Body mass index and mental health problems in general adults: disparity in gender and socioeconomic status

Body Mass Index and risk for onset of mood and anxiety disorders in the general population: Results from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2)

BACKGROUND

Examine the onset of a clinical diagnosis of mood (major depression, dysthymia and bipolar disorder)- and anxiety disorders (panic disorder, agoraphobia without panic disorder, social phobia, specific phobia and generalized anxiety disorder) by Body Mass Index levels at baseline in the general adult population over three years.

METHODS

Data are from NEMESIS-2, a representative psychiatric cohort study in the Netherlands. A total of 5303 subjects aged 18-64 were interviewed with the CIDI (3.0 based on DSM-IV) in two waves, with an interval of three years. The first wave was performed from November 2007 to July 2009, the second wave from November 2010 to June 2012.

RESULTS

Persons with obesity at baseline had a significantly increased risk of the onset of any mood -or anxiety disorder adjusting for covariates compared to persons with a normal Body Mass Index (OR = 1.71; 95% CI: 1.11-2.62). The odds ratio of the underweight category was non-significant. A dose-response effect of the continuous BMI scores on the onset of any mood or anxiety disorder was found (OR = 1.06; 95% CI: 1.02 = 1.10; p < 0.01).

CONCLUSIONS

Obesity at baseline is a risk for the onset of mood -and anxiety disorders at three year follow up.

A taxonomy of groups at risk based on reported and desired body mass index and its relationships with health

This study aimed to identify groups at risk based on reported and desired Body Mass Index (BMI) and their relationships with weight satisfaction, food intake and perceived health, and to analyze gender differences. A pre-experimental observational study was conducted. 3380 individuals (mean age 20.16; 64.4% females) participated in a survey in the context of a healthy university project. Participants anonymously completed the SF-12, reported height, weight, desired weight, satisfaction and quality of intake. Reported BMI (BMI-r) and Desired BMI (BMI-d) were calculated following WHO standards. Combining BMI-r and BMI-d four groups emerged: Favorable Concordance, FC (67.40% normal weight wanting to maintain it), Unfavorable Concordance, UC (9.19% non-normal weight wanting such unhealthy condition), Favorable Discrepancy, FD (13.92% unhealthy weight wanting to move in a healthy direction), and Unfavorable Discrepancy, UD (9.49% normal or non-normal weight desiring an unhealthy condition). FD individuals showed lower levels of self-perceived physical health, poorer perception of the quality of their intake, and less satisfaction with weight. Both UD and UC groups are at risk, showing the UD group the lowest scores in mental health and healthy food intake. Higher proportions of females were found in the UD group, and wanting to lose weight. These findings suggest that health treatment, prevention and promotion programs can benefit from a taxonomy that identifies not only people at risk but the direction and adjustment (i.e. healthy vs non healthy) of their intention to change. Programs could be targeted at different groups, with specific goals and interventions, and avoid the 'one-fits-all' to foster a healthy weight in the young adult university population.

Protective lifestyle behaviours and depression in middle-aged Irish men and women: a secondary analysis

Objective

To examine the association between protective lifestyle behaviours (PLB) and depression in middle-aged Irish adults.

Design

Secondary analysis of a cross-sectional study. PLB (non-smoker, moderate alcohol, physical activity, adequate fruit and vegetable intake) were assessed using a general health and lifestyle questionnaire and a validated FFQ. Depression was assessed using the Center for Epidemiologic Studies Depression Scale. A score of 15–21 indicates mild/moderate depression and a score of 22 or more indicates a possibility of major depression. Binary logistic regression was used to examine the association between PLB and depression.

Setting

Livinghealth Clinic, Mitchelstown, North Cork, Republic of Ireland.

Subjects

Men and women aged 50–69 years were selected at random from a list of patients registered at the clinic (n 2047, 67 % response rate).

Results

Over 8 % of participants engaged in zero or one PLB, 24 % and 39 % had two and three PLB respectively, while 28 % had four PLB. Those who practised three/four PLB were significantly more likely to be female, have a higher level of education and were categorised as having no depressive symptoms. Engaging in zero or one PLB was significantly associated with an increased odds of depression compared with four PLB. Results remained significant after adjusting for several confounders, including age, gender, education and BMI (OR=2·2; 95 % CI 1·2, 4·0; P for trend=0·001).

Conclusions

While causal inference cannot be established in a cross-sectional study, the findings suggest that healthy behaviours may play a vital role in the promotion of positive mental health or, at a minimum, are associated with lower levels of depression.

A U-shaped Association between Body Mass Index and Psychological Distress on the Multiphasic Personality Inventory: Retrospective Cross-sectional Analysis of 19-year-old Men in Korea

Objective personality tests, such as the Minnesota Multiphasic Personality Inventory (MMPI), might be more sensitive to reflect subclinical personality and be more state-dependent in an individual's lifetime, so they are good scales to predict the psychological distress regarding certain states. The aim of this study was to identify the specific pattern between body mass index (BMI) and psychological distress using the objective personality test. For this study, we investigated BMI and the Korean Military Multiphasic Personality Inventory (MPI). A retrospective cross-sectional study was conducted with 19-yr-old examinees who were admitted to the Military Manpower Administration in Korea from February 2007 to January 2010. Of 1,088,107 examinees, we enrolled 771,408 subjects who were psychologically apparent healthy possible-military-service groups. Afterwards, we reviewed and analyzed directly measured BMI and MPI results. In terms of the validity scales, the faking-good subscale showed an inverted U-shaped association, and faking-bad and infrequency subscales showed a U-shaped association with BMI groups. In terms of the neurosis scales, all clinical subscales (anxiety, depression, somatization, and personality disorder) also showed a U-shaped association with BMI groups. For the psychopath scales, the schizophrenia subscale showed a U-shaped association, and the paranoia subscale showed a near-positive correlation with BMI. In conclusion, a specific U-shaped pattern was observed between BMI and the MPI in 19-yr-old men in Korea. Underweight and obesity are related to psychological distress, so supportive advice and education are needed to them.

Gender in Marriage and Life Satisfaction Under Gender Imbalance in China: The Role of Intergenerational Support and SES

This study examined gender differences in the influence of marital status and marital quality on life satisfaction. The roles of intergenerational support and perceived socioeconomic status in the relationship between marriage and life satisfaction were also explored. The analysis was conducted with data from the Chinese General Social Survey (CGSS) in 2006, representing 1,317 women and 1,152 men at least 25 years old. Chi-squared tests and logistic regression models were used in this process. Marriage, including marital status and relationship quality, has a protective function for life satisfaction. Marital status is more important for males, but marital quality is more important for females. The moderating roles of intergenerational support and perceived socioeconomic status are gender specific, perhaps due to norms that ascribe different roles to men and women in marriage.

Anxiety as a consequence of modern dietary pattern in adults in Tehran--Iran

Food intake patterns in relation to mental health have already been revealed. To investigate the relationship between processed food consumption behavior and anxiety disorder, a cross sectional study was conducted. Overall, 1782 young adults aged 18-35 years were randomly selected using cluster sampling method from 22 districts of Tehran-Iran in 2011. Diet assessment was done using a 24 hour recall questionnaire in two times with a week interval. Anxiety level was determined using the validated Speilburger test (Persian version). A proportional odds regression model was used to assess the effect of processed food consumption on anxiety variables. A significant statistical difference was found between men and women in terms of processed food consumption (p<0.001). Adjusting for age, total calorie intake, gender, body mass index, socioeconomic status, and history of sedative drug consumption as well as mental health disorders, the proportional odds regression model showed a significant relationship between increased consumption of processed foods and anxiety (OR=4.73, 95% CI: 2.89-12.54 for state and OR=4.91, 95% CI: 2.88-13.99 for trait). Identification, modification and adjusting incorrect food patterns in the community could be considered as valuable steps to turn down nutritional-based health difficulties.

Body mass index and risk of mental disorders in the general population: results from the Singapore Mental Health Study

OBJECTIVE

The aims of the current study were to elucidate the association between body mass index (BMI) and mental disorders and to examine whether these associations are moderated by socio-demographic correlates and comorbid physical disorders.

METHODS

The Singapore Mental Health Study (SMHS) surveyed adult Singapore residents (Singapore citizens and permanent residents) aged 18 years and above. The survey was conducted from December 2009 to December 2010. The diagnoses of mental disorders were established using the World Mental Health Composite International Diagnostic Interview version 3.0 (CIDI 3.0). BMI was calculated using height and weight which were self-reported by respondents. The Euro-Qol-5Dimensions (EQ-5D) was used to measure the health related quality of life (HRQoL) in the sample.

RESULTS

Six thousand and six hundred sixteen respondents completed the study (response rate of 75.9%) and constituted a representative sample of the adult resident population in Singapore. Being underweight was associated with both lifetime (adjusted odds ratio (OR): 2.3) and 12-month obsessive-compulsive disorder (adjusted OR: 4.4). Obesity was associated with 12-month alcohol dependence (adjusted OR: 8.4). There were no significant differences in the EQ-5D indices or the EQ-VAS scores among the four BMI groups in the population.

CONCLUSIONS

Our findings are somewhat unique and different from those reported in research from Western countries. There is a need for further cross-cultural research to explore and identify genetic, metabolic and cultural differences that underlie the interaction between obesity and mental illnesses.