Rates of psychiatric disorders in a clinical study group of adolescents with extreme obesity and in obese adolescents ascertained via a population based study
Rates of psychiatric disorders in a clinical study group of adolescents with extreme obesity and in obese adolescents ascertained via a population based study
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DOI：
10.1038/sj.ijo.0801449
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发表时间：
2000-12-01
影响因子：
4.9
通讯作者：
Hebebrand, J
中科院分区：
文献类型：
--
作者：
Britz, B;Siegfried, W;Hebebrand, J
目的：比较(1)极度肥胖的青少年和年轻人临床研究组，(2)性别匹配的基于人群的肥胖对照组和(3)相同年龄范围的基于人群的对照组的DSM-IV精神障碍发生率。设计：在(1)肥胖青少年临床研究组和(2)肥胖青少年人群样本中评估精神疾病的发生率，并与(3)使用标准化精神病学访谈的大型人群对照组进行比较。(1)临床研究组：女性30名，男性17名，年龄15-21岁，平均BMI: 42.4 kg/m(2)。(2)以人群为基础的对照组包括1655名（男性805名）青少年和年轻人，其中30名女性和17名男性BMI最高（年龄范围15-21岁；平均BMI: 29.8 kg/m(2)）。(3)以人群为基础的对照组，剔除BMI最高的30名女性和17名男性（n = 1608，男性788）。测量：慕尼黑复合国际诊断访谈（M-CIDI）允许DSM-IV诊断。结果：肥胖青少年临床样本中情绪、焦虑、躯体形态和饮食失调的发生率高于对照组（p值均< 0.01）。以人群为基础的肥胖青少年和年轻人与人口对照之间的发病率没有差异。大多数患者在肥胖发病后出现精神障碍，分别有57%和35%的女性和男性患者报告暴食并缺乏控制。然而，这些患者中只有不到一半符合DSM-IV的饮食失调诊断。结论：寻求长期住院治疗的极度肥胖青少年和年轻人在情感、焦虑、躯体形式和饮食失调方面的终生患病率很高。由于临床研究组的平均BMI明显高于肥胖人群的对照组，我们无法明确研究组的高精神病理发生率是否与极端肥胖或他们寻求治疗的行为有关。
OBJECTIVE: To compare rates of DSM-IV psychiatric disorders between (1) a clinical study group of extremely obese adolescents and young adults, (2) gender-matched population-based obese controls and (3) a population-based control group of the same age range. DDESIGN: Rates of psychiatric disorders were assessed in (1) the clinical study group of obese adolescents and (2) the population based sample of obese adolescents, and compared to (3) a large population-based control group using a standardized psychiatric interview.SUBJECTS: (1) Clinical study group: 30 female and 17 male extremely obese adolescents and young adults (age range: 15-21 y; mean BMI : 42.4 kg/m(2)). (2) Thirty females and 17 males with the highest BMI (age range 15-21 y; mean BMI : 29.8 kg/m(2)) of a population-based control group encompassing 1655 (805 males) adolescents and young adults. (3) The population based control group excluding the 30 females and 17 males with the highest BMI (n = 1608; 788 males).MEASUREMENTS: Munich-Composite International Diagnostic Interview (M-CIDI) allowing for DSM-IV diagnoses.RESULTS: High rates of mood, anxiety, somatoform and eating disorders were detected in the clinical sample of obese adolescents which exceeded those observed in population controls (all P-values < 0.01). Rates between population-based obese adolescents and young adults and population controls did not differ. In most patients the psychiatric disorders set in after onset of obesity, 57% and 35% of the female and male patients, respectively, reported eating binges with lack of control. However, less than one-half of these patients qualified for a DSM-IV diagnosis of an eating disorder.CONCLUSIONS: Extremely obese adolescents and young adults who seek long-term inpatient treatment have a high lifetime prevalence for affective, anxiety, somatoform and eating disorders. Because the mean BMI of the clinical study group was considerably higher than that of the obese population controls, we were not able to clarify whether the high rate of psychopathology in the study group was related to the extreme obesity or to their treatment-seeking behavior.