Family Factors and Obesity in Relation to Mental Health Among Korean Children and Adolescents
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Family factors have been associated with the mental health of children and adolescents. We investigated the relationship between family factors and depressive symptoms in obese Korean children and adolescents.
Participants included 281 overweight or obese youth (aged 10 to 14) who participated in an obesity intervention program. Participants in the highest tertile on the Child Depression Inventory were categorized as the depressive group. Using the Family Adaptability, Partnership, Growth, Affection, and Resolve Test, we defined a highly functional family with a score of 7 or more. We evaluated the associations between the severity of depressive symptoms and family factors after stratifying for gender using multivariate logistic regression.
Poorly functioning family was associated with higher levels of depressive symptoms (boys, odds ratio [OR] = 5.95, 95% CI [2.54–13.93]; girls OR = 3.16, 95% CI [1.19–8.38]). Having a good parental relationship was significantly associated with lower levels of depressive symptoms in boys (OR = 0.30, 95% CI [0.10–0.96]). In girls, severely obese status showed higher association with depressive symptoms compared to girls who were overweight (OR = 4.74, 95% CI [1.01–19.84]).
We identified associations between family functioning, parent-child relations, obesity severity, and depressive symptoms in this sample of overweight and obese youth, suggesting that the development of family-focused interventions to accompany weight loss strategies may benefit the mental health of obese youth.
KeywordsAdolescence Depression Family functioning Obesity Parent-Child Relations
K.H.P., J.P., and H.M.N. suggested the study. K.H.P., J.P., H.M.N., E.J.S., Y.S.J., H.J.L., and Y.K.J. designed the study and developed the study protocol. K.H.P., J.P., and H.M.N. analysed the data. All authors interpreted the results. J.P. and H.M.N. drafted the manuscript. All authors contributed to the critical revision of the manuscript. K.H.P., J.P., H.M.N., E.J.S., Y.S.J., H.J.L., and Y.K.J. have full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
This study was funded by a grant from the Korea Centers for Disease Control and Prevention (grant number: 2015-ER6401-00 and 2016-ER6405-00).
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethics approval was obtained from the Hallym University Sacred Heart Hospital’s Institutional Review Board (approval number: 2015-I134 and 2016-I135).
Informed consent was obtained from all individual participants included in the study.
- Cho, S. C., & Lee, Y. S. (1990). Development of the Korean form of the Kovacs children’s depression inventory. Journal of Korean Neuropsychiatric Association, 29, 943–956.Google Scholar
- Cho, W. K., Han, K., Ahn, M. B., Park, Y.-M., Jung, M. H., Suh, B. –K., & Park, Y.-G. (2018). Metabolic risk factors in Korean adolescents with severe obesity: results from the Korea National Health and Nutrition Examination Surveys (K-NHANES) 2007–2014. Diabetes Research and Clinical Practice, 138, 169–176. https://doi.org/10.1016/j.diabres.2018.01.030.CrossRefPubMedPubMedCentralGoogle Scholar
- Connell, A. M., & Goodman, S. H. (2002). The association between psychopathology in fathers versus mothers and children’s internalizing and externalizing behavior problems: a meta-analysis. Psychological Bulletin, 128(5), 746–773. https://doi.org/10.1037/0033-2909.128.5.746.CrossRefPubMedGoogle Scholar
- Cosco, T. D., Prina, M., Stubbs, B., & Wu, Y. T. (2017). Reliability and validity of the center for epidemiologic studies depression scale in a population-based cohort of middle-aged U.S. adults. Journal of Nursing Measurement, 25(3), 476–485. https://doi.org/10.1891/1061-37220.127.116.116.CrossRefPubMedGoogle Scholar
- Dattilio, F. M., & Epstein, N. B. (2005). Introduction to the special section: The role of cognitive-behavioral interventions in couple and family therapy. Journal of Marital and Family Therapy, 31(1), 7–13. https://doi.org/10.1111/j.1752-0606.2005.tb01539.x.CrossRefPubMedGoogle Scholar
- Gomez-Baya, D., Mendoza, R., Camacho, I., & de Matos, M. G. (2017). Latent growth curve model of perceived family relationship quality and depressive symptoms during middle adolescence in Spain. Journal of Family Issues. https://doi.org/10.1177/0192513x17741174.
- Hickey, E., Fitzgerald, A., & Dooley, B. (2017). The relationship between perceived family support and depressive symptoms in adolescence: what is the moderating role of coping strategies and gender? Community Mental Health Journal, 53(4), 474–481. https://doi.org/10.1007/s10597-017-0087-x.CrossRefPubMedGoogle Scholar
- Hong, H. J., Kim, Y. S., Jon, D.-I., Soek, J. H., Hong, N., Harkavy-Friedman, J. M., & Greenhill, L. L. (2011). Mental health and extracurricular education in Korean first graders. The Journal of Clinical Psychiatry, 72(06), 861–868. https://doi.org/10.4088/JCP.09m05907gry.CrossRefPubMedGoogle Scholar
- Kang, S. K., Yoon, B. B., & Lee, H. R. (1984). A study of family APGAR score for evaluating family function. Journal of the Korean Academy of Family Medicine, 5(12), 6–13.Google Scholar
- Kim, D., Shin, H. J., Kim, S. W., Hong, J. M., Lee, K. S., & Lee, S. H. (2017). Psychological problems of pneumothorax according to resilience, stress, and post-traumatic stress. Psychiatry Investigation, 14(6), 795–800. https://doi.org/10.4306/pi.2017.14.6.795.CrossRefPubMedPubMedCentralGoogle Scholar
- Laird, R., & Kuhn, E. (2014). Family support programs and adolescent mental health: review of evidence. Adolescent Health, Medicine and Therapeutics, 127. https://doi.org/10.2147/ahmt.s48057.
- Lin, H.-C., Tang, T.-C., Yen, J.-Y., Ko, C.-H., Huang, C.-F., Liu, S.-C., & Yen, C.-F. (2008). Depression and its association with self-esteem, family, peer and school factors in a population of 9586 adolescents in southern Taiwan. Psychiatry and Clinical Neurosciences, 62(4), 412–420. https://doi.org/10.1111/j.1440-1819.2008.01820.x.CrossRefPubMedGoogle Scholar
- Maughan, B., Collishaw, S., & Stringaris, A. (2013). Depression in childhood and adolescence. Journal of the Canadian Academy of Child and Adolescent, 22(1), 35–40.Google Scholar
- McArdle, J. J., Hamagami, F., Chang, J. Y., & Hishinuma, E. S. (2014). Longitudinal dynamic analyses of depression and academic achievement in the Hawaiian High Schools Health Survey using contemporary latent variable change models. Structural Equation Modeling, 21(4), 608–629. https://doi.org/10.1080/10705511.2014.919824.CrossRefPubMedPubMedCentralGoogle Scholar
- Must, A., Jacques, P. F., Dallal, G. E., Bajema, C. J., & Dietz, W. H. (1992). Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. New England Journal of Medicine, 327(19), 1350–1355. https://doi.org/10.1056/nejm199211053271904.CrossRefPubMedGoogle Scholar
- Rengasamy, M., Mansoor, B. M. H., Robert, P., Giovanna, H., Jiayan, E., Graham, J. B., & David, A., et al. (2013). The bi-directional relationship between parent–child conflict and treatment outcome in treatment-resistant adolescent depression. Journal of the American Academy of Child & Adolescent Psychiatry, 52(4), 370–377. https://doi.org/10.1016/j.jaac.2013.01.012.CrossRefGoogle Scholar
- Seo, Y. G., Kim, J. H., Kim, Y., Lim, H., Ju, Y. S., Kang, M. J., & Park, K. H., et al. (2018). Validation of body composition using bioelectrical impedance analysis in children according to the degree of obesity. Scandinavian Journal of Medicine & Science in Sports, 28(10), 2207–2215. https://doi.org/10.1111/sms.13248.CrossRefGoogle Scholar
- Srisurapanont, M., Hong, J. P., Tian-Mei, S., Hatim, A., Liu, C. Y., Udomratn, P., Rush, A. J., et al. (2013). Clinical features of depression in Asia: results of a large prospective, cross-sectional study. Asia-Pacific Psychiatry, 5(4), 259–267. https://doi.org/10.1111/appy.12104.CrossRefPubMedGoogle Scholar
- Sutaria, S., Devakumar, D., Yasuda, S. S., Das, S., & Saxena, S. (2018). Is obesity associated with depression in children? Systematic review and meta-analysis. Archives of Disease in Childhood. https://doi.org/10.1136/archdischild-2017-314608.
- Washington, T., Rose, T., Coard, S. I., Patton, D. U., Young, S., Giles, S., & Nolen, M. (2016). Family-level factors, depression, and anxiety among African American Children: a systematic review. Child & Youth Care Forum, 46(1), 137–156. https://doi.org/10.1007/s10566-016-9372-z.CrossRefGoogle Scholar
- Weijers, D., van Steensel, F. J. A., & Bögels, S. M. (2018). Associations between psychopathology in mothers, fathers and their children: a structural modeling approach. Journal of Child and Family Studies, 27(6), 1992–2003. https://doi.org/10.1007/s10826-018-1024-5.CrossRefPubMedPubMedCentralGoogle Scholar
- Yang, J., Yin, P., Wei, D., Wang, K., Li, Y., & Qiu, J. (2017). Effects of parental emotional warmth on the relationship between regional gray matter volume and depression-related personality traits. Society for Neuroscience, 12(3), 337–348. https://doi.org/10.1080/17470919.2016.1174150.CrossRefGoogle Scholar
- Yang, L., Jia, C. X., & Qin, P. (2015). Reliability and validity of the Center for Epidemiologic Studies Depression Scale (CES-D) among suicide attempters and comparison residents in rural China. BMC Psychiatry, 15, 76. https://doi.org/10.1186/s12888-015-0458-1.CrossRefPubMedPubMedCentralGoogle Scholar
- Zheng, Y., Rijsdijk, F., Pingault, J. B., McMahon, R. J., & Unger, J. B. (2016). Developmental changes in genetic and environmental influences on Chinese child and adolescent anxiety and depression. Psychological Medicine, 46(9), 1829–1838. https://doi.org/10.1017/s0033291716000313.CrossRefPubMedGoogle Scholar