Department of Paediatrics, Sykehuset Innlandet HF Divisjon Lillehammer, Lillehammer, Norway.
Clinic of Child and Adolescent Psychiatry, Otta, Sykehuset Innlandet HF Psykisk Helsevern, Brumunddal, Norway.
BMJ Paediatr Open. 2021 Mar 15;5(1):e000881. doi: 10.1136/bmjpo-2020-000881. eCollection 2021.
To examine if underweight (UW), overweight (OW) or obesity (OB), or body mass index (BMI) expressed as its SD score (BMI SDS), were associated with psychological difficulties in preschool children.
Regional cohort study.
Oppland County, Norway.
At the routine school entry health assessment at 5-6 years of age, parents were invited to participate by local public health nurses. The parents completed questionnaires on sociodemographic, health and lifestyle factors of the child and the family, and on the child's neurocognitive development. They assessed psychological health with the Strengths and Difficulties Questionnaire (SDQ). Public health nurses measured weight and height on all eligible children and reported age, sex, height and weight anonymously for the children who declined to participate.
We obtained information on 1088 of 1895 (57%) eligible children. The proportion of UW, OW and OB was slightly higher among the children who declined.
SDQ subscale and Total Difficulties Scores.
The mean SDQ scores and proportion of scores ≥the 90th percentile had a curvilinear pattern from UW through normal weight (NW), OW and OB with NW as nadir, but the pattern was only significant for the mean Emotional problems, Peer problems and Total SDQ Scales, and for the Total SDQ Score ≥the 90th percentile (TDS90). After adjusting for relevant social, developmental, health and behavioural characteristics, TDS90 was only significantly associated with UW in multiple logistic regression analyses, and only with the lowest quartile of BMI SDS in a linear spline regression analysis.
The study suggests that UW and low BMI, but not OW, OB or higher BMI, are independent risk factors for having psychological symptoms in preschool children.
探讨学龄前儿童体重过轻（UW）、超重（OW）或肥胖（OB）或身体质量指数（BMI）与其 SD 评分（BMI SDS）是否与心理困难有关。
区域队列研究。
挪威奥普兰郡。
在 5-6 岁常规入学健康评估时，当地公共卫生护士邀请家长参与。家长通过问卷完成了关于儿童及其家庭的社会人口统计学、健康和生活方式因素以及儿童神经认知发展的调查。他们使用长处和困难问卷（SDQ）评估心理健康状况。公共卫生护士对所有符合条件的儿童进行体重和身高测量，并匿名报告未参与的儿童的年龄、性别、身高和体重。
我们获得了 1895 名符合条件的儿童中 1088 名（57%）的信息。拒绝参与的儿童中 UW、OW 和 OB 的比例略高。
SDQ 子量表和总困难得分。
SDQ 得分的平均值和≥第 90 百分位数的得分比例呈曲线模式，从 UW 到正常体重（NW）、OW 和 OB，NW 为最低点，但仅对平均情绪问题、同伴问题和总 SDQ 量表以及总 SDQ 得分≥第 90 百分位数（TDS90）具有显著意义。在校正了相关的社会、发育、健康和行为特征后，TDS90 在多项逻辑回归分析中仅与 UW 显著相关，在线性样条回归分析中仅与 BMI SDS 的最低四分位数相关。
该研究表明，UW 和低 BMI 是学龄前儿童出现心理症状的独立危险因素，而 OW、OB 或更高的 BMI 则不是。
