Smith Tyler C, Smith Besa
Department of Community Health, School of Health and Human Services, National University, San Diego, California, USA.
The University of California, San Diego, USA.
AIMS Public Health. 2015 Aug 18;2(3):487-500. doi: 10.3934/publichealth.2015.3.487. eCollection 2015.
Childhood obesity has reached epidemic proportions with two to three-fold increases in prevalence in the past three decades. Sedentary lifestyles and nutrition have been linked to these increases though little is known about mental health illnesses in children and teens which may be precursors to negative modifiable health risk factors. The objective of this study was to investigate for a potentially more clinically practical indicator of depression over a multi-item screen in respect to reporting of overweight and obesity in adolescents. This study further investigated modifiers to this association and stability of association.
This cross-sectional study aggregated 2007/2009 California Health Interview Survey data (n = 6,917 adolescents). Univariate analyses of population characteristics and modifiable behaviors with obesity/overweight and depression are presented. Multivariable weighted logistic regression was used to compare the adjusted odds of overweight and obesity for those children with reported depression.
After controlling for gender, race/ethnicity, age, and modifiable behaviors, there was a statistically significant relationship between reported depression and overweight/obesity (OR = 1.24; 95% CI = 1.04, 1.49). This effect size was consistent in hierarchical models overall and stratified by gender.
Overweight and obesity in adolescents should be understood clinically in the context of depression and other mental health illness. This study highlights a routine primary care or parental screening assessment that could indicate tendencies in adolescent boys and girls which may be precursors to overweight or obesity. Further research should be conducted to identify ways for integrating adolescent mental health screens into primary care.
儿童肥胖已达到流行程度，在过去三十年中患病率增加了两到三倍。久坐不动的生活方式和营养状况与肥胖率上升有关，不过对于可能是负面可改变健康风险因素先兆的儿童和青少年心理健康疾病，人们了解甚少。本研究的目的是在多项筛查中，针对青少年超重和肥胖报告情况，调查一种可能在临床上更具实用性的抑郁症指标。本研究还进一步调查了这种关联的调节因素以及关联的稳定性。
这项横断面研究汇总了2007/2009年加利福尼亚健康访谈调查数据（n = 6917名青少年）。呈现了对肥胖/超重和抑郁症的人口特征及可改变行为的单因素分析。采用多变量加权逻辑回归来比较报告有抑郁症的儿童超重和肥胖的调整后几率。
在控制了性别、种族/族裔、年龄和可改变行为后，报告的抑郁症与超重/肥胖之间存在统计学上的显著关系（OR = 1.24；95% CI = 1.04，1.49）。在总体分层模型以及按性别分层的模型中，这种效应大小是一致的。
在临床中应结合抑郁症和其他心理健康疾病来理解青少年的超重和肥胖问题。本研究强调了一种常规的初级保健或家长筛查评估，它可以表明青少年男孩和女孩中可能是超重或肥胖先兆的倾向。应开展进一步研究以确定将青少年心理健康筛查纳入初级保健的方法。
