Abstract
With the dramatic growth of the Chinese economy, the number of children/adolescents with being overweight/having obesity is increasing, which has a certain impact on their psychology, such as depression and anxiety symptoms. Our purpose was to conduct a meta-analysis to assess the prevalence and odds ratios of depression and anxiety symptoms among overweight/obese children/adolescents and non-overweight/obese children/adolescents in China. As of July 2018, the three most comprehensive computerized academic databases in China have been systematically screened, namely China national knowledge infrastructure (CNKI) databases, Wanfang databases and Vip databases. The same operations are performed in PubMed and Web of Science (SCIE) databases without language restrictions. Case-control studies on prevalence of depression and anxiety symptoms in overweight/obese children/adolescents in China were analyzed. Study selection and evaluation were performed independently by three authors. Unweighted prevalence, pooled random-effects estimates of odds ratio (OR), and 95% confidence intervals (CI) were all calculated. A total of 11 eligible studies involving 17,894 subjects were included. The prevalence of depression and anxiety symptoms in overweight/obese children/adolescents was significantly higher than that in non-overweight/non-obese children/adolescents (depression: 21.73% vs. 17.96%, OR = 1.46, 95% CI: 1.14, 1.87, p = 0.003; anxiety: 39.80% vs. 13.99%, OR = 1.47, 95% CI: 1.21, 1.79, p < 0.001). Subgroup analyses conducted according to scale types showed that scale types have certain significance to evaluate the relationship between depression symptoms and overweight/obesity. The OR of depression symptoms between overweight/obese children/adolescents and non-overweight/non-obese children/adolescents was greatest on the Middle School Student Mental Health Scale (MSSMHS) was 2.06 (95% CI: 1.41, 3.02, I2 = 0.00%), Center for Epidemiologic Studies Depression Scale (CES-D) was 1.03 (95% CI: 0.84, 1.25, I2 = 0.00%), and Children’s Depression Inventory (CDI) was 1.21 (95% CI: 1.02, 1.42, I2 = 0.00%). We concluded that the prevalence of depression and anxiety symptoms in overweight/obese children/adolescents in China is higher than that in the non-overweight/obese children/adolescents. The results of the study indicate that the prevalence of depression and anxiety symptoms among overweight/obese children/adolescents in Chinese medical institutions should receive more attention. Physical exercise and psychological interventions should be strengthened to prevent psychological problems. However, because of some clear limitations (no clinical interview and few studies), these results should be interpreted with caution.
Highlights
Overweight and obesity among children and adolescents have become one of the most serious global public health concerns in the 21st century [1]
With the dramatic growth of the Chinese economy, the number of overweight/obese children/adolescents is increasing, which has a certain impact on their psychology, such as depression and anxiety symptoms
We concluded that the prevalence of depression and anxiety symptoms in overweight/obese children/adolescents in China was higher than that in the non-overweight/obese group
Summary
Overweight and obesity among children and adolescents have become one of the most serious global public health concerns in the 21st century [1]. Over the past 30 years, the prevalence of overweightness and obesity among children and adolescents worldwide has increased at an alarming rate [1,2]. There has been a proliferation of fast food restaurants and an increase in activities that lead to less physical activity, such as watching television and playing computer games [6]. In China’s education system, it relies almost entirely on test scores to evaluates progress, which lead to more reading, examinations, or/and homework for Chinese children and less time for physical activities [8]. Overweightness and obesity in children and adolescents can lead to developmental problems, such as poor cognitive function and altered timing of puberty [8]. In addition to the recognized physiological results, attention is increasingly being focused on determining whether mental illness may result from obesity, such as depression and anxiety [12]
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