Association between obesity and behavioral/emotional disorders in primary school-aged children: a cross-sectional study
DOI:
https://doi.org/10.13181/mji.v26i1.1564Keywords:
behavioral disorders, children, emotional disorders, obesity, PSC-17Abstract
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.
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References
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.
Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar. Jakarta: Badan Penelitian dan Pengembangan Kesehatan; 2013. p. 217–8.
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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