Scott Kate M, McGee Magnus A, Wells J Elisabeth, Oakley Browne Mark A
Department of Psychological Medicine, Wellington School of Medicine and Health Sciences, Otago University, New Zealand.
J Psychosom Res. 2008 Jan;64(1):97-105. doi: 10.1016/j.jpsychores.2007.09.006.
The aim of this study was to investigate (i) the associations between mental disorders (in particular the anxiety disorders) and obesity in the general population and (ii) potential moderators of those associations (ethnicity, age, sex, and education).
A nationally representative face-to-face household survey was conducted in New Zealand with 12,992 participants 16 years and older, achieving a response rate of 73.3%. Ethnic subgroups (Maori and Pacific peoples) were oversampled. Mental disorders were measured with the Composite International Diagnostic Interview (CIDI 3.0). Height and weight were self-reported. Obesity was defined as a body mass index (BMI) of 30 kg/m(2) or greater.
Obesity was significantly associated with any mood disorder (OR 1.23), major depressive disorder (OR 1.27), any anxiety disorder (OR 1.46), and most strongly with some individual anxiety disorders such as post-traumatic stress disorder (PTSD) (OR 2.64). Sociodemographic correlates moderated the association between obesity and mood disorders but were less influential in obesity-anxiety disorder associations. Adjustment for the comorbidity between anxiety and mood disorders made little difference to the relationship between obesity and anxiety disorders (OR 1.36) but rendered the association between obesity and mood disorders insignificant (OR 1.05).
Stronger associations were observed between anxiety disorders and obesity than between mood disorders and obesity; the association between PTSD and obesity is a novel finding. These findings are interpreted in light of research on the role of anxiety in eating pathology, and deserve the further attention of researchers and clinicians.
本研究旨在调查(i)普通人群中精神障碍(尤其是焦虑症)与肥胖之间的关联,以及(ii)这些关联的潜在调节因素(种族、年龄、性别和教育程度)。
在新西兰对12992名16岁及以上的参与者进行了具有全国代表性的面对面家庭调查,应答率为73.3%。对少数族裔亚组(毛利人和太平洋岛民)进行了过度抽样。使用复合国际诊断访谈(CIDI 3.0)测量精神障碍。身高和体重由参与者自我报告。肥胖定义为体重指数(BMI)达到30kg/m²或更高。
肥胖与任何情绪障碍(比值比[OR] 1.23)、重度抑郁症(OR 1.27)、任何焦虑症(OR 1.46)显著相关,与某些个体焦虑症如创伤后应激障碍(PTSD)的相关性最强(OR 2.64)。社会人口统计学相关因素调节了肥胖与情绪障碍之间的关联,但在肥胖与焦虑症的关联中影响较小。对焦虑症和情绪障碍的共病情况进行调整后,肥胖与焦虑症之间的关系变化不大(OR 1.36),但肥胖与情绪障碍之间的关联变得不显著(OR 1.05)。
观察到焦虑症与肥胖之间的关联比情绪障碍与肥胖之间的关联更强;PTSD与肥胖之间的关联是一个新发现。这些发现根据焦虑在饮食病理学中的作用研究进行了解释,值得研究人员和临床医生进一步关注。