Association between obesity and behavioral/emotional disorders in primary school-aged children: a cross-sectional study

  • Clarissa J. Aditya Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
  • Rini Sekartini Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
Keywords: behavioral disorders, children, emotional disorders, obesity, PSC-17
Abstract viewed: 2422 times
PDF downloaded: 988 times
HTML downloaded: 171 times
EPUB downloaded: 114 times

Abstract

Background: Obesity in children can increase the risks of various chronic diseases. Mental disorders associated with obesity in children include: depression, anxiety, low self-esteem, hyperkinetic disorders, and increased aggressiveness. This relationship is estimated due to vulnerable genetic expressions in obese individuals. This study aimed to find the association between obesity and behavioral/emotional disorder in primary school-aged children.

Methods: This cross-sectional study was conducted on 384 children at Menteng 1 Elementary School, Jakarta from July to September 2015. The study was conducted to find the association between the children’s nutritional status and behavioral/emotional disorders screened by the 17-item Pediatric Symptom Checklist (PSC-17). Chi square analysis was applied in this study.

Results: The prevalence of obese children at Menteng 1 Elementary School, Jakarta reached 23.2%, which is higher than Jakarta’s prevalence (14%). 8.7% of the subjects were obese and 13.6% of them were having behavioral/emotional disorders. 20.0% of the obese subjects had behavioral/emotional disorders. The prevalence was higher for internalizing subscale, which was consistent with other studies. Association between obesity and behavioral/emotional disorders was significant for externalizing sub-scale (p=0.036). Externalizing problems caused by obesity might be affected by the social stigma of their peer group. However, obesity in children did not have a statistically significant relationship in internalization sub-scale, attention, and PSC-17 total score (p>0.05). No significant associations towards those sub-scales were thought to be influenced by other factors, playing a role in causing mental disorders in children.

Conclusion: In general, obesity was not associated with behavioral and emotional disorders in children, but obesity was related to externalizing behavioral/emotional disorders.

References

  1. Ng M, Fleming T, Robinsin M, Thomson B, Greaetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766–81.

  2. Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar. Jakarta: Badan Penelitian dan Pengembangan Kesehatan; 2013. p. 217–8.

  3. Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. Lancet. 2002;360(9331):473–82. https://doi.org/10.1016/S0140-6736(02)09678-2

  4. Halfon N, Larson K, Slusser W. Associations between obesity and comorbid mental health, developmental, and physical health conditions in a nationally representative sample of US children aged 10 to 17. Acad Pediatr. 2013;13(1):6–13. https://doi.org/10.1016/j.acap.2012.10.007

  5. Harahap DF, Sjarif DR, Soedjatmiko, Widodo DP, Tedjasaputra MS. Identification of emotional and behavior problems in obese children using Child Behavior Checklist (CBCL) and 17-items Pediatric Symptom Checklist (PSC- 17). Paediatr Indones. 2010; 50(1):42–8. https://doi.org/10.14238/pi50.1.2010.42-8

  6. Barlow SE. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120(Suppl4):164–92. https://doi.org/10.1542/peds.2007-2329C

  7. Gardner W, Lucas A, Kolko DJ, Campo JV. Comparison of the PSC-17 and alternative mental health screens in an at-risk primary care sample. J Am Acad Child Adolesc Psychiatry. 2007;46(5):611–8. https://doi.org/10.1097/chi.0b013e318032384b

  8. Handayani D, Rismarini, Kesuma Y, Purnamasari R, Husin S. Hubungan defisiensi besi dengan perilaku anak usia sekolah di kota Palembang. Sari Pediatr. 2015;16(5):307–14. Indonesian. https://doi.org/10.14238/sp16.5.2015.307-14

  9. Feigelman S. Middle childhood. Chapter 11. In: Kliegman RM, Stanton BF, Schor NF, St Geme JW, Behrman RE, editors. Nelson textbook of pediatrics. 19th ed. Philadelphia (PA): Elsevier Saunders; 2011. p36–9. https://doi.org/10.1016/B978-1-4377-0755-7.00011-7

  10. Cortese S, Vincenzi B. Obesity and ADHD: clinical and neurobiological implications. Curr Top Behav Neurosci. 2012;9:199–218. https://doi.org/10.1007/7854_2011_154

  11. Breuillaud L, Clara Rossetti, Elsa MM, Cristophe Mérinat, Olivier Halfon, Pierre Magistretti, et al. Deletion of CREB-regulated transcription coactivator 1 induces pathological aggression, depression-related behaviors, and neuroplasticity genes dysregulation in mice. Biol Psychiatry. 2012;72(7):528–36. https://doi.org/10.1016/j.biopsych.2012.04.011

  12. Williams MJ, Goergen P, Rajendran J, Klockars A, Kasagiannis A, Fredriksson R, et al. Regulation of aggression by obesity-linked genes TfAP-2 and Twz through octopamine signaling in Drosophila. Genetics. 2014;196(1):349–62. https://doi.org/10.1534/genetics.113.158402

  13. Benson LP, Williams RJ, Novick MB. Pediatric obesity and depression: a cross- sectional analysis of absolute BMI as it relates to children's depression index scores in obese 7- to 17-year-old children. Clin Pediatr (Phila). 2013;52(1):24–9. https://doi.org/10.1177/0009922812459949

  14. Erickson SJ, Robinson TN, Haydel KF, Killen JD. Are overweight children unhappy?: Body mass index, depressive symptoms, and overweight concerns in elementary school children. Arch Pediatr Adolesc Med. 2000;154(9):931–5. https://doi.org/10.1001/archpedi.154.9.931

  15. Zeller MH, Reiter-Purtill J, Ramey C. Negative peer perceptions of obese children in the classroom environment. Obesity (Silver Spring). 2008;16(4):755–62. https://doi.org/10.1038/oby.2008.4

  16. Curtin C, Bandini LG, Perrin EC, Tybor DJ, Must A. Prevalence of overweight in children and adolescents with attention deficit hyperactivity disorder and autism spectrum disorders: a chart review. BMC Pediatr. 2005;5:48. https://doi.org/10.1186/1471-2431-5-48

  17. Holtkamp K, Konrad K, Müller B, Heussen N, Herpertz S, Herpertz-Dahlmann B, et al. Overweight and obesity in children with attention- deficit/ hyperactivity disorder. Int J Obes Relat Metab Disord. 2004;28(5):685–9. https://doi.org/10.1038/sj.ijo.0802623

  18. Cortese S, Angriman M, Maffeis C, Isnard P, Konofal E, Lecendreux M, et al. Attention-deficit/hyperactivity disorder (ADHD) and obesity: a systematic review of the literature. Crit Rev Food Sci Nutr. 2008;48(6):524–37. https://doi.org/10.1080/10408390701540124

  19. Serrano-Gonzalez M, McConnel C, Bokhary M, Oden J, Lopez X. Association of non- high-density lipoprotein cholesterol with psychosocial dysfunction in children and adolescents with obesity. Child Obes. 2015;11(5):647–9. https://doi.org/10.1089/chi.2015.0043

Published
2017-05-16
How to Cite
1.
Aditya CJ, Sekartini R. Association between obesity and behavioral/emotional disorders in primary school-aged children: a cross-sectional study. Med J Indones [Internet]. 2017May16 [cited 2024Apr.26];26(1):70-5. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/1564
Section
Community Research