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Mental Disorders in Obese Children and Adolescents

From the Pediatric Department, Necker-Enfants Malades Hospital, Paris, France.

Address correspondence and reprint requests to G. Vila, PhD, CHU Necker-Enfants Malades, 149 rue de Sèvres, 75015 Paris, France. E-mail: cmp-tiphaine{at}wanadoo.fr

OBJECTIVE: To evaluate the type and frequency of psychiatric disorders in obese children and adolescents; to assess the correlation between psychopathology and severity of obesity; to explore the relationship between psychiatric disorders in obese children and obesity and psychopathology in their parents.

METHODS: One hundred fifty-five children referred and followed for obesity were evaluated (98 girls and 57 boys; age, 5 to 17 years). Psychiatric disorders were assessed through a standardized diagnostic interview schedule (K-SADS R) and self-report questionnaires completed by the child (STAIC Trait-anxiety and CDI for depression) or his (her) parents (CBCL or GHQ). These obese children were compared with insulin-dependent diabetic (IDDM) outpatient children (N = 171) on questionnaire data.

RESULTS: Eighty-eight obese children obtained a DSM-IV diagnosis, most often an anxiety disorder (N = 63). Psychological disorders were particularly pronounced in those obese children whose parents were disturbed. There was no correlation between severity of obesity in the child or his (her) parents and frequency of psychiatric disorders. Compared with diabetic children, they displayed significantly higher internalized and externalized questionnaire scores and poorer social skills.

CONCLUSION: These results highlight the importance of including a child psychiatric component in the treatment of obesity, which must engage the whole family.

Key Words: child, • adolescent, • obesity, • mental disorders, • psychopathology, • parents.

Abbreviations: BMI = body mass index;; CBCL = Child Behavior Check-List;; CDI = Child Depression Inventory;; GHQ-28 = General Health Questionnaire;; K-SADS = Kiddie Schedule for Affective Disorders and Schizophrenia, Present Episode Version;; SES = socio-economic status;; STAIC = State and Trait Anxiety Inventory for Children.

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