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|Title:||The Relationship Between Childhood- And Adolescent-Onset Psychopathology And Adult Body Weight|
|Authors:||Korczak, Daphne J.|
|Department:||Clinical Health Sciences (Health Research Methodology)|
|Keywords:||child psychiatry;obesity;depression;disruptive behaviour;epidemiology;Psychiatry and Psychology;Psychiatry and Psychology|
|Abstract:||<p>Current public health initiatives recognize that obesity is increasing to epidemic proportions in developed countries. In keeping with the view of obesity as a developmental, progressive condition, targeting childhood factors that predict increases in body mass index (BMI) may result in the development of more effective prevention interventions. To date, prospective studies of child-onset psychopathology and adult overweight in representative community samples are limited by short duration of follow-up into adulthood and an inability to make psychiatric diagnoses. Where available, childhood data has been analyzed together with adolescent data, such that it is difficult to disentangle the relationship between early psychological distress and adult overweight in these developmentally heterogeneous groups. The main objective of this thesis is to examine the relationship between childhood and adolescent symptoms of (i) Depression (ii) Attention Deficit Hyperactivity Disorder [ADHD] and (iii) Conduct Disorder [CD] with adult overweight, in a large, prospectively followed, community sample of Canadian children.</p> <p><strong> </strong>This thesis includes the 1,992 children aged 4-11 years and 1,302 adolescents aged 12-16 years who participated in the Ontario Child Health Survey (OCHS), a provincially funded, prospective cohort study of the psychiatric and general child health of a representative sample ofOntario community children undertaken in 1983 with follow-up assessment in 2000. Data are collected from multiple informants; psychiatric disorders are determined by a combination of parental, youth and teacher self-report and interviewer-administered measures. BMI is a derived variable determined from self-reported height and weight in 2000. Multiple regression analyses are undertaken to examine the association of child and adolescent mental illness with adult overweight, after controlling for the effects of age, sex, socioeconomic status, parental psychiatric history and, among the adolescent subgroup, cigarette smoking and alcohol use.</p> <p>Adults with a history of depression, ADHD or CD identified in childhood have increased body mass (BMI = 27.2 kg/m<sup>2</sup>, 27.7 kg/m<sup>2</sup>, and 27.9 kg/m<sup>2</sup>, respectively) compared to their nonaffected peers (BMI= 24.8 kg/m<sup>2</sup>). Children who experienced increased depressive symptoms (among boys) and CD symptoms (boys and girls) are at greater risk for future weight gain than children with fewer symptoms. Adolescent girls with Depression or Conduct Disorder are heavier in adulthood than their psychologically healthier peers. Although ADHD was initially found to be associated with adult overweight, this relationship is accounted for by the effect of conduct disturbance, regardless of child sex.</p> <p>This thesis suggests that psychopathology in childhood and adolescence predicts increased adult body mass in a large community sample ofOntarioyouth. In childhood, boys with depressive symptoms and boys and girls with disruptive behaviour are at particular risk. Among adolescents, girls with greater depressive symptoms or conduct disturbance are at increased risk of future weight gain. Research examining the trajectories of children with depressive and externalizing disorders is needed to understand the mechanism of the relationship between these disorders in childhood and eating behaviours in adulthood.</p>|
|Appears in Collections:||Open Access Dissertations and Theses|
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