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儿童和青少年精神病理学预示着成年后体重指数增加:来自前瞻性社区样本的结果。

Child and adolescent psychopathology predicts increased adult body mass index: results from a prospective community sample.

作者信息

Korczak Daphne J, Lipman Ellen, Morrison Katherine, Duku Eric, Szatmari Peter

机构信息

*Department of Psychiatry, The Hospital for Sick Children, The University of Toronto, Toronto, Canada; †Division of Child Psychiatry, ‡Department of Psychiatry and Behavioural Neurosciences, §Department of Clinical Epidemiology and Biostatistics, ‖Offord Centre for Child Studies, McMaster University, Hamilton, Canada; ¶Department of Pediatrics, McMaster University, Hamilton, Canada.

出版信息

J Dev Behav Pediatr. 2014 Feb-Mar;35(2):108-17. doi: 10.1097/DBP.0000000000000015.

Abstract

OBJECTIVE

To examine the relationship between childhood and adolescent symptoms of (1) depression, (2) attention-deficit hyperactivity disorder (ADHD), and (3) conduct disorder (CD) with adult body mass index (BMI) in a prospective longitudinal study of 3294 community participants in the Ontario Child Health Survey.

METHODS

One thousand nine hundred ninety-two children aged 4 to 11 years and 1302 adolescents aged 12 to 16 years at study entry in 1983 underwent follow-up in 2000. Body mass index data were available for 1886 adult participants in the year 2000, which comprised the final study sample. Data were collected from youth, parents, and teachers using a combination of parental, youth, and teacher self-report and semistructured interview. Body mass index is a derived variable determined from the self-reported height and weight in 2000.

RESULTS

Adults with depression, ADHD, or CD identified in childhood had increased body weight (BMI = 27.2 kg/m, 27.7 kg/m, and 27.9 kg/m, respectively) compared with their nonaffected peers (BMI = 24.8 kg/m; p < .001). Greater depressive symptoms in childhood were associated with increased adult BMI among boys (p = .02). Among adolescents, depression and sex interact in the association with adult BMI (p = .01). The association of childhood ADHD with adult overweight was completely accounted for by the effect of comorbid child conduct disturbance (p < .001) for both girls and boys. Greater conduct symptoms were associated with increased adult BMI (p = .04) among adolescent girls.

CONCLUSION

This epidemiologic study suggests that psychopathology in childhood is associated with increased adult BMI. Early identification of psychiatric illness may present key opportunities for targeted prevention of obesity.

摘要

目的

在安大略儿童健康调查中,对3294名社区参与者进行前瞻性纵向研究,以探讨儿童期及青少年期(1)抑郁症、(2)注意力缺陷多动障碍(ADHD)和(3)品行障碍(CD)的症状与成人体重指数(BMI)之间的关系。

方法

1983年研究开始时,1992名4至11岁儿童和1302名12至16岁青少年在2000年接受了随访。2000年有1886名成年参与者的体重指数数据,构成了最终研究样本。通过父母、青少年和教师的自我报告以及半结构化访谈相结合的方式,从青少年、父母和教师那里收集数据。体重指数是根据2000年自我报告的身高和体重得出的派生变量。

结果

与未受影响的同龄人相比,儿童期被诊断为患有抑郁症、ADHD或CD的成年人体重增加(BMI分别为27.2kg/m、27.7kg/m和27.9kg/m)(BMI = 24.8kg/m;p < 0.001)。儿童期更严重的抑郁症状与男孩成年后BMI增加有关(p = 0.02)。在青少年中,抑郁症与性别在与成年BMI的关联中存在相互作用(p = 0.01)。儿童期ADHD与成人超重之间的关联,在女孩和男孩中均完全由共病的儿童品行障碍的影响所解释(p < 0.001)。青少年女孩中,更严重的品行症状与成年BMI增加有关(p = 0.04)。

结论

这项流行病学研究表明,儿童期精神病理学与成年后BMI增加有关。早期识别精神疾病可能为肥胖的针对性预防提供关键机会。

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