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Anxiety and depression in children and adolescents with obesity: a nationwide study in Sweden.
BMC Medicine ( IF 9.3 ) Pub Date : 2020-02-21 , DOI: 10.1186/s12916-020-1498-z
Louise Lindberg 1 , Emilia Hagman 1 , Pernilla Danielsson 1 , Claude Marcus 1 , Martina Persson 2, 3, 4
Affiliation  

BACKGROUND Anxiety and depression are more common in children with obesity than in children of normal weight, but it is unclear whether this association is independent of other known risk factors. Interpretation of results from previous studies is hampered by methodological limitations, including self-reported assessment of anxiety, depression, and anthropometry. The aim of this study was to investigate whether obesity increases the risk of anxiety or depression independently of other risk factors in a large cohort of children and adolescents, using robust measures with regard to exposure and outcome. METHODS Children aged 6-17 years in the Swedish Childhood Obesity Treatment Register (BORIS, 2005-2015) were included (n = 12,507) and compared with a matched group (sex, year of birth, and area of residence) from the general population (n = 60,063). The main outcome was a diagnosis of anxiety or depression identified through ICD codes or dispensed prescribed medication within 3 years after the end of obesity treatment. Hazard ratios (HRs) with 95% confidence intervals (CIs) from Cox proportional models were adjusted for several known confounders. RESULTS Obesity remained a significant risk factor for anxiety and depression in children and adolescents after adjusting for Nordic background, neuropsychiatric disorders, family history of anxiety/depression, and socioeconomic status. Girls in the obesity cohort had a 43% higher risk of anxiety and depression compared to girls in the general population (adjusted HR 1.43, 95% CI 1.31-1.57; p < 0.0001). The risk in boys with obesity was similar (adjusted HR 1.33, 95% CI 1.20-1.48; p < 0.0001). In sensitivity analyses, excluding subjects with neuropsychiatric disorders and a family history of anxiety/depression, the estimated risks in individuals with obesity were even higher compared with results from the main analyses (adjusted HR [95% CI]: girls = 1.56 [1.31-1.87], boys = 2.04 [1.64-2.54]). CONCLUSIONS Results from this study support the hypothesis that obesity per se is associated with risk of both anxiety and depression in children and adolescents.

中文翻译:

肥胖儿童和青少年的焦虑和抑郁:瑞典的一项全国研究。

背景技术与正常体重的儿童相比,肥胖儿童的焦虑和抑郁更为普遍,但尚不清楚这种关联是否独立于其他已知的危险因素。方法学的局限性阻碍了以往研究结果的解释,包括自我报告的对焦虑,抑郁和人体测量学的评估。这项研究的目的是使用针对暴露和结局的有效措施,调查肥胖是否增加了一大批儿童和青少年的焦虑或抑郁风险,而与其他风险因素无关。方法纳入瑞典儿童肥胖治疗登记册(BORIS,2005-2015年)中的6-17岁儿童(n = 12,507),并与普通人群中的匹配人群(性别,出生年份和居住地区)进行比较。 (n = 60063)。主要结果是在肥胖症治疗结束后的三年内,通过ICD法规或已分配的处方药诊断出焦虑或抑郁。针对多个已知的混杂因素,对来自Cox比例模型的具有95%置信区间(CI)的危险比(HR)进行了调整。结果在调整了北欧背景,神经精神疾病,焦虑/抑郁的家族病史和社会经济状况之后,肥胖仍然是儿童和青少年焦虑和抑郁的重要危险因素。与普通人群中的女孩相比,肥胖人群中的女孩患焦虑和抑郁的风险高43%(校正后的HR 1.43,95%CI 1.31-1.57; p <0.0001)。肥胖男孩的风险相似(校正后的HR 1.33,95%CI 1.20-1.48; p <0.0001)。在敏感性分析中,排除患有神经精神疾病和焦虑/抑郁症家族史的受试者,与主要分析结果相比,肥胖个体的估计风险甚至更高(校正后的HR [95%CI]:女孩= 1.56 [1.31-1.87],男孩= 2.04 [1.64-2.54])。结论这项研究的结果支持以下假设:肥胖本身与儿童和青少年的焦虑和抑郁风险相关。
更新日期:2020-02-21
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