Background
Methods
Subjects
Exposure variables
Definition of anxiety and depressive disorders
Covariates
Statistical analysis
Results
Obesity cohort | Comparison group | |||
---|---|---|---|---|
Girls, n = 5867 | Boys, n = 6640 | Girls, n = 28,270 | Boys, n = 31,793 | |
Nordic | 3943 (67.2) | 4400 (66.3) | 20,010 (70.8) | 22,837 (71.8) |
Anxiety and/or depressive disordersa | 681 (11.6) | 532 (8.0) | 1707 (6.0) | 1310 (4.1) |
Age at first anxiety and/or depressive disorders | 14.5 (2.3) | 13.9 (2.7) | 14.7 (2.5) | 14.0 (2.8) |
Anxiety disorderb | 518 (8.8) | 403 (6.1) | 1331 (4.7) | 995 (3.1) |
Age at first anxiety disorder | 14.4 (2.4) | 13.8 (2.8) | 14.5 (2.5) | 13.8 (2.9) |
Depressive disorderb | 426 (7.3) | 297 (4.5) | 966 (3.4) | 634 (2.0) |
Age at first depressive disorder | 15.1 (1.8) | 14.5 (2.4) | 15.4 (1.9) | 14.8 (2.3) |
Neuropsychiatric disorderc | 786 (13.4) | 1412 (21.3) | 1301 (4.6) | 2793 (8.8) |
ADHD/ADD | 612 (10.4) | 1107 (16.7) | 1005 (3.6) | 2286 (7.2) |
Autism spectrum disorder | 201 (3.4) | 473 (7.1) | 342 (1.2) | 809 (2.5) |
Mild intellectual disability | 127 (2.2) | 207 (3.1) | 186 (0.7) | 331 (1.0) |
Parental anxiety/depressiond | 3129 (53.3) | 3666 (53.3) | 11,663 (41.3) | 13,382 (42.1) |
Mothers | 2477 (42.2) | 2891 (43.5) | 8762 (31.0) | 9916 (31.2) |
Fathers | 1450 (24.7) | 1700 (25.6) | 5224 (18.5) | 6126 (19.3) |
SES | ||||
Low SES | 1067 (18.2) | 1253 (18.9) | 3593 (12.7) | 4089 (12.9) |
Medium-low SES | 2202 (37.5) | 2513 (37.9) | 8023 (28.4) | 9057 (28.5) |
Medium-high SES | 1996 (34.0) | 2248 (33.9) | 10,689 (37.8) | 12,182 (38.3) |
High SES | 568 (9.7) | 590 (8.9) | 5564 (19.7) | 6037 (19.0) |
Missing | 34 (0.6) | 36 (0.5) | 403 (1.4) | 433 (1.4) |
Risk factors for anxiety and depression
Sensitivity and interaction analyses
Crude HR (95% CI); p | Adjusted HR (95% CI); p | |
---|---|---|
Anxiety and/or depressive disorders | ||
Girls | 1.61 (1.35–1.92)*** | 1.56 (1.31–1.87)*** |
Boys | 2.04 (1.65–2.53)*** | 2.04 (1.64–2.54)*** |
Anxiety disorder | ||
Girls | 1.55 (1.27–1.89)*** | 1.49 (1.22–1.82)*** |
Boys | 1.86 (1.46–2.39)*** | 1.88 (1.46–2.42)*** |
Depressive disorder | ||
Girls | 1.81 (1.42–2.30)*** | 1.80 (1.41–2.29)*** |
Boys | 2.69 (1.94–3.72)*** | 2.68 (1.92–3.74)*** |
Risk factors for anxiety and depression in children and adolescents with obesity
Anxiety and/or depressive disorders | Anxiety disorder | Depressive disorder | ||||
---|---|---|---|---|---|---|
Girls | Boys | Girls | Boys | Girls | Boys | |
Age at start of obesity treatment | 1.29 (1.25–1.33)*** | 1.15 (1.11–1.19)*** | 1.24 (1.20–1.28)*** | 1.11 (1.06–1.15)*** | 1.37 (1.32–1.43)*** | 1.23 (1.17–1.29)*** |
BMI SDS at start of obesity treatment | 0.95 (0.78–1.16); 0.63 | 1.28 (1.04–1.57)* | 0.94 (0.75–1.17); 0.56 | 1.20 (0.95–1.53); 0.13 | 1.09 (0.85–1.41); 0.48 | 1.24 (0.93–1.65); 0.14 |
Treatment response | ||||||
No response vs. good response | 1.07 (0.88–1.30); 0.51 | 1.10 (0.87–1.40); 0.41 | 1.00 (0.80–1.25); 0.98 | 1.08 (0.83–1.41); 0.57 | 1.01 (0.79–1.30); 0.94 | 1.09 (0.79–1.51); 0.59 |
Poor response vs. good response | 1.20 (0.93–1.55); 0.17 | 1.62 (1.22–2.16)** | 1.11 (0.83–1.49); 0.49 | 1.57 (1.13–2.19)** | 1.18 (0.86–1.61); 0.31 | 1.83 (1.27–2.65)** |
Dropouts vs. good response | 1.47 (1.16–1.86)** | 1.46 (1.13–1.90)** | 1.38 (1.06–1.80)* | 1.45 (1.08–1.95)* | 1.32 (0.97–1.78); 0.08 | 1.35 (0.94–1.93); 0.10 |
Nordic background (non-Nordic vs. Nordic) | 0.55 (0.45–0.68)*** | 0.58 (0.46–0.73)*** | 0.56 (0.44–0.70)*** | 0.67 (0.52–0.86)** | 0.42 (0.32–0.56)*** | 0.33 (0.23–0.48)*** |
Neuropsychiatric disorder (yes vs. no) | 3.99 (3.40–4.67)*** | 4.07 (3.42–4.85)*** | 4.12 (3.44–4.94)*** | 3.53 (2.89–4.32)*** | 4.32 (3.55–5.27)*** | 5.33 (4.19–6.78)*** |
Maternal anxiety/depression (yes vs. no) | 1.33 (1.14–1.56)** | 1.30 (1.09–1.55)** | 1.35 (1.13–1.61)** | 1.35 (1.10–1.65)** | 1.40 (1.15–1.70)** | 1.53 (1.21–1.94)** |
Paternal anxiety/depression (yes vs. no) | 1.08 (0.91–1.29); 0.38 | 1.28 (1.06–1.54)** | 1.14 (0.94–1.39); 0.19 | 1.32 (1.07–1.63)* | 0.97 (0.77–1.22); 0.80 | 1.28 (1.00–1.64); 0.05 |
SES | ||||||
Low vs. high SES | 0.82 (0.59–1.14); 0.25 | 0.83 (0.58–1.19); 0.30 | 1.02 (0.68–1.53); 0.92 | 0.92 (0.60–1.41); 0.70 | 0.70 (0.46–1.04); 0.08 | 0.71 (0.44–1.16); 0.18 |
Medium-low vs. high SES | 0.85 (0.63–1.13); 0.26 | 0.79 (0.57–1.08); 0.14 | 1.08 (0.75–1.54); 0.69 | 0.96 (0.66–1.41); 0.84 | 0.62 (0.43–0.88)** | 0.69 (0.46–1.05); 0.09 |
Medium-high vs. high SES | 0.93 (0.70–1.24); 0.61 | 0.67 (0.48–0.92)* | 1.17 (0.82–1.65); 0.39 | 0.80 (0.54–1.18); 0.26 | 0.82 (0.59–1.15); 0.25 | 0.66 (0.44–1.00); 0.05 |