psychischer Auffälligkeiten vorzubeugen.
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Affiliation(s)
- Petra Hampel
- Europa-Universität Flensburg, Abteilung Gesundheitspsychologie und -bildung
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
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Wu Z, Han J, Xue J, Xi P, Wang H, He L, Wang Q, Liang H, Sun X, Tian D. Deletion of liver kinase B1 in POMC neurons predisposes to diet-induced obesity. Life Sci 2020; 258:118204. [PMID: 32763296 DOI: 10.1016/j.lfs.2020.118204] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/27/2020] [Accepted: 08/01/2020] [Indexed: 01/10/2023]
Abstract
AIMS Liver kinase B1 (LKB1) is a serine/threonine kinase. Although many biological functions of LKB1 have been identified, the role of hypothalamic LKB1 in the regulation of central energy metabolism and susceptibility to obesity is unknown. Therefore, we constructed POMC neuron-specific LKB1 knockout mice (PomcLkb1 KO) and studied it at the physiological, morphological, and molecular biology levels. MAIN METHODS Eight-week-old male PomcLkb1 KO mice and their littermates were fed a standard chow fat diet (CFD) or a high-fat diet (HFD) for 3 months. Body weight and food intake were monitored. Dual-energy X-ray absorptiometry was used to measure the fat mass and lean mass. Glucose and insulin tolerance tests and serum biochemical markers were evaluated in the experimental mice. In addition, the levels of peripheral lipogenesis genes and central energy metabolism were measured. KEY FINDINGS PomcLkb1 KO mice did not exhibit impairments under normal physiological conditions. After HFD intervention, the metabolic phenotype of the PomcLkb1 KO mice changed, manifesting as increased food intake and an enhanced obesity phenotype. More seriously, PomcLkb1 KO mice showed increased leptin resistance, worsened hypothalamic inflammation and reduced POMC neuronal expression. SIGNIFICANCE We provide evidence that LKB1 in POMC neurons plays a significant role in regulating energy homeostasis. LKB1 in POMC neurons emerges as a target for therapeutic intervention against HFD-induced obesity and metabolic diseases.
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Affiliation(s)
- Zhaoxia Wu
- Department of Clinical Laboratory Diagnostics, Tianjin Medical University, Tianjin 300203, China
| | - Jie Han
- Department of Human Anatomy and Histology, Tianjin Medical University, Tianjin 300070, China
| | - Jie Xue
- Department of Human Anatomy and Histology, Tianjin Medical University, Tianjin 300070, China
| | - Pengjiao Xi
- Department of Clinical Laboratory Diagnostics, Tianjin Medical University, Tianjin 300203, China
| | - Haomin Wang
- Department of Human Anatomy and Histology, Tianjin Medical University, Tianjin 300070, China
| | - Lu He
- Department of Human Anatomy and Histology, Tianjin Medical University, Tianjin 300070, China
| | - Qiming Wang
- Department of Human Anatomy and Histology, Tianjin Medical University, Tianjin 300070, China
| | - Huimin Liang
- Department of School of Nursing, Tianjin Medical University, Tianjin 300070, China
| | - Xuguo Sun
- Department of Clinical Laboratory Diagnostics, Tianjin Medical University, Tianjin 300203, China.
| | - Derun Tian
- Department of Clinical Laboratory Diagnostics, Tianjin Medical University, Tianjin 300203, China; Department of Human Anatomy and Histology, Tianjin Medical University, Tianjin 300070, China.
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Le Strat Y, Melchior M, Gorwood P, Tebeka S, Dubertret C. The role of comorbidity in the association of obesity with unemployment and disability. Ann Epidemiol 2020; 45:61-68. [PMID: 32336657 DOI: 10.1016/j.annepidem.2020.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 02/06/2020] [Accepted: 03/03/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The association of obesity with a large range of physical conditions and numerous psychiatric disorders has been extensively studied. Our study sought the extent to which physical conditions or psychiatric disorders associated with obesity mediate the association of obesity with unemployment or disability. METHODS Using data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III, 2012-2013), we estimated the prevalence of unemployment as a function of obesity taking into account these comorbidities. Data on self-reported height and weight were available for 35,725 respondents. Clinician-diagnosed physical conditions were self-reported and lifetime psychiatric disorders were assessed with a semistructured interview. RESULTS The adjusted prevalence of obesity was 30.4%. Participants with obesity were more likely than participants without obesity to report at least one of the 31 assessed physical conditions (64.46% vs. 46.87%; P < .001). Participants with obesity were more likely to report at least one of the 24 assessed psychiatric diagnoses than respondents without obesity (60.57 vs. 56.75%; P < .001). The rates of unemployment were higher in participants with obesity than in those without obesity (15.75% vs. 11.26%; P < .001). Similarly, participants with obesity reported higher rates of disability than those without obesity. Although the number of physical conditions and psychiatric disorders partly explains this association, obesity remained significantly associated with unemployment and greater disability when controlling for the number of physical conditions and psychiatric disorders. CONCLUSIONS Obesity is associated with high rates of unemployment and with high disability. This is not explained solely by the high rate of physical conditions and psychiatric disorders associated with obesity.
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Affiliation(s)
- Yann Le Strat
- Université de Paris, INSERM U1266, Paris, France; Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
| | - Maria Melchior
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Philip Gorwood
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France; CMME, Sainte Anne Hospital, AP-HP, Colombes, France
| | - Sarah Tebeka
- Université de Paris, INSERM U1266, Paris, France; Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France.
| | - Caroline Dubertret
- Université de Paris, INSERM U1266, Paris, France; Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
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Kaiser KA, Carson TL, Dhurandhar EJ, Neumeier WH, Cardel MI. Biobehavioural approaches to prevention and treatment: A call for implementation science in obesity research. Obes Sci Pract 2020; 6:3-9. [PMID: 32128237 PMCID: PMC7042105 DOI: 10.1002/osp4.384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/11/2019] [Accepted: 10/24/2019] [Indexed: 12/31/2022] Open
Abstract
Much progress has been made in the last 30 years in understanding the causes and mechanisms that contribute to obesity, yet widely available and successful strategies for prevention and treatment remain elusive at population levels. This paper discusses the biobehavioural framework and provides suggestions for applying it to enable greater progress in the science of obesity prevention and treatment, including an increased focus on implementation of science strategies. The objective is to promote a re-evaluation of current views about preventing and treating obesity within a unified biobehavioural framework. Further integration of research exploring how both behavioural and biological components interact is a critical step forward.
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Affiliation(s)
- Kathryn A. Kaiser
- Department of Health Behavior, School of Public HealthUniversity of Alabama at BirminghamBirminghamAlabama
- Nutrition Obesity Research CenterUniversity of Alabama at BirminghamBirminghamAlabama
| | - Tiffany L. Carson
- Nutrition Obesity Research CenterUniversity of Alabama at BirminghamBirminghamAlabama
- Division of Preventive Medicine, School of MedicineUniversity of Alabama at BirminghamBirminghamAlabama
| | - Emily J. Dhurandhar
- Department of Kinesiology and Sport ManagementTexas Tech UniversityLubbockTexas
| | - William H. Neumeier
- United States Army Research Institute of Environmental MedicineNatickMassachusetts
| | - Michelle I. Cardel
- Department of Health Outcomes & Biomedical Informatics, College of MedicineUniversity of FloridaGainesvilleFlorida
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Evidence that genes involved in hedgehog signaling are associated with both bipolar disorder and high BMI. Transl Psychiatry 2019; 9:315. [PMID: 31754094 PMCID: PMC6872724 DOI: 10.1038/s41398-019-0652-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/23/2019] [Accepted: 10/20/2019] [Indexed: 12/16/2022] Open
Abstract
Patients with bipolar disorder (BD) show higher frequency of obesity and type 2 diabetes (T2D), but the underlying genetic determinants and molecular pathways are not well studied. Using large publicly available datasets, we (1) conducted a gene-based analysis using MAGMA to identify genes associated with BD and body mass index (BMI) or T2D and investigated their functional enrichment; and (2) performed two meta-analyses between BD and BMI, as well as BD and T2D using Metasoft. Target druggability was assessed using the Drug Gene Interaction Database (DGIdb). We identified 518 and 390 genes significantly associated with BD and BMI or BD and T2D, respectively. A total of 52 and 12 genes, respectively, were significant after multiple testing correction. Pathway analyses conducted on nominally significant targets showed that genes associated with BD and BMI were enriched for the Neuronal cell body Gene Ontology (GO) term (p = 1.0E-04; false discovery rate (FDR) = 0.025) and different pathways, including the Signaling by Hedgehog pathway (p = 4.8E-05, FDR = 0.02), while genes associated with BD and T2D showed no specific enrichment. The meta-analysis between BD and BMI identified 64 relevant single nucleotide polymorphisms (SNPs). While the majority of these were located in intergenic regions or in a locus on chromosome 16 near and in the NPIPL1 and SH2B1 genes (best SNP: rs4788101, p = 2.1E-24), five were located in the ETV5 gene (best SNP: rs1516725, p = 1E-24), which was previously associated with both BD and obesity, and one in the RPGRIP1L gene (rs1477199, p = 5.7E-09), which was also included in the Signaling by Hedgehog pathway. The meta-analysis between BD and T2D identified six significant SNPs, three of which were located in ALAS1 (best SNP: rs352165, p = 3.4E-08). Thirteen SNPs associated with BD and BMI, and one with BD and T2D, were located in genes which are part of the druggable genome. Our results support the hypothesis of shared genetic determinants between BD and BMI and point to genes involved in Hedgehog signaling as promising targets.
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