Body Mass Index Status across Different Psychiatric Disorders in a National Survey amongst Children and Adolescents: To Identify the Role of Gender
,
Abstract
Objective: Body mass index undergoes a substantial change in some psychiatric disorders. This study aimed to explore the status of body mass index (BMI) in different psychiatric disorders in a national survey among children and adolescents and to identify the role of gender in this regard.
Method: A total of 30 532 children and adolescents were randomly selected using cluster sampling method with equal blocks of 3 age groups and 2 genders. Psychiatric disorders were assessed using a standardized face-to-face diagnostic interview of Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (KSADS-PL), and Body Mass Index (BMI) was measured for each participant.
Results: In this study, 22 730 children and adolescents (109 46 boys and 11784 girls), with valid data of BMI, completed the KSADS-PL interview. The prevalence of psychiatric disorders was 21.2% among underweight participants, 22.8% among overweight participants, and 22.2% among obese participants, which was significantly higher than normal weight participants with 19.6% (X2 = 17.55; p = 0.001). In boys’ subgroup, depression and separation anxiety were mostly seen among the underweight category, while tic disorder was mostly seen in the obese category. In girls’ subgroup, on the other hand, generalized anxiety was mostly observed in the underweight category, while oppositional defiant disorder (ODD), depression, and mental retardation were mostly observed in the obese category. In total, the highest mean BMI rates were among the children and adolescents with alcohol abuse disorder, mania, and panic disorder. However, the lowest BMI rates were among those with attention deficit hyperactivity disorder (ADHD), separation anxiety disorder (SAD), and enuresis.
Conclusion: This study gives an overall picture of BMI status in different psychiatric disorders according to gender. Furthermore, in a multidisciplinary approach, the results of this study drew the attention of child psychiatrists to the status of BMI in their clients.
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3. DALYs GBD, Collaborators H. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1603-58.
4. Hassanzadeh J, Mohammadbeigi A, Eshrati B, Moemenbellah-Fard MD. Estimation of the regional burden of non-communicable diseases due to obesity and overweight in Markazi province, Iran, 2006-2007. J Cardiovasc Dis Res. 2012; 3(1): 26–31.
5. Collaborators GBDO, Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med. 2017;377(1):13-27.
6. Weihrauch-Bluher S, Schwarz P, Klusmann JH. Childhood obesity: increased risk for cardiometabolic disease and cancer in adulthood. Metabolism: clinical and experimental. Metabolism. 2019;92:147-52.
7. Hert MD, Dekker JM, Wood D, Kahl KG, Moller HJ. Cardiovascular disease and diabetes in people with severe mental illness. Rev Psiquiatr Salud Ment. 2009;2(1):49-59
8. Field AE, Coakley EH, Must A, Spadano JL, Laird N, Dietz WH, et al. Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med. 2001 ;161(13):1581-6.
9. Simon GE, Von Korff M, Saunders K, Miglioretti DL, Crane PK, van Belle G, et al. Association between obesity and psychiatric disorders in the US adult population. Arch Gen Psychiatry. 2006;63(7):824-30.
10. Hasler G, Lissek S, Ajdacic V, Milos G, Gamma A, Eich D, et al. Major depression predicts an increase in long-term body weight variability in young adults. Obes Res. 2005;13(11):1991-8.
11. Zhou Q, Wang T, Basu K. Negative association between BMI and depressive symptoms in middle aged and elderly Chinese: Results from a national household survey. Psychiatry Res. 2018;269:571-578.
12. Mannan M, Mamun A, Doi S, Clavarino A. Prospective Associations between Depression and Obesity for Adolescent Males and Females- A Systematic Review and Meta-Analysis of Longitudinal Studies. PLoS One. 2016;11(6):e0157240.
13. Mohammadi MR, Khaleghi A, Mostafavi SA, Ahmadi N, Kamali K, Hooshyari Z, et al. Gender Determines the Pattern of Correlation between Body Mass Index and Major Depressive Disorder among Children and Adolescents: Results from Iranian Children and Adolescents' Psychiatric Disorders Study. Child Obes. 2019;15(5):331-7.
14. Darby A, Hay P, Mond J, Quirk F, Buttner P, Kennedy L. The rising prevalence of comorbid obesity and eating disorder behaviors from 1995 to 2005. Int J Eat Disord. 2009;42(2):104-8.
15. McCarty CA, Kosterman R, Mason WA, McCauley E, Hawkins JD, Herrenkohl TI, et al. Longitudinal associations among depression, obesity and alcohol use disorders in young adulthood. General hospital psychiatry. Gen Hosp Psychiatry. 2009;31(5):442-50.
16. Cortese S, Faraone SV, Bernardi S, Wang S, Blanco C. Adult attention-deficit hyperactivity disorder and obesity: epidemiological study. T Br J Psychiatry. 2013; 203(1): 24–34.
17. Rajan TM, Menon V. Psychiatric disorders and obesity: A review of association studies. J Postgrad Med. 2017; 63(3): 182–190.
18. Mohammadi MR, Ahmadi N, Khaleghi A, Mostafavi SA, Kamali K, Rahgozar M, et al. Prevalence and Correlates of Psychiatric Disorders in a National Survey of Iranian Children and Adolescents. Iran J Psychiatry. 2019; 14(1): 1–15.
19. Ghanizadeh A, Mohammadi MR, Yazdanshenas A. Psychometric properties of the Farsi translation of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. BMC Psychiatry. 2006;6:10.
20. Mohammadi MR, Mostafavi SA, Hooshyari Z, Khaleghi A, Ahmadi N, Kamali K, et al. National Growth Charts for BMI among Iranian Children and Adolescents in Comparison with the WHO and CDC Curves. Childhood Obesity. 2019; http://doi.org/10.1089/chi.2019.0107, Online Ahead of Print:October 10, 2019
21. Vila G, Zipper E, Dabbas M, Bertrand C, Robert JJ, Ricour C, et al. Mental disorders in obese children and adolescents. Psychosom Med. 2004;66(3):387-94.
22. Rankin J, Matthews L, Cobley S, Han A, Sanders R, Wiltshire HD, et al. Psychological consequences of childhood obesity: psychiatric comorbidity and prevention. Adolesc Health Med Ther. 2016;7:125-46.
23. de Wit LM, van Straten A, van Herten M, Penninx BW, Cuijpers P. Depression and body mass index, a u-shaped association. BMC Public Health. 2009;9:14.
24. de Wit L, Luppino F, van Straten A, Penninx B, Zitman F, Cuijpers P. Depression and obesity: a meta-analysis of community-based studies. Psychiatry research. Psychiatry Res. 2010;178(2):230-5.
25. Rofey DL, Kolko RP, Iosif AM, Silk JS, Bost JE, Feng W, et al. A longitudinal study of childhood depression and anxiety in relation to weight gain. Child Psychiatry Hum Dev. 2009;40(4):517-26
26. Burke NL, Storch EA. A meta-analysis of weight status and anxiety in children and adolescents. J Dev Behav Pediatr. 2015;36(3):133-45.
27. Degrauw RS, Li JZ, Gilbert DL. Body mass index changes and chronic neuroleptic drug treatment for Tourette syndrome. Pediatr Neurol. 2009;41(3):183-6.
28. Vagstrand K, Barkeling B, Forslund HB, Elfhag K, Linne Y, Rossner S, et al. Eating habits in relation to body fatness and gender in adolescents--results from the 'SWEDES' study. Eur J Clin Nutr. 2007;61(4):517-25.
29. Fuglestad AJ, Boys CJ, Chang PN, Miller BS, Eckerle JK, Deling L, et al. Overweight and obesity among children and adolescents with fetal alcohol spectrum disorders. Alcohol Clin Exp Res. 2014;38(9):2502-8.
30. Rojdmark S, Calissendorff J, Brismar K. Alcohol ingestion decreases both diurnal and nocturnal secretion of leptin in healthy individuals. Clin Endocrinol (Oxf). 2001;55(5):639-47.
31. Koob GF. A role for GABA mechanisms in the motivational effects of alcohol. Biochemical pharmacology. Biochem Pharmacol. 2004;68(8):1515-25.
32. Yeomans MR, Gray RW. Opioid peptides and the control of human ingestive behaviour. Neurosci Biobehav Rev. 2002;26(6):713-28.
33. Mostafavi SA, Solhi M, Mohammadi MR, Akhondzadeh S. Melatonin for Reducing Weight Gain Following Administration of Atypical Antipsychotic Olanzapine for Adolescents with Bipolar Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial. J Child Adolesc Psychopharmacol. 2017 Jun;27(5):440-4.
34. Fleet-Michaliszyn SB, Soreca I, Otto AD, Jakicic JM, Fagiolini A, Kupfer DJ, et al. A prospective observational study of obesity, body composition, and insulin resistance in 18 women with bipolar disorder and 17 matched control subjects. J Clin Psychiatry. 2008; 69(12): 1892–1900.
35. Goldstein BI, Liu SM, Zivkovic N, Schaffer A, Chien LC, Blanco C. The burden of obesity among adults with bipolar disorder in the United States. Bipolar Disord. 2011;13(4):387-95.
36. Reilly-Harrington NA, Feig EH, Huffman JC. Bipolar Disorder and Obesity: Contributing Factors, Impact on Clinical Course, and the Role of Bariatric Surgery. Curr Obes Rep. 2018;7(4):294-300.
37. Lykouras L, Michopoulos J. Anxiety disorders and obesity. Psychiatriki. 2011;22(4):307-13.
38. Pagoto SL, Schneider KL, Bodenlos JS, Appelhans BM, Whited MC, Ma Y, et al. Association of post-traumatic stress disorder and obesity in a nationally representative sample. Obesity (Silver Spring). 2012;20(1):200-5.
39. Cortese S, Vincenzi B. Obesity and ADHD: clinical and neurobiological implications. Curr Top Behav Neurosci. 2012;9:199-218.
40. Mostafavi SA, Mohammadi MR, Hosseinzadeh P, Eshraghian MR, Akhondzadeh S, Hosseinzadeh-Attar MJ, et al. Dietary intake, growth and development of children with ADHD in a randomized clinical trial of Ritalin and Melatonin co-administration: Through circadian cycle modification or appetite enhancement? Iran J Psychiatry. 2012;7(3):114-9.
41. Mohammadi MR, Mostafavi SA, Keshavarz SA, Eshraghian MR, Hosseinzadeh P, Hosseinzadeh-Attar MJ, et al. Melatonin effects in methylphenidate treated children with attention deficit hyperactivity disorder: a randomized double blind clinical trial. Iran J Psychiatry. 2012; 7(2): 87–92.
42. Diez-Suarez A, Vallejo-Valdivielso M, Marin-Mendez JJ, de Castro-Manglano P, Soutullo CA. Weight, Height, and Body Mass Index in Patients with Attention-Deficit/Hyperactivity Disorder Treated with Methylphenidate. J Child Adolesc Psychopharmacol. 2017;27(8):723-30.
2. Rehm J, Shield KD. Global Burden of Disease and the Impact of Mental and Addictive Disorders. Current psychiatry reports. 2019;21(2):10.
3. DALYs GBD, Collaborators H. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1603-58.
4. Hassanzadeh J, Mohammadbeigi A, Eshrati B, Moemenbellah-Fard MD. Estimation of the regional burden of non-communicable diseases due to obesity and overweight in Markazi province, Iran, 2006-2007. J Cardiovasc Dis Res. 2012; 3(1): 26–31.
5. Collaborators GBDO, Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med. 2017;377(1):13-27.
6. Weihrauch-Bluher S, Schwarz P, Klusmann JH. Childhood obesity: increased risk for cardiometabolic disease and cancer in adulthood. Metabolism: clinical and experimental. Metabolism. 2019;92:147-52.
7. Hert MD, Dekker JM, Wood D, Kahl KG, Moller HJ. Cardiovascular disease and diabetes in people with severe mental illness. Rev Psiquiatr Salud Ment. 2009;2(1):49-59
8. Field AE, Coakley EH, Must A, Spadano JL, Laird N, Dietz WH, et al. Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med. 2001 ;161(13):1581-6.
9. Simon GE, Von Korff M, Saunders K, Miglioretti DL, Crane PK, van Belle G, et al. Association between obesity and psychiatric disorders in the US adult population. Arch Gen Psychiatry. 2006;63(7):824-30.
10. Hasler G, Lissek S, Ajdacic V, Milos G, Gamma A, Eich D, et al. Major depression predicts an increase in long-term body weight variability in young adults. Obes Res. 2005;13(11):1991-8.
11. Zhou Q, Wang T, Basu K. Negative association between BMI and depressive symptoms in middle aged and elderly Chinese: Results from a national household survey. Psychiatry Res. 2018;269:571-578.
12. Mannan M, Mamun A, Doi S, Clavarino A. Prospective Associations between Depression and Obesity for Adolescent Males and Females- A Systematic Review and Meta-Analysis of Longitudinal Studies. PLoS One. 2016;11(6):e0157240.
13. Mohammadi MR, Khaleghi A, Mostafavi SA, Ahmadi N, Kamali K, Hooshyari Z, et al. Gender Determines the Pattern of Correlation between Body Mass Index and Major Depressive Disorder among Children and Adolescents: Results from Iranian Children and Adolescents' Psychiatric Disorders Study. Child Obes. 2019;15(5):331-7.
14. Darby A, Hay P, Mond J, Quirk F, Buttner P, Kennedy L. The rising prevalence of comorbid obesity and eating disorder behaviors from 1995 to 2005. Int J Eat Disord. 2009;42(2):104-8.
15. McCarty CA, Kosterman R, Mason WA, McCauley E, Hawkins JD, Herrenkohl TI, et al. Longitudinal associations among depression, obesity and alcohol use disorders in young adulthood. General hospital psychiatry. Gen Hosp Psychiatry. 2009;31(5):442-50.
16. Cortese S, Faraone SV, Bernardi S, Wang S, Blanco C. Adult attention-deficit hyperactivity disorder and obesity: epidemiological study. T Br J Psychiatry. 2013; 203(1): 24–34.
17. Rajan TM, Menon V. Psychiatric disorders and obesity: A review of association studies. J Postgrad Med. 2017; 63(3): 182–190.
18. Mohammadi MR, Ahmadi N, Khaleghi A, Mostafavi SA, Kamali K, Rahgozar M, et al. Prevalence and Correlates of Psychiatric Disorders in a National Survey of Iranian Children and Adolescents. Iran J Psychiatry. 2019; 14(1): 1–15.
19. Ghanizadeh A, Mohammadi MR, Yazdanshenas A. Psychometric properties of the Farsi translation of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. BMC Psychiatry. 2006;6:10.
20. Mohammadi MR, Mostafavi SA, Hooshyari Z, Khaleghi A, Ahmadi N, Kamali K, et al. National Growth Charts for BMI among Iranian Children and Adolescents in Comparison with the WHO and CDC Curves. Childhood Obesity. 2019; http://doi.org/10.1089/chi.2019.0107, Online Ahead of Print:October 10, 2019
21. Vila G, Zipper E, Dabbas M, Bertrand C, Robert JJ, Ricour C, et al. Mental disorders in obese children and adolescents. Psychosom Med. 2004;66(3):387-94.
22. Rankin J, Matthews L, Cobley S, Han A, Sanders R, Wiltshire HD, et al. Psychological consequences of childhood obesity: psychiatric comorbidity and prevention. Adolesc Health Med Ther. 2016;7:125-46.
23. de Wit LM, van Straten A, van Herten M, Penninx BW, Cuijpers P. Depression and body mass index, a u-shaped association. BMC Public Health. 2009;9:14.
24. de Wit L, Luppino F, van Straten A, Penninx B, Zitman F, Cuijpers P. Depression and obesity: a meta-analysis of community-based studies. Psychiatry research. Psychiatry Res. 2010;178(2):230-5.
25. Rofey DL, Kolko RP, Iosif AM, Silk JS, Bost JE, Feng W, et al. A longitudinal study of childhood depression and anxiety in relation to weight gain. Child Psychiatry Hum Dev. 2009;40(4):517-26
26. Burke NL, Storch EA. A meta-analysis of weight status and anxiety in children and adolescents. J Dev Behav Pediatr. 2015;36(3):133-45.
27. Degrauw RS, Li JZ, Gilbert DL. Body mass index changes and chronic neuroleptic drug treatment for Tourette syndrome. Pediatr Neurol. 2009;41(3):183-6.
28. Vagstrand K, Barkeling B, Forslund HB, Elfhag K, Linne Y, Rossner S, et al. Eating habits in relation to body fatness and gender in adolescents--results from the 'SWEDES' study. Eur J Clin Nutr. 2007;61(4):517-25.
29. Fuglestad AJ, Boys CJ, Chang PN, Miller BS, Eckerle JK, Deling L, et al. Overweight and obesity among children and adolescents with fetal alcohol spectrum disorders. Alcohol Clin Exp Res. 2014;38(9):2502-8.
30. Rojdmark S, Calissendorff J, Brismar K. Alcohol ingestion decreases both diurnal and nocturnal secretion of leptin in healthy individuals. Clin Endocrinol (Oxf). 2001;55(5):639-47.
31. Koob GF. A role for GABA mechanisms in the motivational effects of alcohol. Biochemical pharmacology. Biochem Pharmacol. 2004;68(8):1515-25.
32. Yeomans MR, Gray RW. Opioid peptides and the control of human ingestive behaviour. Neurosci Biobehav Rev. 2002;26(6):713-28.
33. Mostafavi SA, Solhi M, Mohammadi MR, Akhondzadeh S. Melatonin for Reducing Weight Gain Following Administration of Atypical Antipsychotic Olanzapine for Adolescents with Bipolar Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial. J Child Adolesc Psychopharmacol. 2017 Jun;27(5):440-4.
34. Fleet-Michaliszyn SB, Soreca I, Otto AD, Jakicic JM, Fagiolini A, Kupfer DJ, et al. A prospective observational study of obesity, body composition, and insulin resistance in 18 women with bipolar disorder and 17 matched control subjects. J Clin Psychiatry. 2008; 69(12): 1892–1900.
35. Goldstein BI, Liu SM, Zivkovic N, Schaffer A, Chien LC, Blanco C. The burden of obesity among adults with bipolar disorder in the United States. Bipolar Disord. 2011;13(4):387-95.
36. Reilly-Harrington NA, Feig EH, Huffman JC. Bipolar Disorder and Obesity: Contributing Factors, Impact on Clinical Course, and the Role of Bariatric Surgery. Curr Obes Rep. 2018;7(4):294-300.
37. Lykouras L, Michopoulos J. Anxiety disorders and obesity. Psychiatriki. 2011;22(4):307-13.
38. Pagoto SL, Schneider KL, Bodenlos JS, Appelhans BM, Whited MC, Ma Y, et al. Association of post-traumatic stress disorder and obesity in a nationally representative sample. Obesity (Silver Spring). 2012;20(1):200-5.
39. Cortese S, Vincenzi B. Obesity and ADHD: clinical and neurobiological implications. Curr Top Behav Neurosci. 2012;9:199-218.
40. Mostafavi SA, Mohammadi MR, Hosseinzadeh P, Eshraghian MR, Akhondzadeh S, Hosseinzadeh-Attar MJ, et al. Dietary intake, growth and development of children with ADHD in a randomized clinical trial of Ritalin and Melatonin co-administration: Through circadian cycle modification or appetite enhancement? Iran J Psychiatry. 2012;7(3):114-9.
41. Mohammadi MR, Mostafavi SA, Keshavarz SA, Eshraghian MR, Hosseinzadeh P, Hosseinzadeh-Attar MJ, et al. Melatonin effects in methylphenidate treated children with attention deficit hyperactivity disorder: a randomized double blind clinical trial. Iran J Psychiatry. 2012; 7(2): 87–92.
42. Diez-Suarez A, Vallejo-Valdivielso M, Marin-Mendez JJ, de Castro-Manglano P, Soutullo CA. Weight, Height, and Body Mass Index in Patients with Attention-Deficit/Hyperactivity Disorder Treated with Methylphenidate. J Child Adolesc Psychopharmacol. 2017;27(8):723-30.
| Files | ||
| Issue | Vol 14 No 4 (2019) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v14i4.1975 | |
| Keywords | ||
| Adolescent Body Mass Inde Child Gender Psychiatric Disorder | ||
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How to Cite
1.
Mohammadi MR, Mostafavi S-A, Hooshyari Z, Khaleghi A, Ahmadi N. Body Mass Index Status across Different Psychiatric Disorders in a National Survey amongst Children and Adolescents: To Identify the Role of Gender. Iran J Psychiatry. 2019;14(4):253-264.
