ESRA AKYÜZ ÖZKAN, Ali İrfan GÜL, Zeynep Tuba OZDEMİR, Hasim HUSREVSAHİ, Zehra YILDIRIM, Esra DOMUR, Ummugulsum Aliye GECİT

Evaluation of Depression and Social Anxiety Symptoms in Obese Children

Obez çocuklarda depresyon ve sosyal anksiyete belirtilerinin değerlendirilmesi. Amaç: Bu çalışma ile obez çocuklarda depresyon ve sosyal anksiyete belirtilerinin değerlendirilmesi amaçlanmıştır.Yöntem: Çocukluk Çağı Depresyon Envanteri (ÇÇDE) ve Çocuklar için Sosyal Anksiyete Ölçeği- Gözden Geçirilmiş (ÇESAÖ-GG) 80 obez ve 82 kontrol grubuna uygulanmıştır.Bulgular: Obez grupta 42 erkek ve 38 kız çocuk mevcut olup ortalama yaş 12.48±2.70 yıl (7-17 yıl), ortalama vücut kitle indeksi (VKİ) 27.47±3.72 kg/m2 idi. Kontrol grubunda ise 43 erkek 39 kız çocuk mevcut olup ortalama yaş 12.93±2.32 yıl (9-17 yıl), ortalama VKİ 16.92±5.17 kg/m2 idi. Ortalama sosyal anksiyete skoru obez grupta kontrol grubuna göre daha yüksekti. Ortalama depresyon skoru obezlerde kontrollere göre anlamlı derecede yüksekti. Ortalama depresyon skoru obez kızlarda ve aynı zamanda erkeklerde daha yüksekti. Ortalama sosyal anksiyete skoru obez kızlarda ve erkeklerde kontrol grubuna göre daha yüksekti. Depresyon ve sosyal anksiyete skorları ile VKİ arasında obez erkek ve kızlarda korelasyon bulunamadı. Obez çocukların %21.5'i, kontrol grubunun %14.3'si (ÇÇDE) kesme değerinin üzerinde idi ve istatistiksel olarak anlamlıydı. Obez kızların %15.2'si, obez erkeklerin %10.4'ü kesme değerinin üzerinde idi ve cinsiyetler arasındaki bu fark istatistiksel olarak anlamlı değildi.Tartışma: Depresyon ve sosyal anksiyete belirtileri obez çocuklarda daha yaygındır ve obezite derecesi ile ilişkili değildir. Çocukluk çağı obezitesini önlemek yetişkinlikteki psikiyatrik bozuklukların azaltılmasında her iki cinsiyet için de son derece önemlidir.

Obez çocuklarda depresyon ve sosyal anksiyete belirtilerinin değerlendirilmesi

Evaluation of depression and social anxiety symptoms in obese children. Objective: The present study aimed to assess depression and social anxiety symptoms in obese children.Methods: The Children's Depression Inventory (CDI) and the Social Anxiety Scale for Children - Revised (SASC-R) were administered to 80 obese children and 82 controls.Results: The obese group consisted of 42 male and 38 female children, mean age 12.48±2.70 years (range 7-17 years), mean body mass index (BMI) was 27.47±3.72 kg/m2; controls were 43 male, 39 female children, mean age 12.93±2.32 years (range 9-17 years), mean BMI was 16.92±5.17 kg/m2. Mean social anxiety scores were higher in the obese group than in the control group. Mean depression scores were significantly higher in the obese group than in the control group. The mean depression scores were higher in obese females compared to control females as well as in males. The mean social anxiety scores were higher in obese females than in controls as well as in males. There was no correlation between BMI and depression and social anxiety scores in obese males and females. Among obese childeren 21.5% and among the control group 14.3% had a value of CDI above the cut-off point, and this was statistically significant. Among obese childeren 15.2% of females and 10.4% of males had a value above the cut-off point, but the difference between sexes was not statistically significant.Discussion: Depression and social anxiety symptoms were more common in obese children and did not relate to the degree of obesity. The prevention of childhood obesity is important in both sexes for reducing the risk of psychological disorder in adulthood.

PDF

___

Mirmiran P, Sherafat-Kazemzadeh R, Jalali-Farahani S, Azizi F. Childhood obesity in the Middle East: a review. East Mediterr Health J 2010; 16:1009-1017.
Lobstein T, Frelut ML. Prevalence of overweight among children in Europe. Obes Rev 2003; 4:195-200. [CrossRef]
Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999-2004. JAMA 2006; 295:1549-1555. [CrossRef]
Barlow SE; Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007; 120(Suppl.4):164-192. [CrossRef]
Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. Lancet 2002; 360:473- 482. [CrossRef]
Resch M, Haász P, Sidó Z. Obesity as psychosomatic disease. European Psychiatry 1998; 13(Suppl.4):315. [CrossRef]
Atlantis E, Goldney RD, Wittert GA. Obesity and depression or anxiety. BMJ 2009; 339:b3868. [CrossRef]
Atlantis E, Ball K. Association between weight perception and psychological distress. Int J Obes (Lond) 2008; 32:715-721. [CrossRef]
Simon GE, Von Korff M, Saunders K, Miglioretti DL, Crane PK, van Belle G, Kessler RC. Association between obesity and psychiatric disorders in the US adult population. Arch Gen Psychiatry 2006; 63:824-830. [CrossRef]
Claesson IM, Josefsson A, Sydsjö G. Prevalence of anxiety and depressive symptoms among obese pregnant and postpartum women: an intervention study. BMC Public Health 2010; 10:766. [CrossRef]
Heimberg RG, Liebowitz MR, Hope DA, Schneier FR (editors). Social Phobia: Diagnosis, Assessment and Treatment. New York: The Guilford Press, 1995, 3-20.
Sullivan M, Karlsson J, Sjöström L, Backman L, Bengtsson C, Bouchard C, Dahlgren S, Jonsson E, Larsson B, Lindstedt S. Swedish obese subjects (SOS)--an intervention study of obesity. Baseline evaluation of health and psychosocial functioning in the first 1743 subjects examined. Int J Obes Relat Metab Disord 1993; 17:503-512.
Smith RE, Sarason IG. Social anxiety and the evaluation of negative interpersonal feedback. J Consult Clin Psychol 1975; 43:429. [CrossRef]
Liebowitz MR, Gorman JM, Fyer AJ, Klein DF. Social phobia. Review of a neglected anxiety disorder. Arch Gen Psychiatry 1985; 42:729-736. [CrossRef]
Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, Wei R, Curtin LR, Roche AF, Johnson CL. 2000 CDC Growth Charts for the United States: methods and development. Vital Health Stat 11 2002; 246:1-190.
Kovacs M. Rating scale to assess depression in school aged children. Acta Paedopsychiatr 1981; 46:305-315.
Kovacs M. The Children's Depression Inventory (CDI). Psychopharmacol Bull 1985; 21:995-998.
Oy B. Depression scale for children: The study of validity and reliability. Turk Psikiyatri Derg 1991; 2:132-136.
La Greca AM, Dandes SK, Wick P, Shaw K, Stone WL. Development of the social anxiety scale for children: reliability and concurrent validity. J Clin Child Psychol 1988; 17:84-91. [CrossRef]
La Greca AM, Stone WL. Social anxiety scale for children revised: factor structure and concurrent validity. J Clin Child Psychol 1993; 22:17-27. [CrossRef]
Demir T, Eralp-Demir D, Ozmen E, Uysal O. The validity and reliability of Capa Social Anxiety Scale in Children and Adolescents. Dusunen Adam The Journal of Psychiatry and Neurological Sciences 1999; 12:23-30. (Turkish)
Castelnuovo-Tedesco P, Schievel D. Studies of super obesity: psychological characteristics of superobese patients. Int J Psychiatry Med 1975; 6:465-480. [CrossRef]
Oyekcin DG, Yildiz D, Sahin EM, Gur S. Depression and Anxiety in Obese Patients. Turkish Journal of Endocrinology and Metabolism 2011; 15:121-124.
Eren I, Erdi O. The frequency of psychiatric disorders in obese patients. Journal of Clinical Psychiatry 2003; 6:152-157. (Turkish)
Dallar Y, Erdeve SS, Cakir I, Kostu M. Does obesity lead to depression and self-esteem deficiency in children? Gulhane Medical Journal 2006; 48:1-3. (Turkish)
Esposito M, Gallai B, Roccella M, Marotta R, Lavano F, Lavano SM, Mazzotta G, Bove D, Sorrentino M, Precenzano F, Carotenuto M. Anxiety and depression levels in prepubertal obese children: a case-control study. Neuropsychiatr Dis Treat 2014; 10:1897-1902.
Roohafza H, Kelishadi R, Sadeghi M, Hashemipour M, Pourmoghaddas A, Khani A. Are obese adolescents more depressed? J Educ Health Promot 2014; 3:74.
Rofey DL, Kolko RP, Iosif AM, Silk JS, Bost JE, Feng W, Szigethy EM, Noll RB, Ryan ND, Dahl RE. A longitudinal study of childhood depression and anxiety in relation to weight gain. Child Psychiatry Hum Dev 2009; 40:517-526. [CrossRef]
Mustillo S, Worthman C, Erkanli A, Keeler G, Angold A, Costello EJ. Obesity and psychiatric disorder: developmental trajectories. Pediatrics 2003; 111(4 Pt 1):851-859. [CrossRef]
Stunkard AJ, Stinnett JL, Smoller JW. Psychological and social aspects of the surgical treatment of obesity. Am J Psychiatry 1986; 143:417-429. [CrossRef]
Price RA, Cadoret RJ, Stunkard AJ, Troughton E. Genetic contributions to human fatness: an adoption study. Am J Psychiatry 1987; 144:1003-1008. [CrossRef]
Canetti L, Bachar E, Berry EM. Food and emotion. Behav Processes 2002; 60:157-164. [CrossRef]
Kaplan HI, Kaplan HS. The psychosomatic concept of obesity. J Nerv Ment Dis 1957; 125:181-201.
Wurtman RJ, Wurtman JJ. Brain serotonin, carbohydrate-craving, obesity and depression. Obes Res 1995; 3(Suppl.4):477-480. [CrossRef]
Istvan J, Zavela K, Weidner G. Body weight and psychological distress in NHANES I. Int J Obes Relat Metab Disord 1992; 16:999-1003.
Faith MS, Matz PE, Jorge MA. Obesity-depression associations in the population. J Psychosom Res 2002; 53:935-942. [CrossRef]
Carpenter KM, Hasin DS, Allison DB, Faith MS. Relationships between obesity and DSM-IV major depressive disorder, suicide ideation, and suicide attempts: results from a general population study. Am J Public Health 2000; 90:251-257. [CrossRef]
Anderson SE, Cohen P, Naumova EN, Jacques PF, Must A. Adolescent obesity and risk for subsequent major depressive disorder and anxiety disorder: prospective evidence. Psychosom Med 2007; 69:740-747. [CrossRef]
Jorm AF, Korten AE, Christensen H, Jacomb PA, Rodgers B, Parslow RA. Association of obesity with anxiety, depression and emotional well-being: a community survey. Aust N Z J Public Health 2003; 27:434-440. [CrossRef]