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Muha J, Schumacher A, Campisi SC, Korczak DJ. Depression and emotional eating in children and adolescents: A systematic review and meta-analysis. Appetite 2024; 200:107511. [PMID: 38788931 DOI: 10.1016/j.appet.2024.107511] [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: 12/13/2023] [Revised: 04/24/2024] [Accepted: 05/22/2024] [Indexed: 05/26/2024]
Abstract
Major Depressive Disorder in youth is associated with obesity and adult cardiovascular disease (CVD) risk. Eating in response to emotions (emotional eating) is a potential contributing factor to this association. Although emotional eating is associated with Major Depressive Disorder in adults, findings in children and adolescents are mixed. This systematic review and meta-analysis aims to determine the association between depression and emotional eating in children and adolescents. Systematic searches were conducted in seven databases. Studies were included if the study population had a mean age of ≤18 years and assessed both depression and emotional eating using validated measures. The search generated 12,241 unique studies, of which 37 met inclusion criteria. Random-effects meta-analyses of study outcomes were performed. Thirty-seven studies (26,026 participants; mean age = 12.4 years, SD = 3.1) were included. The mean effect size was significant for both cross-sectional and longitudinal data (Hedges' g = 0.48, p < 0.0001; g = 0.37, p = 0.002, respectively), revealing a positive moderately strong association between depressive symptoms and emotional eating in youth. Among longitudinal studies, the association was stronger when depressive symptoms and emotional eating were assessed using child and adolescent self-report versus parent-report. No studies examined youth with a clinical diagnosis of depression. Meta-analyses revealed that depressive symptoms and emotional eating are positively associated in children and adolescents. However, further research in clinical samples is needed. Results raise the possibility for the importance of emotional eating in the link between depression and early CVD risk, though further examination is required to determine whether emotional eating is a potential treatment target to decrease CVD risk among adolescents with increased depression symptoms.
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Affiliation(s)
- Jessica Muha
- Neurosciences and Mental Health, Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada; Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Anett Schumacher
- Neurosciences and Mental Health, Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
| | - Susan C Campisi
- Neurosciences and Mental Health, Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada; Nutrition and Dietetics Program, Clinical Public Health Division, Dalla Lana School of Public Health, University of Toronto, Canada
| | - Daphne J Korczak
- Neurosciences and Mental Health, Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
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2
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Bordelois P, Koenen KC, Elkind MSV, Suglia SF, Keyes KM. Childhood internalizing and externalizing problems and cardiovascular and diabetes mellitus risk in adolescence. J Affect Disord 2023; 335:239-247. [PMID: 37149053 PMCID: PMC10809325 DOI: 10.1016/j.jad.2023.04.084] [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: 12/06/2022] [Revised: 03/22/2023] [Accepted: 04/18/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Among adults, common psychopathology is a risk factor for cardiovascular diseases (CVD) and type 2 diabetes mellitus (T2DM). We investigated whether childhood internalizing and externalizing problems are prospectively associated with clinically elevated CVD and T2DM risk factors in adolescence. METHODS Data were from the Avon Longitudinal Study of Parents and Children. Childhood internalizing (emotional) and externalizing (hyperactivity and conduct) problems were rated on the Strengths and Difficulties Questionnaire (parent version) (N = 6442). BMI was measured at age 15 and triglycerides, low-density lipoprotein cholesterol and homeostasis model assessment of insulin resistance, IR, were assessed at age 17. We estimated associations using multivariate log-linear regression. Models were adjusted for confounding and participants attrition. RESULTS Children with hyperactivity or conduct problems were more likely to become obese and to develop clinically high levels of triglycerides and HOMA-IR in adolescence. In fully adjusted models, IR was associated with hyperactivity (relative risk, RR = 1.35, 95 % confidence interval, CI = 1.00-1.81) and conduct problems (RR = 1.37, CI = 1.06-1.78). High triglycerides were associated with hyperactivity (RR = 2.05, CI = 1.41-2.98) and with conduct problems (RR = 1.85, CI = 1.32-2.59). BMI only minimally explained these associations. Emotional problems were not associated with increased risk. LIMITATIONS Residual attrition bias, reliance on parent's reports of children's behaviors, non-diverse sample. CONCLUSIONS This research suggests that childhood externalizing problems might be a novel independent risk factor for CVD/T2DM. Future research should corroborate these findings and investigate mechanisms. Pediatricians may need to assess and treat CVD/T2DM risk factors in adolescents with a history of externalizing problems.
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Affiliation(s)
- Paula Bordelois
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America.
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States of America
| | - Mitchell S V Elkind
- Division of Neurology Clinical Outcomes Research and Population Sciences (NeuroCORPS), Columbia University, New York, NY, United States of America
| | - Shakira F Suglia
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, United States of America
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
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Li K, Chen L, Wang K, Jiang X, Ji Y, Fang S, Wei H. Emotional problems mediate the association between attention deficit/hyperactivity disorder and obesity in adolescents. BMC Psychiatry 2023; 23:381. [PMID: 37259044 DOI: 10.1186/s12888-023-04882-x] [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: 03/13/2023] [Accepted: 05/17/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Attention deficit/hyperactivity disorder (ADHD) has been identified as a risk factor for obesity in both children and adolescents. However, the mechanisms underlying the relationship between ADHD and obesity are still unclear. This study aimed to test a theoretical model of whether anxiety/depression is an intermediary factor in the ADHD-obesity relationship. METHODS Data were derived from the National Health Interview Survey (NHIS), a principal source of information on the health of the civilian noninstitutionalized population of the United States. A total of 35,108 adolescents aged 12-17 years old from 2010-2015 NHIS and 2016-2018 NHIS representing 46,550,729 individuals in the weighted population, had a parent-reported previous ADHD diagnosis, emotional problems, and height and weight data. Mediation analyses were used to explore whether anxiety/depression is an intermediary factor in the relationship between ever having ADHD and obesity. Mediation analyses were performed using multiple logistic regressions. RESULTS The findings showed that ADHD was a predictor of obesity. This relationship was partially mediated by depression(2010-2015: β=0.28, 95%CI:0.13-0.43; 2016-2018: β=0.26, 95%CI:0.03-0.49), as well as anxiety (2010-2015: β=0.28, 95%CI:0.18-0.38). CONCLUSIONS Our study suggests the hypothetical role of depression and anxiety as underlying mechanisms in the association between ever having ADHD and obesity in adolescents. When treating children with ADHD, clinicians need to be particularly attentive to whether they show emotional problems and use interventions to eliminate anxiety/depression to protect against obesity.
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Affiliation(s)
- Ke Li
- Department of Child Health Care, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Liangliang Chen
- Department of Developmental and Behavioral Pediatrics, (Fujian Branch of Shanghai Children's Medical Center), Fujian Children's Hospital, Fuzhou, China
| | - Kai Wang
- Department of Pediatrics, 1st Affiliated Hospital to Zhengzhou University, Zhengzhou, China
| | - Xiaodong Jiang
- Rehabilitation Medicine Department, Wuhan Children's Hospital(Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Yiting Ji
- Department of Child and Adolescent Healthcare, Children's Hospital of Soochow University, Suzhou, China
| | - Shuanfeng Fang
- Department of Child Health Care, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China.
| | - Haiyan Wei
- Department of Endocrinology and Genetic Metabolism, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China.
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Tao H, Fan S, Zhu T, You L, Zheng D, Yan L, Ren M. Psychiatric disorders and Type 2 diabetes mellitus: A bidirectional Mendelian randomization. Eur J Clin Invest 2023; 53:e13893. [PMID: 36259254 DOI: 10.1111/eci.13893] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/11/2022] [Accepted: 10/17/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Extensive observational evidence put forward the association between psychiatric disorders and type 2 diabetes mellitus (T2DM). However, causal relationships between these two diseases required further research. Thus, we evaluated the bidirection casual effect between five psychiatric disorders and T2DM using two-sample mendelian randomization (MR). METHODS By selecting single nucleotide polymorphisms associated with T2DM and five psychiatric disorders (attention-deficit hyperactivity disorder (ADHD), major depressive disorder (MDD), schizophrenia, anxiety disorder and panic disorder), a bidirectional two-sample MR was applied to evaluate causality between these diseases. The inverse-variance weighted (IVW) method was used as the primary analysing approach for estimating possible causal effects. MR-Egger and weighted median were also conducted to verify the results. The funnel plot, Cochran's Q test and MR-Egger intercept test were used for sensitivity analyses. In addition, potential mediators were investigated by risk factor analyses. RESULTS Genetic susceptibilities of ADHD and MDD would increase the risk of T2DM (ADHD: OR = 1.14, 95%CI 1.08-1.20; p = 5.7 × 10 - 6 ; MDD: OR = 1.22, 95%CI 1.09-1.36; p = 0.0004 ). In addition, genetic predisposition to T2DM was also associated with ADHD (OR = 1.09, 95%CI 1.04-1.14; p = 0.0004). Several risk factors of T2DM were implicated in the above causal associations, including smoking, high body mass index, waist-to-hip ratio and elevated serum triglycerides. CONCLUSION Our studies indicated a causal effect of ADHD and MDD on increasing the risk of T2DM, which was potentially mediated by smoking and obesity-related phenotypes. Meanwhile, we found a causal effect of T2DM on ADHD. Thus, prevention strategies for T2DM should also include mental health and vice versa.
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Affiliation(s)
- Haoran Tao
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Clinical Research Center for Metabolic Diseases, Guangzhou key laboratory for Metabolic Diseases, Guangzhou, China
| | - Shujin Fan
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Clinical Research Center for Metabolic Diseases, Guangzhou key laboratory for Metabolic Diseases, Guangzhou, China
| | - Tianxin Zhu
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Clinical Research Center for Metabolic Diseases, Guangzhou key laboratory for Metabolic Diseases, Guangzhou, China
| | - Lili You
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Clinical Research Center for Metabolic Diseases, Guangzhou key laboratory for Metabolic Diseases, Guangzhou, China
| | - Dinghao Zheng
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Clinical Research Center for Metabolic Diseases, Guangzhou key laboratory for Metabolic Diseases, Guangzhou, China
| | - Li Yan
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Clinical Research Center for Metabolic Diseases, Guangzhou key laboratory for Metabolic Diseases, Guangzhou, China
| | - Meng Ren
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Clinical Research Center for Metabolic Diseases, Guangzhou key laboratory for Metabolic Diseases, Guangzhou, China
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Fahad S, Nguyen-Thi-Lan H, Nguyen-Manh D, Tran-Duc H, To-The N. Analyzing the status of multidimensional poverty of rural households by using sustainable livelihood framework: policy implications for economic growth. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:16106-16119. [PMID: 36178652 PMCID: PMC9523647 DOI: 10.1007/s11356-022-23143-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/16/2022] [Indexed: 05/06/2023]
Abstract
Poverty is a multifaceted and location-based issue that cannot be quantified using monetary metrics alone. This study aims to evaluate the multidimensional poverty status of poor households in Ha Giang province, Vietnam, by using the DFID (Department for International Development) sustainable livelihood framework, an integrating technique for spatial recognition of multidimensional poverty, was developed and deployed to conduct a county-level poverty assessment in rural Vietnam. The multidimensional poverty standard is considered a novel approach to assess poverty, identify causes of poverty, and encourage poor households to sustainably escape poverty. A household survey was conducted in three rural districts, namely Dong Van, Hoang Su Phi, and Bac Quang in Ha Giang province, Vietnam, during 2016 to 2021. The results of the study show that surveyed households are deficient in all five main sources of livelihood, in which the three most deficient capital sources are natural capital, social capital, and financial capital. The findings revealed that the majority of farming households were classified as multidimensionally poor. The multidimensionally poor regions were not only poorer in single-dimensional and aggregate ratings than the income-poor and recognized poor regions, but they also had several vulnerabilities and insecurity. The assessment of multidimensional poverty, by distinguishing the poor, marginalized, and dispossessed dimensions, should be extremely beneficial for each region to design and execute poverty reduction programs accordingly, and it would contribute to improving the persistence of alleviating poverty. The article also proposes a number of sustainable poverty reduction measures, in which the root is to improve the spirit of self-raising to escape poverty of households.
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Affiliation(s)
- Shah Fahad
- School of Management, Hainan University, Haikou, 570228 Hainan Province China
| | - Huong Nguyen-Thi-Lan
- VNU University of Economics and Business-Vietnam National University, Hanoi, Vietnam
| | - Dung Nguyen-Manh
- VNU University of Economics and Business-Vietnam National University, Hanoi, Vietnam
| | - Hiep Tran-Duc
- VNU University of Economics and Business-Vietnam National University, Hanoi, Vietnam
| | - Nguyen To-The
- VNU University of Economics and Business-Vietnam National University, Hanoi, Vietnam
- TIMAS, Thang Long University, Hanoi, Vietnam
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Orlando L, Savel KA, Madigan S, Colasanto M, Korczak DJ. Dietary patterns and internalizing symptoms in children and adolescents: A meta-analysis. Aust N Z J Psychiatry 2022; 56:617-641. [PMID: 34313455 PMCID: PMC9131419 DOI: 10.1177/00048674211031486] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
CONTEXT Studies of child and adolescent internalizing symptoms and dietary pattern have produced mixed results. OBJECTIVES To quantify the association between dietary patterns and internalizing symptoms, including depression, in children and adolescents. DATA SOURCES Embase, PsycINFO, MEDLINE, Web of Science and Cochrane up to March 2021. STUDY SELECTION Observational studies and randomized controlled trials with mean age ⩽ 18 years, reporting associations between diet patterns and internalizing symptoms. DATA EXTRACTION Mean effect sizes and 95% confidence intervals were determined under a random-effects model. RESULTS Twenty-six studies were cross-sectional, 12 were prospective, and 1 used a case-control design. The total number of participants enrolled ranged from 73,726 to 116,546. Healthy dietary patterns were negatively associated with internalizing (r = -0.07, p < 0.001, 95% confidence interval [-0.12, 0.06]) and depressive symptoms (r = -0.10, p < 0.001, 95% confidence interval [-0.18, -0.08]). Effect sizes were larger for studies of healthy dietary patterns and internalizing and depressive symptoms using self-report versus parent-report measures, as well as in cross-sectional studies of healthy dietary patterns and depression compared to prospective studies. Unhealthy dietary patterns were positively associated with internalizing (r = 0.09, p < 0.001, 95% confidence interval [0.06, 0.14]) and depressive symptoms (r = 0.10, p < 0.01, 95% CI [0.05, 0.17]). Larger effect sizes were observed for studies of unhealthy dietary patterns and internalizing and depressive symptoms using self-report versus parent-report measures. LIMITATIONS A lack of studies including clinical samples and/or physician diagnosis, and a paucity of studies in which anxiety symptoms were the primary mental health outcome. CONCLUSION Greater depression and internalizing symptoms are associated with greater unhealthy dietary patterns and with lower healthy dietary intake among children and adolescents.
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Affiliation(s)
- Laura Orlando
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Katarina A Savel
- Department of Human Biology, University of Toronto, Toronto, ON, Canada
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, University of Calgary, Alberta Children’s Hospital Research Institute, Calgary, AB, Canada
| | - Marlena Colasanto
- Applied Psychology and Human Development, University of Toronto, Toronto, ON, Canada,Department of Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Daphne J Korczak
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada,Daphne J Korczak, Department of Psychiatry, The Hospital for Sick Children, 555 University Avenue, 1145 Burton Wing, Toronto, ON M5G 1X8, Canada.
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Obeid N, Flament MF, Buchholz A, Henderson KA, Schubert N, Tasca G, Thai H, Goldfield G. Examining Shared Pathways for Eating Disorders and Obesity in a Community Sample of Adolescents: The REAL Study. Front Psychol 2022; 13:805596. [PMID: 35432146 PMCID: PMC9008728 DOI: 10.3389/fpsyg.2022.805596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 02/16/2022] [Indexed: 11/21/2022] Open
Abstract
Several psychosocial models have been proposed to explain the etiology of eating disorders (EDs) and obesity separately despite research suggesting they should be conceptualized within a shared theoretical framework. The objective of the current study was to test an integrated comprehensive model consisting of a host of common risk and protective factors (socio-environmental, psychological, and behavioral) expected to explain both eating and weight disorders simultaneously in a large school-based sample of adolescents. Data were collected from 3,043 youth (60% female, 14.00 ± 1.61) from 41 schools in the Ottawa region, Canada. Working with interested school staff, validated self-report scales in the form of a questionnaire booklet were administered to participating students to assess several understood risk and protective factors common to both eating disorders and obesity. Anthropometric measurements of weight and height were taken at the end of the questionnaire administration period by trained research staff. Structural equation modeling with cross-validation was used to test the hypothesized model. Findings demonstrated that dysregulated eating was associated with both eating disorder and weight status with diet culture and emotion dysregulation directly associated with some of these disordered eating patterns. It equally pointed to how lifestyle made up of high sedentary behaviors, low vigorous exercise and varied eating patterns contributed to both emotion dysregulation and poor body image which subsequently affected eating issues and weight status simultaneously, signaling the complex interplay of psychosocial factors that underlie these concerns. This study provides evidence for an integrated psychosocial model consisting of socio-environmental, psychological, and behavioral factors may best explain the complex interplay of risk and protective factors influencing eating disorders and obesity. It equally highlights understanding the direct and indirect effects of some of the most salient risk factors involved in eating and weight-related concerns, including the strong effects of diet culture and stressors such as weight-based teasing, providing interventionalists evidence of important risk factors to consider targeting in eating disorder and weight-based prevention efforts.
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Affiliation(s)
- Nicole Obeid
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- *Correspondence: Nicole Obeid,
| | | | - Annick Buchholz
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Centre for Healthy Active Living, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Katherine A. Henderson
- Department of Psychology, Carleton University, Ottawa, ON, Canada
- Anchor Psychological Services, Ottawa, ON, Canada
| | - Nick Schubert
- Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Giorgio Tasca
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Helen Thai
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Gary Goldfield
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Department of Psychology, Carleton University, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
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The Infant Health Study - Promoting mental health and healthy weight through sensitive parenting to infants with cognitive, emotional, and regulatory vulnerabilities: protocol for a stepped-wedge cluster-randomized trial and a process evaluation within municipality settings. BMC Public Health 2022; 22:194. [PMID: 35090411 PMCID: PMC8796192 DOI: 10.1186/s12889-022-12551-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 01/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background Child mental health problems are a major public health concern associated with poor mental and physical health later in development. The study evaluates a new community-based intervention to promote sensitive parenting and reduce enduring mental health problems and unhealthy weight among vulnerable infants aged 9-24 months. Methods We use a step-wedge cluster randomized controlled trial design conducted within a home visiting program offered by community health nurses to infant families in Denmark. Sixteen municipalities are randomly allocated to implement the intervention starting at three successive time points from May 1, 2022 to January 1, 2023. A total of 900-1000 families will be included. A standardized program, Psykisk Udvikling og Funktion (PUF), is used to identify infants with major problems of eating, sleep, emotional or behavioral regulation or developmental problems. The intervention builds on the Video-Feedback Intervention to Promote Positive Parenting (VIPP) program, adapted to the PUF-context and named the VIPP-PUF. Children will be followed up at ages 18 and 24 months. Primary outcome measure is the Strengths and Difficulties Questionnaire (SDQ) at child age 24 months. The other outcome measures include body mass index z-scores, the Ages and Stages Questionnaire Social-Emotional (ASQ:SE2); the Child Behavior Checklist (CBCL 1½ -5); Eating behavior Questionnaires; the Being a Mother-questionnaire (BaM13); the Parental Stress Scale (PSS); and the WHO-5 well-being index (WHO-5). Data on child and family factors are obtained from National registries and the Child Health Database. Quantitative measures are applied to examine the effectiveness of the VIPP-PUF intervention and the implementation process. Qualitative measures include interviews with CHNs, parents and municipality stakeholders to explore factors that may influence the adherence and effectiveness of the intervention. Discussion The study examines a service-setting based intervention building on the promotion of sensitive parenting to vulnerable infants. We use a mixed methods approach to evaluate the intervention, taking into account the influences of COVID-19 pandemic running since March 2020. Overall, the study has potential to add to the knowledge on the possibilities of prevention within the municipality child health care to reduce the risk of mental health problems and unhealthy weight in early childhood. Trial registration www.ClinicalTrials.gov; IDNCT04601779; Protocol ID 95-110-21307. Registered 25 June 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12551-z.
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Sands A, van Dijk MT, Abraham E, Yangchen T, Talati A, Weissman MM. The Long-Term Outcomes of Prepubertal Depression and Internalizing Problems: A Scoping Review. Harv Rev Psychiatry 2022; 30:163-180. [PMID: 35576448 PMCID: PMC9887604 DOI: 10.1097/hrp.0000000000000337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LEARNING OBJECTIVES After participating in this activity, learners should be better able to:• Discuss whether prepubertal depression shows longitudinal continuity with depression in adulthood.• Summarize existing literature on adult emotional and functional outcomes of prepubertal depression and internalizing problems. BACKGROUND Adolescent- and young adult-onset depression are common, recurrent, and can cause significant distress and psychosocial impairment across the life span, but recognition of prepubertal internalizing problems and depression, along with their prevalence, clinical course, and long-term outcomes, remains elusive. OBJECTIVE To examine whether prepubertal depression, which can manifest differently from adult depression, shows longitudinal continuity with depression in adulthood, and to summarize existing literature on adult emotional and functional outcomes of prepubertal depression and internalizing problems. METHODS A scoping review was conducted for peer-reviewed cohort articles published between 2000 and 2020 using PubMed and PsycINFO. From 4309 identified references, 17 articles were included. RESULTS Prepubertal depression confers increased risk of recurrence of depression in adulthood, with similar findings for prepubertal internalizing problems. No studies found prepubertal depression or internalizing problems predicting adult substance abuse, and no studies asked about adult bipolar diagnoses. More research is needed to draw clear conclusions regarding their implications for other psychiatric, medical, or psychosocial outcomes. CONCLUSION The reviewed studies provide limited evidence that prepubertal depression onset predicts adult depression. The small evidence base and heterogeneous methodological assessments may limit, however, the ability to draw meaningful conclusions about the long-term course of prepubertal-onset depression. Well-designed studies with longer follow-up and multiple assessments in adulthood are needed to clarify and assess the potential effects of prepubertal depression on adult health and functioning. This information will eventually become available as the samples in recently initiated longitudinal cohort studies of children mature further.
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Affiliation(s)
- Adam Sands
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University,New York-Presbyterian Hospital/Columbia University Medical Center, New York, NY
| | - Milenna T. van Dijk
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University,Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY
| | - Eyal Abraham
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University,Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY
| | - Tenzin Yangchen
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY
| | - Ardesheer Talati
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University,Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY
| | - Myrna M. Weissman
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University,Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY
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10
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Liu CY, Schoeler T, Davies NM, Peyre H, Lim KX, Barker ED, Llewellyn C, Dudbridge F, Pingault JB. Are there causal relationships between attention-deficit/hyperactivity disorder and body mass index? Evidence from multiple genetically informed designs. Int J Epidemiol 2021; 50:496-509. [PMID: 33221865 DOI: 10.1093/ije/dyaa214] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) and body mass index (BMI) are associated. However, it remains unclear whether this association reflects causal relationships in either direction or confounding. Here, we implemented genetically informed methods to examine bidirectional causality and potential confounding. METHODS Three genetically informed methods were employed: (i) cross-lagged twin-differences analyses to assess bidirectional effects of ADHD symptoms and BMI at ages 8, 12, 14 and 16 years in 2386 pairs of monozygotic twins from the Twins Early Development Study (TEDS); (ii) within- and between-family ADHD and BMI polygenic score (PS) analyses in 3320 pairs of dizygotic TEDS twins; and (iii) two-sample bidirectional Mendelian randomization (MR) using summary statistics from genome-wide association studies (GWAS) on ADHD (N = 55,374) and BMI (N = 806,834). RESULTS Mixed results were obtained across the three methods. Twin-difference analyses provided little support for cross-lagged associations between ADHD symptoms and BMI over time. PS analyses were consistent with bidirectional relationships between ADHD and BMI, with plausible time-varying effects from childhood to adolescence. MR findings also suggested bidirectional causal effects between ADHD and BMI. Multivariable MR indicated the presence of substantial confounding in bidirectional relationships. CONCLUSIONS The three methods converged to highlight multiple sources of confounding in the association between ADHD and BMI. PS and MR analyses suggested plausible causal relationships in both directions. Possible explanations for mixed causal findings across methods are discussed.
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Affiliation(s)
- Chao-Yu Liu
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Tabea Schoeler
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Neil M Davies
- Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Public Health and Nursing, K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Hugo Peyre
- Laboratoire de Sciences Cognitives et Psycholinguistique, PSL University, Paris, France.,Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
| | - Kai-Xiang Lim
- Social, Genetic & Developmental Psychiatry Centre, King's College London, London, UK
| | - Edward D Barker
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Clare Llewellyn
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Frank Dudbridge
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Jean-Baptiste Pingault
- Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Social, Genetic & Developmental Psychiatry Centre, King's College London, London, UK
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11
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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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12
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Racicka-Pawlukiewicz E, Kuć K, Bielecki M, Hanć T, Cybulska-Klosowicz A, Bryńska A. The Association between Executive Functions and Body Weight/BMI in Children and Adolescents with ADHD. Brain Sci 2021; 11:brainsci11020178. [PMID: 33535492 PMCID: PMC7912721 DOI: 10.3390/brainsci11020178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 11/21/2022] Open
Abstract
Despite the increasing body of research on Attention Deficit Hyperactivity Disorder (ADHD), the results of the studies assessing the relationship between executive function deficit and the risk of obesity in people with ADHD are incongruent. Our study aimed to assess the relationship between measures of executive functions and body weight and Body Mass Index (BMI) in children and adolescents with ADHD and control subjects. The study group consisted of 58 subjects aged from 8 to 17 years with ADHD. The Control group consisted of 62 healthy age and sex-matched participants from primary and secondary schools. Weight, height, and BMI measurements were standardized. The Sustained Attention to Response Test (SART) and the Attention Network Test (ANT) were used to assess executive functions. Based on the analysis of the correlation and analysis of moderation, we found that subjects with higher weight in the study group presented a lower efficiency of the inhibition processes and gave more impulsive and incorrect answers. The occurrence of impulsive reactions might contribute to the risk of excessive weight in children and adolescents with ADHD.
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Affiliation(s)
- Ewa Racicka-Pawlukiewicz
- Department of Child and Adolescent Psychiatry, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland;
- Correspondence:
| | - Katarzyna Kuć
- Department of Psychology, SWPS University of Social Sciences and Humanities, 03-815 Warsaw, Poland; (K.K.); (M.B.)
| | - Maksymilian Bielecki
- Department of Psychology, SWPS University of Social Sciences and Humanities, 03-815 Warsaw, Poland; (K.K.); (M.B.)
| | - Tomasz Hanć
- Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, 61-614 Poznan, Poland;
| | - Anita Cybulska-Klosowicz
- Laboratory of Neuroplasticity, Nencki Institute of Experimental Biology of Polish Academy of Sciences, 02-093 Warsaw, Poland;
| | - Anita Bryńska
- Department of Child and Adolescent Psychiatry, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland;
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13
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Goldstein BI, Korczak DJ. Links Between Child and Adolescent Psychiatric Disorders and Cardiovascular Risk. Can J Cardiol 2020; 36:1394-1405. [DOI: 10.1016/j.cjca.2020.06.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 06/28/2020] [Accepted: 06/29/2020] [Indexed: 12/27/2022] Open
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14
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Geuijen PM, Buitelaar JK, Fliers EA, Maras A, Schweren LJS, Oosterlaan J, Hoekstra PJ, Franke B, Hartman CA, Rommelse NN. Overweight in family members of probands with ADHD. Eur Child Adolesc Psychiatry 2019; 28:1659-1669. [PMID: 31004292 PMCID: PMC6861202 DOI: 10.1007/s00787-019-01331-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/01/2019] [Indexed: 12/12/2022]
Abstract
The widely reported association between ADHD and overweight may be attributable to genetic and environmental factors also present in unaffected family members. Therefore, the purpose of this study was to examine the association between ADHD and overweight within families. A cohort was used of families with at least one member with ADHD, recruited as part of the Dutch node of the International Multicenter ADHD Genetics (IMAGE) study, with assessments taking place between 2003 and 2006, 2009 and 2012, and 2013 and 2015. The three assessment waves yielded N = 1828 youth assessments and N = 998 parent assessments from N = 447 unique families. Overweight was defined as a body mass index (BMI) ≥ 85th percentile for youth of the same age and sex; overweight in adults as a BMI ≥ 25. Effects of age, gender, and medication use (psychostimulants, antipsychotics, and melatonin) were taken into account. Generalized estimation equations were used to correct for within-family and within-subject correlations. There was no difference in risk between ADHD-affected youth and their unaffected siblings (OR 0.92, 95% CI 0.78-1.09). However, compared to population prevalence data, all ADHD family members alike were at increased risk for being overweight: ADHD-affected youth (OR 1.33, 95% CI 1.13-1.59), unaffected siblings (OR 1.73, 95% CI 1.45-2.08), mothers (OR 1.74, 95% CI 1.40-2.17) and fathers (OR 1.78, 95% CI 1.46-2.15). Parental overweight-but not parental ADHD-was predictive of offspring overweight (mothers OR 1.40; 95% CI 1.14-1.73, fathers OR 1.83; 95% CI 1.41-2.36). Being overweight runs in ADHD families, yet is not specifically linked to ADHD within families. Shared unhealthy lifestyle factors (including nutrition, sleep, exercise, stress) as well as genetic factors shared by family members likely explain the findings.
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Affiliation(s)
- Pauline M Geuijen
- Karakter Child and Adolescent Psychiatry University Center, Reinier Postlaan 12, 6525 GC, Nijmegen, The Netherlands.
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Jan K Buitelaar
- Karakter Child and Adolescent Psychiatry University Center, Reinier Postlaan 12, 6525 GC, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ellen A Fliers
- Virenze Child and Adolescent Psychiatry, Gorinchem, The Netherlands
- Yulius Academy, Yulius Mental Health Organization, Barendrecht, The Netherlands
| | - Athanasios Maras
- Yulius Academy, Yulius Mental Health Organization, Barendrecht, The Netherlands
| | - Lizanne J S Schweren
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jaap Oosterlaan
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
- Department of Pediatrics, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
| | - Pieter J Hoekstra
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Accare University Child and Adolescent Psychiatry Center, Groningen, The Netherlands
| | - Barbara Franke
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Catharina A Hartman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Nanda N Rommelse
- Karakter Child and Adolescent Psychiatry University Center, Reinier Postlaan 12, 6525 GC, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
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15
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Maternal smoking and low family income during pregnancy as predictors of the relationship between depression and adiposity in young adults. J Dev Orig Health Dis 2018; 9:552-560. [PMID: 30111386 DOI: 10.1017/s2040174418000533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
There is an increasing incidence of overweight/obesity and mental health disorders in young adults and the two conditions often coexist. We aimed to investigate the influence of antenatal and postnatal factors that may underlie this association with a focus on maternal prenatal smoking, socio-economic status and gender. Data from the Western Australian Pregnancy Cohort (Raine) Study (women enrolled 1989-1991) including 1056 offspring aged 20 years (cohort recalled 2010-2012) were analyzed (2015-2016) using multivariable models for associations between offspring depression scores (DASS-21 Depression-scale) and body mass index (BMI), adjusting for pregnancy and early life factors and offspring behaviours. There was a significant positive relationship between offspring depression-score and BMI independent of gender and other psychosocial covariates. There was a significant interaction between maternal prenatal smoking and depression-score (interaction coefficient=0.096; 95% CI: 0.006, 0.19, P=0.037), indicating the relationship between depression-score and BMI differed according to maternal prenatal smoking status. In offspring of maternal prenatal smokers, a positive association between BMI and depression-score (coefficient=0.133; 95% CI: 0.05, 0.21, P=0.001) equated to 1.1 kg/m2 increase in BMI for every 1standard deviation (8 units) increase in depression-score. Substituting low family income during pregnancy for maternal prenatal smoking in the interaction (interaction coefficient=0.091; 95% CI: 0.01, 0.17, P=0.027) showed a positive association between BMI and depression score only among offspring of mothers with a low family income during pregnancy (coefficient=0.118; 95% CI: 0.06, 0.18, P<0.001). There were no significant effects of gender on these associations. Whilst further studies are needed to determine whether these associations are supported in other populations, they suggest potentially important maternal behavioural and socio-economic factors that identify individuals vulnerable to the coexistence of obesity and depression in early adulthood.
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16
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The longitudinal association between temperament and physical activity in young children. Prev Med 2018; 111:342-347. [PMID: 29197529 DOI: 10.1016/j.ypmed.2017.11.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 11/20/2017] [Accepted: 11/26/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine the longitudinal association of negative affect and physical activity in a population of preschool children. STUDY DESIGN Participants included 763 children (53% male) attending scheduled health supervision visits in their primary care physicians' offices. Data were collected at two time points at mean ages 27 (SD=5.4) and 47 (SD=6.2) months. Negative affect (NA) was measured using the Negative Affectivity (frustration/anger, decreased soothability) domain of the Children's Behavior Questionnaire. Physical Activity (PA) was assessed using a parent-report questionnaire. Multiple regression analyses tested the association between NA and PA, adjusting for child age, sex, z-BMI, PA at Time 1, maternal education, household income, and season, and examined for sex differences in the relationship between NA and PA. RESULTS The longitudinal association between NA at Time 1 and PA at Time 2 was moderated by sex (p<0.001). After adjusting for covariates, females with greater NA at Time 1 had decreased PA at Time 2 (p=0.01), whereas males with greater NA at Time 1 had increased PA at Time 2 (p=0.01). Specifically, among females, every 1 unit increase in NA at Time 1 was associated with a 9.9min/day decrease in PA at Time 2 (95% CI: -17.1, -2.8). CONCLUSIONS NA and PA were associated early in childhood and the effects of NA on PA were gender specific. These findings underscore the importance of longitudinal and gender-specific analyses in mood-obesity research.
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Wynchank D, Bijlenga D, Lamers F, Kooij JJS, Bron TI, Beekman ATF, Penninx BWJH. The Association Between Metabolic Syndrome, Obesity-Related Outcomes, and ADHD in Adults With Comorbid Affective Disorders. J Atten Disord 2018; 22:460-471. [PMID: 27422611 DOI: 10.1177/1087054716659137] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE ADHD may predispose to obesity, a metabolic syndrome component. Affective disorders are also associated with MetSyn and ADHD. This study examined whether ADHD confers any added risk of MetSyn and obesity-related associations in a large sample with varying stages of affective disorders. METHOD Participants included 2,303 adults from the Netherlands Study of Depression and Anxiety. Three groups were compared (controls, those with depressive/anxiety disorders without ADHD; and those with depressive/anxiety disorders and ADHD) for presence of MetSyn risk factors, body mass index, and waist-hip ratio. ADHD symptoms were identified by using a T-score > 65 (Conners Adult ADHD Rating Scale). RESULTS Multivariable analyses were additionally adjusted for sociodemographic, lifestyle, health factors, and affective disorders. Analyses showed no significant association between MetSyn, obesity-related variables, and comorbid ADHD. High Inattention and Hyperactivity/Impulsivity symptoms were not associated with MetSyn. CONCLUSION This study did not confirm that MetSyn and obesity-related parameters are increased in comorbid ADHD.
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Affiliation(s)
- Dora Wynchank
- 1 PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands
| | - Denise Bijlenga
- 1 PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands
| | - Femke Lamers
- 2 VU University Medical Center, Amsterdam, The Netherlands
| | | | - Tannetje I Bron
- 1 PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands
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18
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Lankinen V, Fröjd S, Marttunen M, Kaltiala-Heino R. Perceived rather than actual overweight is associated with mental health problems in adolescence. Nord J Psychiatry 2018; 72:89-96. [PMID: 29124989 DOI: 10.1080/08039488.2017.1389987] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Overweight and perceived overweight are common among adolescents. The nature of the relationship between overweight/perceived overweight and mental health problems is still unclear. AIMS The aim of this study was to examine whether actual overweight, perceived overweight or both are associated with internalizing and externalizing disorders among adolescents. METHODS Data were collected by two similar school surveys in all Finnish-speaking secondary schools in Tampere (population 200,000) in the academic years 2002-2003 and 2012-2013. A total of 2775 acceptable responses were received. All the analyses were carried out separately for girls and boys. Mean age of the respondents was 15.6 years. RESULTS In multivariate analyses perceived overweight, not actual weight, was significantly associated with higher risk of self-reported depression (OR: 4.3, 95% CI: 2.9-6.3, p < .001) and self-reported conduct disorder (OR: 2.3, 95% CI: 1.6-3.3, p < .001) in girls and with higher risk of self-reported depression (OR: 3.26, 95% CI: 1.65-6.4, p = .001) and self-reported social phobia (OR: 2.4, 95% CI: 1.0-5.6, p = .05) in boys. CONCLUSION Perceived overweight rather than actual weight status is associated with both internalizing and externalizing mental health problems in adolescents.
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Affiliation(s)
- Vilma Lankinen
- a Faculty of Medicine , University of Tampere , Tampere , Finland
| | - Sari Fröjd
- b Faculty of Social Sciences, Health Sciences Unit , University of Tampere , Tampere , Finland
| | - Mauri Marttunen
- c Mental Health Unit, Department of Health , National Institute for Health and Welfare , Helsinki , Finland.,d Department of Adolescent Psychiatry , Helsinki University , Helsinki , Finland
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19
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Vannucci A, Ohannessian CM. Body Mass Index z-Scores and Weight Status Predict Conduct Disorder Symptoms in Adolescents. J Adolesc Health 2017; 61:657-660. [PMID: 28867351 PMCID: PMC5667563 DOI: 10.1016/j.jadohealth.2017.05.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/18/2017] [Accepted: 05/25/2017] [Indexed: 11/16/2022]
Abstract
PURPOSE The goal of the study was to examine whether baseline body mass index (BMI) z-scores and weight status predicted conduct disorder (CD) symptoms in 368 adolescents (15-17 years). METHODS Participants in the 10th and 11th grades completed self-report questionnaires at baseline and at a 2-year follow-up. Baseline BMI z-scores and weight status were derived from self-reports of height and weight. CD symptoms were assessed using a symptom checklist. Covariates included baseline demographics, depressive symptoms, alcohol consumption, drug use, and a retrospective report of CD symptoms before age 15 years. RESULTS A cubic association was observed between baseline BMI z-scores and follow-up CD symptoms (p = .047), such that a positive association emerged only among adolescents with BMI z-scores of greater than ∼1.5. Adolescents who were obese at baseline reported more follow-up CD symptoms than nonoverweight adolescents (p = .008). Higher baseline BMI z-scores were associated with increased odds of endorsing probable CD at follow-up (p's < .03). Obese adolescents were more likely to report the presence of probable CD at follow-up than overweight and nonoverweight adolescents (p's ≤ .01). CONCLUSIONS Findings suggest that nutritional status, particularly high BMI z-scores and obese weight status, may contribute to elevated CD symptoms during adolescence, which should be dually addressed in screening and intervention efforts.
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Affiliation(s)
- Anna Vannucci
- Center for Behavioral Health, Connecticut Children's Medical Center, Hartford, Connecticut.
| | - Christine McCauley Ohannessian
- Center for Behavioral Health, Connecticut Children’s Medical Center, 282 Washington Street, Hartford, CT, USA 06106,Department of Pediatrics and Psychiatry, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT, USA 06030
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20
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Tucker JM, Cadieux A, Culver K, Smith L, Stratbucker W. Psychiatric diagnoses and medication treatment among patients presenting for paediatric weight management: associations with adiposity, aerobic fitness and cardiometabolic health. Clin Obes 2017; 7:145-150. [PMID: 28320057 DOI: 10.1111/cob.12185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/19/2017] [Accepted: 02/08/2017] [Indexed: 01/31/2023]
Abstract
We compared anthropometry, cardiometabolic risk and aerobic fitness among obese youth in weight management who were diagnosed with one or more psychiatric disorders (PD), with (PD+M) or without (PD-M) a prescribed psychotropic medication with those with no PD (NPD). Physical measures were evaluated at baseline, and psychiatric diagnoses and related medications were identified from medical records. Of 99 patients 64 (65%) had a diagnosed PD, and of those, 23 (36%) had a related medication (PD+M). Compared to NPD, PD-M had a higher body mass index (BMI) (P = 0.003), BMI z-score (P = 0.015), percent body fat (P = 0.005) and waist circumference (P < 0.001), after adjusting for age, but PD+M did not. Cardiometabolic risk did not differ between groups, but aerobic fitness was lower among PD-M (P = 0.001) and PD+M (P = 0.008) compared to NPD. Obese youth in weight management exhibit high rates of psychiatric diagnoses that are associated with lower fitness and higher adiposity and may impact treatment efficacy.
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Affiliation(s)
- J M Tucker
- Healthy Weight Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - A Cadieux
- Healthy Weight Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - K Culver
- Healthy Weight Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
| | - L Smith
- Healthy Weight Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
| | - W Stratbucker
- Healthy Weight Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
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Owens EB, Zalecki C, Gillette P, Hinshaw SP. Girls with childhood ADHD as adults: Cross-domain outcomes by diagnostic persistence. J Consult Clin Psychol 2017; 85:723-736. [PMID: 28414486 DOI: 10.1037/ccp0000217] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To ascertain adult outcomes in 10 domains reflecting symptomatology (internalizing, externalizing, self-injury, substance use), attainment (education, employment), and impairment (health, social, driving, overall) as a function of both childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) and persistence of ADHD symptoms across time. METHOD We prospectively followed 140 grade-school-aged girls with rigorously diagnosed childhood ADHD and 88 age- and ethnicity-matched comparison girls for 16 years. Outcome measures were obtained via self- and parent-report questionnaires, interviews, and objective tests. RESULTS Childhood ADHD, whether it remitted or persisted, was a pernicious risk factor for a limited number of poor outcomes, including low educational attainment, unplanned pregnancy, body mass index (BMI), and clinician-rated impairment. Childhood ADHD that persisted over time, whether completely or partially, was associated with a number of additional detrimental outcomes in the externalizing, internalizing, self-injury, occupational, social, and overall impairment domains. Finally, in this all-female sample, ADHD was not associated with objective measures of employment, substance use, or driving outcomes. CONCLUSIONS We discuss the considerable impairments accruing from both childhood-limited and adult-persisting ADHD, with major implications for the health and well-being of females with this neurodevelopmental disorder. (PsycINFO Database Record
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Affiliation(s)
| | | | - Peter Gillette
- Institute of Human Development, University of California, Berkeley
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22
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Abstract
While psychiatric comorbidities of attention-deficit/hyperactivity disorder (ADHD) have been extensively explored, less attention has been paid to somatic conditions possibly associated with this disorder. However, mounting evidence in the last decade pointed to a possible significant association between ADHD and certain somatic conditions, including obesity. This papers provides an update of a previous systematic review on the relationship between obesity and ADHD (Cortese and Vincenzi, Curr Top Behav Neurosci 9:199-218, 2012), focusing on pertinent peer-reviewed empirical papers published since 2012. We conducted a systematic search in PubMed, Ovid, and Web of Knowledge databases (search dates: from January 1st, 2012, to July 16th, 2016). We retained a total of 41 studies, providing information on the prevalence of obesity in individuals with ADHD, focusing on the rates of ADHD in individuals with obesity, or reporting data useful to gain insight into possible mechanisms underlying the putative association between ADHD and obesity. Overall, over the past 4 years, an increasing number of studies have assessed the prevalence of obesity in individuals with ADHD or the rates of ADHD in patients with obesity. Although findings are mixed across individual studies, meta-analytic evidence shows a significant association between ADHD and obesity, regardless of possible confounding factors such as psychiatric comorbidities. An increasing number of studies have also addressed possible mechanisms underlying the link between ADHD and obesity, highlighting the role, among others, of abnormal eating patterns, sedentary lifestyle, and possible common genetic alterations. Importantly, recent longitudinal studies support a causal role of ADHD in contributing to weight gain. The next generation of studies in the field should explore if and to which extent the treatment of comorbid ADHD in individuals with obesity may lead to long-term weight loss, ultimately improving their overall well-being and quality of life.
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Affiliation(s)
- Samuele Cortese
- Academic Unit of Psychology, Developmental Brain-Behaviour Laboratory, University of Southampton, Southampton, UK.
- The Child Study Center at NYU Langone Medical Center, New York, NY, USA.
| | - Luca Tessari
- Academic Unit of Psychology, Developmental Brain-Behaviour Laboratory, University of Southampton, Southampton, UK
- Department of Woman and Child Health, University of Padua, Padua, Italy
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Goldstein BI, Blanco C, He JP, Merikangas K. Correlates of Overweight and Obesity Among Adolescents With Bipolar Disorder in the National Comorbidity Survey-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry 2016; 55:1020-1026. [PMID: 27871636 DOI: 10.1016/j.jaac.2016.08.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 08/23/2016] [Accepted: 09/21/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Despite substantial evidence on the prevalence and correlates of overweight and obesity (OW/OB) in adults with bipolar disorder (BD), little is known about this topic in adolescents with BD. METHOD The method consisted of the National Comorbidity Survey-Adolescent Supplement, a face-to-face survey of mental disorders from 2001 through 2004, using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview. Participants were adolescents 13 to 17 years of age, with bipolar disorder I or II (n = 295), major depressive disorder (n = 1,112), or controls with neither mood disorder (n = 8,716). Analyses examined for group differences in the prevalence of OW/OB and for correlates of OW/OB in the group with BD. RESULTS There were no significant differences in weight categories across groups. OW and OB in adolescents with BD were associated with significantly higher lifetime rates of suicide attempt (odds ratio 3.02, 95% CI 1.11-8.24), physical or sexual abuse (2.82, 1.20-6.60), binge eating or bulimia (2.66, 1.13-6.26), and conduct disorder (2.60, 1.10-6.13) in covariate-adjusted analyses. OW and OB also were significantly associated with seeing a professional for depression, being hospitalized overnight for depression, and receiving general medical treatment. CONCLUSION The similar prevalence of OW/OB in adolescents with and without BD suggests that this potent association in adults likely comprises a consequence of BD or its correlates. In contrast, the strong association of OW/OB with proxies for depression severity, including suicide attempts and hospitalization, is already evident even in this young, nonclinical sample. Studies are warranted to determine whether early intervention of OW/OB in BD might optimize physical and mental health.
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Affiliation(s)
- Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, and the University of Toronto, Toronto, Canada.
| | - Carlos Blanco
- National Institute on Drug Abuse and the Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, MD
| | - Jian-Ping He
- Genetic Epidemiology Research Branch and the Developmental Trajectories of Mental Disorders Branch, National Institute of Mental Health
| | - Kathleen Merikangas
- Genetic Epidemiology Research Branch and the Developmental Trajectories of Mental Disorders Branch, National Institute of Mental Health
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Dennison M, Sisson SB, Morris A. Obesogenic behaviours and depressive symptoms in children: a narrative literature review. Obes Rev 2016; 17:735-57. [PMID: 27138864 DOI: 10.1111/obr.12419] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/24/2016] [Accepted: 03/25/2016] [Indexed: 12/22/2022]
Abstract
This review examines peer-reviewed, published articles exploring the role of obesogenic behaviours, including physical activity, screen time, and diet, and depressive symptoms, in 6- to 12-year-old children. Searches were conducted March-May 2014 and in August 2015 using PubMed, PsychInfo, and Embase. Eligible studies published between January 1990-August 2015 included 8- to 12-year-old children, any of the three previously identified obesogenic behaviours, and a measure of depressive symptoms. The search yielded 415 articles that were screened and assessed for eligibility; 21 were retained. Some studies included depression and a single obesogenic behaviour, while others included multiple obesogenic behaviours. Fifteen studies assessed physical activity, twelve assessed screen time, and five assessed dietary intake. Lower physical activity was associated with higher depression in 80% of studies. Higher screen time was associated with higher depression in all studies. Poor dietary intake was associated with higher depression in 60% of studies. Significant associations were found between depression and all three obesogenic behaviours. Stronger associations were found between depression and physical activity and screen time than between depression and dietary intake. This review broadens the understanding of the relationship between obesogenic behaviours and depression, and shows outcome consistency despite the lack of a consistent measurement technique. © 2016 World Obesity.
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Affiliation(s)
- Michelle Dennison
- University of Oklahoma Health Sciences Center, Department of Nutritional Sciences, Oklahoma City, OK, USA.,Oklahoma City Indian Clinic, Oklahoma City, OK, USA
| | - Susan B Sisson
- University of Oklahoma Health Sciences Center, Department of Nutritional Sciences, Oklahoma City, OK, USA
| | - Amanda Morris
- Oklahoma State University - Tulsa, College of Human Sciences, Tulsa, OK, USA
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Jelalian E, Jandasek B, Wolff JC, Seaboyer LM, Jones RN, Spirito A. Cognitive-Behavioral Therapy Plus Healthy Lifestyle Enhancement for Depressed, Overweight/Obese Adolescents: Results of a Pilot Trial. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2016; 48:S24-S33. [PMID: 27310418 DOI: 10.1080/15374416.2016.1163705] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The objective of this article was to conduct a treatment development study to examine the feasibility, acceptability, and preliminary efficacy of treating depressed, overweight/obese adolescents using both an exercise regimen and a Cognitive Behavioral Therapy (CBT) protocol modified to address aspects of healthy living and nutrition (CBT plus healthy lifestyle; CBT-HL). A randomized controlled repeated measures design was used to test the hypothesis that CBT-HL would lead to greater reductions in depressed mood and weight compared to CBT for Depression Only (CBT). Participants (n=33; 24 in CBT-HL condition) included 33 adolescents (median age 15, 73% female, 61% white, 36% Hispanic) who met DSM-IV criteria for Current Major Depressive Episode (MDE) and had BMI ≥ 85th percentile. CBT-HL was found to be feasible to implement with most adolescents. Both conditions resulted in improvement in depressed mood. The CBT-HL protocol was more effective in stabilizing weight status as assessed by BMI. Percent time spent in MVPA was increased at 12 weeks for adolescents in CBT-HL compared to those in CBT. The CBT-HL protocol was acceptable to most, but not all, adolescents, and resulted in an improvement in depressed mood as well as stabilization of weight status. A larger study to test efficacy and moderators of treatment outcome is necessary to better understand which adolescents would benefit most from the increased demands of exercise and adhering to nutrition recommendations in addition to standard CBT for depression. Revisions to the treatment protocol to support weight loss, not just stabilization, are also suggested.
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Affiliation(s)
- Elissa Jelalian
- a Department of Psychiatry and Human Behavior , Warren Alpert Medical School of Brown University; Rhode Island Hospital.,b Weight Control and Diabetes Research Center, The Miriam Hospital
| | - Barbara Jandasek
- c Department of Psychiatry and Human Behavior , Warren Alpert Medical School of Brown University, and Rhode Island Hospital
| | - Jennifer C Wolff
- c Department of Psychiatry and Human Behavior , Warren Alpert Medical School of Brown University, and Rhode Island Hospital
| | | | - Richard N Jones
- e Department of Psychiatry and Human Behavior , Warren Alpert Medical School of Brown University
| | - Anthony Spirito
- e Department of Psychiatry and Human Behavior , Warren Alpert Medical School of Brown University
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Nigg JT, Johnstone JM, Musser ED, Long HG, Willoughby MT, Shannon J. Attention-deficit/hyperactivity disorder (ADHD) and being overweight/obesity: New data and meta-analysis. Clin Psychol Rev 2015; 43:67-79. [PMID: 26780581 DOI: 10.1016/j.cpr.2015.11.005] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 09/18/2015] [Accepted: 11/24/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Literature has suggested that ADHD may be associated with increased risk of obesity. If so, this would have important clinical implications. OBJECTIVE To clarify the size of the association between ADHD and obesity and to evaluate key moderators of the association including medication, gender, age, and psychiatric comorbidity. METHOD Two preliminary studies are presented to supply critical additional data for the meta-analysis: a two-year longitudinal study of an ADHD case-control sample of 313 children aged 7-11, and a national survey study of 45,309 families in the United States using the 2012 National Survey of Children's Health. Formal meta-analysis was then conducted. The identification procedure yielded 43 studies, reporting 225 comparisons or effect sizes, studying 703,937 participants An overall effect size was estimated with a random effects model (after pooling within study using a modified fixed effects model). Effect size was then examined in relation to medication, gender, age, and psychiatric comorbidity. RESULTS The new study of children revealed no reliable association of ADHD and body mass index at any age or time point. In the national survey, ADHD was associated with obesity only in adolescent girls but not in children or boys; this effect was statistically accounted for by covarying of depression and conduct disorder. In the meta-analysis, the composite effect size was OR=1.22 (95% CI=1.11-1.34); 22 studies provided effects with medication controlled, yielding a composite effect size of OR=1.30 (95% CI=1.12-1.50). Pooled across age the association without covariates was reliable in females (OR=1.19 [1.01-1.41]) but not males (OR=1.10 [0.95-1.23]) although males and females did not statistically differ. Pooled across gender, the association was significantly larger in adults (>18years) (OR=1.37 [1.19-1.58]) than in youth (OR=1.13 [1.00-1.27]), p=.04. CONCLUSIONS ADHD has a small overall association with obesity, but this effect is moderate in adults. The effect is likely to be of no clinical significance in children, possible clinical significance in adolescent girls with comorbid disorders, and of clinical relevance by adulthood.
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Affiliation(s)
- Joel T Nigg
- Oregon Health & Science University, Portland, OR, United States.
| | | | - Erica D Musser
- Florida International University, Miami, FL, United States
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[Frequency of overweight and obesity in children and adolescents with autism and attention deficit/hyperactivity disorder]. REVISTA PAULISTA DE PEDIATRIA 2015; 34:71-7. [PMID: 26525687 DOI: 10.1016/j.rpped.2015.06.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/15/2015] [Accepted: 06/16/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the frequency of overweight and obesity in children and adolescents with autism spectrum disorder (ASD) and with attention deficit/hyperactivity disorder (ADHD) and their parents, in comparison with children and adolescents without developmental disorders. METHODS Anthropometric measures were obtained in 69 outpatients with ASD (8.4±4.2 years old), 23 with ADHD (8.5±2.4) and 19 controls without developmental disorders (8.6±2.9) between August and November 2014. Parents of patients with ASD and ADHD also had their anthropometric parameters taken. Overweight was defined as a percentile ≥85; obesity as a percentile ≥95; and underweight as a percentile ≤5. For adults, overweight was defined as a BMI between 25 and 30kg/m(2) and obesity as a BMI higher than 30kg/m(2). RESULTS Children and adolescents with ASD and ADHD had higher BMI percentile (p<0.01) and z-score (p<0.01) than controls, and increased frequency of overweight and obesity (p=0.04). Patients with ASD and ADHD did not differ between them in these variables, nor regarding abdominal circumference. Parents of children with ASD and ADHD did not differ between themselves. CONCLUSIONS Children and adolescents with ASD and ADHD are at a higher risk of overweight and obesity than children without developmental problems in the community.
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Kummer A, Barbosa IG, Rodrigues DH, Rocha NP, Rafael MDS, Pfeilsticker L, Silva ACSE, Teixeira AL. [Frequency of overweight and obesity in children and adolescents with autism and attention deficit/hyperactivity disorder]. ACTA ACUST UNITED AC 2015. [PMID: 26525687 PMCID: PMC4795724 DOI: 10.1016/j.rppede.2015.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Objective: To assess the frequency of overweight and obesity in children and adolescents with autism spectrum disorder (ASD) and with attention deficit/hyperactivity disorder (ADHD) and their parents, in comparison with children and adolescents without developmental disorders. Methods: Anthropometric measures were obtained in 69 outpatients with ASD (8.4±4.2 years old), 23 with ADHD (8.5±2.4) and 19 controls without developmental disorders (8.6±2.9) between August and November 2014. Parents of patients with ASD and ADHD also had their anthropometric parameters taken. Overweight was defined as a percentile ≥85; obesity as a percentile ≥95; and underweight as a percentile ≤5. For adults, overweight was defined as a BMI between 25 and 30kg/m2 and obesity as a BMI higher than 30kg/m2. Results: Children and adolescents with ASD and ADHD had higher BMI percentile (p<0.01) and z-score (p<0.01) than controls, and increased frequency of overweight and obesity (p=0.04). Patients with ASD and ADHD did not differ between them in these variables, nor regarding abdominal circumference. Parents of children with ASD and ADHD did not differ between themselves. Conclusions: Children and adolescents with ASD and ADHD are at a higher risk of overweight and obesity than children without developmental problems in the community.
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Affiliation(s)
- Arthur Kummer
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil.
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