Are Obese Adolescents and Young Adults at Higher Risk for Mental Disorders? A Community Survey

Abstract

LAMERTZ, CHRISTINA M., CORINNA JACOBI, ALEXANDER YASSOURIDIS, KLAUS ARNOLD, AND ANDREAS W. HENKEL. Are obese adolescents and young adults at higher risk for mental disorders? A community survey. Obes Res. 2002;10:1152-1160. Objective: Associations between body mass index (BMI) and mental disorders meeting Axis-I diagnoses according to the Diagnostic and Statistical Manual for Mental Disorders IV (DSM-IV) were investigated in The Early Developmental Stages of Psychopathology Study in a large populationbased sample, which included adolescents and young adults of both genders for the first time. Research Methods and Procedures:A total of 3021 German subjects ranging from 14 to 24 years of age were assessed for specific DSM-IV diagnoses derived from a modified version of the standardized Composite International Diagnostic Interview, and general psychological disturbances, using the Symptom Checklist-90-Revised. BMI percentiles for age and gender were calculated to avoid systematic bias in the BMI distribution resulting from the young age range represented in the sample. Additionally, subjects with a lifetime diagnosis of any eating disorder were excluded from statistical analysis to control the confounding effect of body weight-related eating disorders on associations between BMI and psychopathology. Results:The results based on logistic regression analyses and MANOVAs demonstrate that the BMI is not associated with mental disorders or general psychopathologies. There were no significant associations between BMI and mood, anxiety, substance, and somatoform disorders, a result that contrasts with almost all previous clinical studies. Additionally, in contrast to clinical investigations and most epidemiological studies, neither obesity nor underweight was significantly associated with any kind of general psychopathology. Discussion: The overall finding that obesity is not significantly related to marked psychopathology in the general German population of adolescents and young adults has important clinical implications.

Mental disorders in patients with obesity in comparison with healthy probands

“…26 There is evidence for an increased prevalence rate of mental disorders, in particular depression, in treatmentseeking obese patients, whereas the findings concerning Mental disorders in patients with obesity in comparison with healthy probands H Baumeister and M Härter obese individuals from community samples are, as yet, inconsistent. [7][8][9][10][11][12][13][14]27 Obese individuals show a high current (4-week), 12-month and lifetime prevalence rate of comorbid mental disorders, irrespective of the underlying setting. In comparison with physically healthy probands, prevalence rates of obese individuals are significantly increased.…”

“…Of eight recent epidemiological studies, six found increased prevalence rates of mental disorders, [7][8][9][10][11][12] whereas two did not. 13,14 However, despite their strengths, these studies have several shortcomings, which restrict their results. First, half of the studies focus solely on depression.…”

“…[7][8][9]11,12 Two of the remaining studies are restricted to adolescents and young adults, and only used small sample sizes of obese individuals. 10,14 The only study to focus on more than one disorder, comprising a representative sample of adults aged 18-64 years, reported cross-tab calculations instead of prevalence rates. 13 Second, prevalence rates of comorbid mental disorders are not based on national representative surveys in any of the studies, with the exception of those by Carpenter and co-workers 7 and Heo et al 11 To date, there is no study reporting prevalence rates of major categories of mental disorders in obese individuals on the basis of a representative national survey of an adult population.…”

Psychiatric disorders and symptom severity in referred versus non-referred overweight children and adolescents

“…Vila et al [46] interviewed 155 referred obese youngsters (5-17 years) using the K-SADS-R and demonstrated current mental disorders in 56.77% of the sample. On the other hand, Lamertz and colleagues [27] found considerably lower prevalence rates. From a large-scale community survey on mental disorders in youth, the authors picked out all participants (14-17 years) with a BMI above 95th percentile (n = 86) and demonstrated life-time psychiatric disorders to be equal in overweight and normal weight youth (38.80% versus 39.65%).…”

“…Unfortunately, in the study by Vila et al [46] eating disorders were not included. Lamertz et al [27] diagnosed eating disorders in 3.85% of the overweight youngsters (BMI > 90th percentile; n = 312). Finally, in the study by Mustillo et al [31] BN was present on at least one of the assessments in 0.63% of those youngsters who had been obese on at least one of the assessments.…”