Le Bonheur Children's Hospital, Children's Foundation Research Institute.
Department of Pediatrics, University of Tennessee Health Science Center.
Behav Med. 2020 Apr-Jun;46(2):92-99. doi: 10.1080/08964289.2019.1570073. Epub 2019 Feb 6.
Youth with obesity are more likely than normal-weight peers to experience psychosocial problems. Empirically-based recommendations for addressing pediatric obesity include intensive interdisciplinary weight management comprising medical, behavioral health, nutrition, and exercise components. The present study examined changes in psychosocial functioning associated with frequency of participation in an interdisciplinary pediatric weight management program. Participants were 86 patients (55.8% females; median age = 11.5 years; 67.4% Non-Hispanic Black; median BMI percentile = 99.5) enrolled in an interdisciplinary pediatric weight management program for at least one year. Psychosocial functioning was measured with the Pediatric Symptom Checklist (PSC-17), a caregiver-completed mental health screen that assesses internalizing, externalizing, and attention difficulties as well as global functioning. The PSC-17 was completed at the initial clinic visit (baseline) and repeated one-year later (annual). The Wilcoxon Signed Rank test indicated that annual PSC-17 scores were significantly lower than baseline scores across all domains. Spearman correlation coefficients revealed no significant association between total number of clinic visits and PSC-17 global or subscale scores. However, the number of visits for exercise-only sessions was significantly correlated with caregiver-reported improvement in internalizing behaviors. Findings suggest that participation in interdisciplinary pediatric weight management may improve psychosocial functioning in youth with obesity and that attending supervised exercise sessions may be especially beneficial for improving internalizing behavior symptoms.
肥胖青少年比正常体重的同龄人更有可能经历心理社会问题。基于实证的小儿肥胖症治疗建议包括医疗、行为健康、营养和运动等多学科综合体重管理。本研究考察了参与跨学科小儿体重管理计划的频率与心理社会功能变化之间的关系。参与者为 86 名患者（55.8%为女性；中位数年龄=11.5 岁；67.4%为非西班牙裔黑人；中位数 BMI 百分位数=99.5），他们至少参加了一年的跨学科小儿体重管理计划。采用儿童症状清单（PSC-17）评估心理社会功能，这是一种由照顾者完成的心理健康筛查工具，可评估内化、外化和注意力困难以及整体功能。PSC-17 在初始临床就诊时（基线）和一年后（年度）重复进行。Wilcoxon 符号秩检验表明，所有领域的年度 PSC-17 评分均明显低于基线评分。Spearman 相关系数显示，就诊总次数与 PSC-17 总分或子量表评分之间无显著关联。然而，仅参加运动课程的就诊次数与照顾者报告的内化行为改善显著相关。研究结果表明，参与跨学科小儿体重管理可能会改善肥胖青少年的心理社会功能，而参加监督性运动课程可能特别有益于改善内化行为症状。
