Shameem Sana, Luft Megan, Harrington Michael, Nahhas Ramzi W, Hatesohl Michael, Gentile Julie, Gainer Danielle
Boonshoft School of Medicine, Wright State University, Dayton, OH, USA.
Department of Psychiatry, Wright State University, Dayton, OH, USA.
J Autism Dev Disord. 2024 Jun 22. doi: 10.1007/s10803-024-06432-0.
Co-occurring intellectual/developmental disability (IDD) and overweight/obesity (OW/OB) is an important consideration of IDD psychiatric care. The relationship between OW/OB and comorbid diagnoses of Autism Spectrum Disorder (ASD) and/or IDD remains inadequately described in existing literature. The purpose of this study is to explore these co-occurring diagnoses. Improved understanding of associated comorbidities can guide clinicians toward interventions to minimize complications associated with OW/OB. We conducted a retrospective review of adult patients of a telepsychiatry clinic with IDD or ASD defined by DSM-5. ICD-10 diagnosis of IDD or ASD, demographics, BMI, comorbidities, and current medications were recorded. Binary logistic regression was used to estimate associations between each predictor and the outcomes overweight (body mass index (BMI) ≥ 25 kg/m) and obesity (BMI ≥ 30 kg/m). Prevalence of obesity in these 412 adults was 52.4% (95% CI 47.5, 57.3). There was a significant inverse relationship between IDD severity and the odds of each outcome (p < .001). 80.3% of patients were being actively treated with an antidepressant. Patients taking an antidepressant had twice the odds of obesity (adjusted OR 2.03, 95% CI 1.23, 3.41, p = .006). These findings provide a sense of urgency for prevention of OW/OB and its associated medical sequelae. Prevalence of obesity was higher in this sample compared to the general population. The inverse relationship between IDD severity and OW/OB warrants further research examining age, caregiver involvement, and access to care as potential modifiers.
智力/发育障碍（IDD）与超重/肥胖（OW/OB）并存是IDD精神科护理的一个重要考量因素。现有文献对OW/OB与自闭症谱系障碍（ASD）和/或IDD共病诊断之间的关系描述仍不充分。本研究的目的是探讨这些并存诊断。更好地了解相关共病情况可指导临床医生采取干预措施，以尽量减少与OW/OB相关的并发症。我们对一家远程精神病诊所符合《精神疾病诊断与统计手册》第5版（DSM-5）定义的IDD或ASD成年患者进行了回顾性研究。记录了国际疾病分类第10版（ICD-10）对IDD或ASD 的诊断、人口统计学特征、体重指数（BMI）、共病情况和当前用药情况。采用二元逻辑回归来估计每个预测因素与超重（体重指数（BMI）≥25 kg/m²）和肥胖（BMI≥30 kg/m²）结局之间的关联。这412名成年人中肥胖的患病率为52.4%（95%置信区间47.5, 57.3）。IDD严重程度与每个结局的几率之间存在显著的负相关关系（p < 0.001）。80.3%的患者正在接受抗抑郁药积极治疗。服用抗抑郁药的患者肥胖几率是未服用者的两倍（调整后的比值比为2.03，95%置信区间1.23, 3.41，p = 0.006）。这些发现为预防OW/OB及其相关的医学后遗症提供了紧迫感。与一般人群相比，该样本中肥胖的患病率更高。IDD严重程度与OW/OB之间的负相关关系值得进一步研究，以考察年龄、照顾者参与情况和获得医疗服务的机会作为潜在调节因素。
