Dellenmark-Blom Maria, Järvholm Kajsa, Sjögren Lovisa, Levinsson Anna, Dahlgren Jovanna
Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Psychology, Lund University, Lund, Sweden.
Front Psychiatry. 2024 Aug 19;15:1332598. doi: 10.3389/fpsyt.2024.1332598. eCollection 2024.
Neurodevelopmental disorders (NDD), psychiatric comorbidity and cognitive deficits are commonly seen in children with obesity; however, little is known about the overlap between these conditions. This study aimed to examine the undiagnosed and diagnosed frequency of NDDs and explore its association with psychiatric conditions and general intellectual ability (IQ) in children presenting for obesity treatment.
In this observational study at two outpatient obesity clinics during 2018-2019, 80 children (8-17 years) were consecutively recruited, and screened for NDD unless already diagnosed with an NDD. A psychiatric unit evaluated children who screened positive for NDD. Diagnoses and clinical background factors were collected from medical records. IQ was assessed with the Weschler Intelligence Scales and internalizing symptoms were assessed using the Beck Youth Inventories. Associations between background factors, IQ and internalizing symptoms were explored in relation to having an NDD or not.
We found that 47/80 children had at least one NDD. Children with a diagnosed NDD before study start (n = 30) had significantly more comorbidities than children diagnosed after the study screening (n = 17) ( = .01). Greater cognitive impairment was seen in children with NDD compared with children without an NDD ( = .01). Also, 33/73 participants self-reported substantial internalizing symptoms. At follow-up, 21/79 participants, in addition to NDD, had been diagnosed with another psychiatric disorder. Ten of these were children that had been diagnosed with an NDD before study start.
The overlap between NDD, cognitive deficits and psychiatric conditions in children with obesity is an important consideration for clinical practice. Screening for these conditions may be necessary when providing targeted interventions.
神经发育障碍（NDD）、精神共病和认知缺陷在肥胖儿童中很常见；然而，对于这些情况之间的重叠知之甚少。本研究旨在检查肥胖治疗门诊儿童中未诊断和已诊断的NDD发生率，并探讨其与精神疾病状况和一般智力（智商）的关联。
在2018 - 2019年期间于两家门诊肥胖诊所进行的这项观察性研究中，连续招募了80名儿童（8 - 17岁），除非已被诊断患有NDD，否则均进行NDD筛查。一个精神科单元对NDD筛查呈阳性的儿童进行评估。从病历中收集诊断和临床背景因素。使用韦氏智力量表评估智商，使用贝克青少年量表评估内化症状。探讨背景因素、智商和内化症状与是否患有NDD之间的关联。
我们发现47/80名儿童至少患有一种NDD。研究开始前已诊断患有NDD的儿童（n = 30）比研究筛查后诊断出的儿童（n = 17）有更多的共病（P = 0.01）。与没有NDD的儿童相比，患有NDD的儿童认知障碍更严重（P = 0.01）。此外，73名参与者中有33名自我报告有明显的内化症状。在随访中，79名参与者中有21名除NDD外还被诊断患有另一种精神障碍。其中10名是在研究开始前就已被诊断患有NDD的儿童。
肥胖儿童中NDD、认知缺陷和精神疾病状况之间的重叠是临床实践中需要重要考虑的因素。在提供有针对性的干预措施时，可能有必要对这些情况进行筛查。
