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Annesi JJ, Stewart FA. Self-regulatory and self-efficacy mechanisms of weight loss in women within a community-based behavioral obesity treatment. J Behav Med 2024:10.1007/s10865-024-00494-2. [PMID: 38762607 DOI: 10.1007/s10865-024-00494-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 04/17/2024] [Indexed: 05/20/2024]
Abstract
Given the traditional methods of treating obesity through education on controlling eating and increasing exercise have largely failed beyond the very short term, a more intensive focus on psychosocial correlates of those weight-loss behaviors has been suggested. Multiple behavioral theories incorporate self-regulation, self-efficacy, and mood; however, their interrelations and effects over both the short and long term within cognitive-behavioral obesity treatments remain unclear. Within a novel community-based program with women with obesity who had either low (n = 29) or high (n = 71) mood disturbance scores, there were significant improvements in exercise- and eating-related self-regulation and eating-related self-efficacy-primary targets of that intervention-with no significant difference in those changes by mood disturbance grouping. Changes in the summed exercise- and eating-related self-regulation scores significantly mediated relationships between changes in eating-related self-efficacy and weight (over both 6 and 12 months). There were similar results with mediation assessed via the extent exercise-related self-regulation carried over to eating-related self-regulation. In both of those models a reciprocal relationship between self-regulation and self-efficacy changes was indicated. In serial multiple mediation equations, paths of changes in exercise-related self-regulation → eating-related self-regulation → eating-related self-efficacy → weight were significant. However, paths were not significant when change in self-efficacy was entered as the predictor (initial) variable. Findings suggest viability in first focusing on exercise-related self-regulation, then eating-related self-regulation, in the course of increasing self-efficacy and probabilities for inducing enough sustained weight loss to improve obesity-associated health risks. Benefits of field-based research findings generalizing to weight-management applications were suggested.
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Affiliation(s)
- James J Annesi
- California State University, Monterey Bay, Seaside, CA, USA.
- Mind Body Wellbeing, LLC, Manahawkin, NJ, USA.
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2
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Annesi JJ. Coaction of Exercise and Eating Improvements Within a Behavioral Obesity Treatment: Directionality and Psychological Mechanisms. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:826-838. [PMID: 35507500 DOI: 10.1080/02701367.2022.2057904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/16/2022] [Indexed: 06/14/2023]
Abstract
Purpose: Because coaction (a favorable change in one behavior increasing the probability of a similarly favorable change in another behavior) associated with health behaviors has been identified, directionalities of such relationships within weight-loss behaviors (e.g., exercise, healthy eating) and their theory-based psychological mechanisms requires more investigation. Method: Women with obesity and either disturbed mood (n = 61) or normal mood (n = 58) participated in a cogntive-behavioral weight-management treatment within a community setting. Analyses of both group differences, and mediation models using aggregate data of behavioral and psychological variables, were conducted. Results: Improvements in measures of self-regulation, self-efficacy, mood, exercise, and fruit/vegetable intake were significant overall; with fruit/vegetable increase greater in the disturbed mood group. The prediction of increase in fruits/vegetables from baseline-Month 6 by increase in exercise from bascline-Month 3 (β = .24) was stronger than effects of change in fruit/vegetabe intake on exercise (β = .16). Overall mediation models were significant where changes in self-regulation and self-efficacy were entered as serial mediators of predictions of fruit/vegetable change by change in exercise (R2= .35 and .32), and vice versa (R2= .24 and .23). Paths demonstrating effects through self-regulation change and self-efficacy change were significant in the prediction of eating and exercise changes, respectively. Conclusion: Contributions to advancements in behavioral theory and treatment curricula targeting self-regulation and self-efficacy to improve exercse-eating change relationships were suggested. .
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Affiliation(s)
- James J Annesi
- University of Alabama at Birmingham
- Central Coast YMCA, Monterey, CA
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3
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Fields ND, Whitcomb BW, Bertone-Johnson ER, Martínez AD, VanKim NA. Race-specific associations between psychological distress and obesity: the role of social cohesion. ETHNICITY & HEALTH 2023; 28:446-457. [PMID: 35289677 PMCID: PMC9475492 DOI: 10.1080/13557858.2022.2052713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/07/2022] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Nearly two-thirds of Black women in the US are obese. Studies have focused more on lifestyle and behavioral factors to explain racial disparities; less research has examined psychosocial factors such as psychological distress and social cohesion. While research suggests that social cohesion may confer benefits for health, no studies have assessed how social cohesion is related to both mental health and obesity, and potential racial differences. Our study examined associations between psychological distress, social cohesion, and obesity among Black and White adult women. DESIGN Data are from the 2014-2018 National Health Interview Survey (n = 66,743). Participants self-reported psychological distress (Kessler K6 scale), obesity (body mass index≥30 kg/m2), and social cohesion. We fit logistic regression models of obesity with likelihood ratio tests for effect modification by social cohesion and by race. RESULTS Psychological distress was associated with a 1.19 and 1.31 higher odds of obesity for Black (95% confidence interval: 1.05, 1.36) and White women (1.24, 1.39), respectively. Social cohesion was associated with a 0.75 lower odds of obesity among White (0.69, 0.81) but not Black women (odds ratio 0.94; 0.80, 1.10). Tests of interaction indicated no differences by social cohesion or race in the association between psychological distress and obesity. CONCLUSION Findings highlight complex relationships between psychological distress, obesity, and social cohesion in Black and White women. Public health efforts should focus on understanding mechanisms relating social factors to health.
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Affiliation(s)
- Nicole D. Fields
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst School of Public Health and Health Sciences, Amherst, MA, USA
| | - Brian W. Whitcomb
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst School of Public Health and Health Sciences, Amherst, MA, USA
| | - Elizabeth R. Bertone-Johnson
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst School of Public Health and Health Sciences, Amherst, MA, USA
- Department of Health Promotion and Policy, University of Massachusetts Amherst School of Public Health and Health Sciences, Amherst, MA, USA
| | - Airín D. Martínez
- Department of Health Promotion and Policy, University of Massachusetts Amherst School of Public Health and Health Sciences, Amherst, MA, USA
| | - Nicole A. VanKim
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst School of Public Health and Health Sciences, Amherst, MA, USA
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Panda SS, Nayak A, Shah S, Aich P. A Systematic Review on the Association between Obesity and Mood Disorders and the Role of Gut Microbiota. Metabolites 2023; 13:metabo13040488. [PMID: 37110147 PMCID: PMC10144251 DOI: 10.3390/metabo13040488] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023] Open
Abstract
Obesity is a complex health condition that increases the susceptibility to developing cardiovascular diseases, diabetes, and numerous other metabolic health issues. The effect of obesity is not just limited to the conditions mentioned above; it is also seen to have a profound impact on the patient’s mental state, leading to the onset of various mental disorders, particularly mood disorders. Therefore, it is necessary to understand the mechanism underlying the crosstalk between obesity and mental disorders. The gut microbiota is vital in regulating and maintaining host physiology, including metabolism and neuronal circuits. Because of this newly developed understanding of gut microbiota role, here we evaluated the published diverse information to summarize the achievement in the field. In this review, we gave an overview of the association between obesity, mental disorders, and the role of gut microbiota there. Further new guidelines and experimental tools are necessary to understand the microbial contribution to regulate a balanced healthy life.
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Dille M, Nikolic A, Wahlers N, Fahlbusch P, Jacob S, Hartwig S, Lehr S, Kabra D, Klymenko O, Al-Hasani H, Kotzka J, Knebel B. Long-term adjustment of hepatic lipid metabolism after chronic stress and the role of FGF21. Biochim Biophys Acta Mol Basis Dis 2022; 1868:166286. [PMID: 34624498 DOI: 10.1016/j.bbadis.2021.166286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/27/2021] [Accepted: 10/01/2021] [Indexed: 12/14/2022]
Abstract
Chronic stress leads to post-traumatic stress disorder (PTSD) and metabolic disorders including fatty liver. We hypothesized that stress-induced molecular mechanisms alter energy metabolism, thereby promoting hepatic lipid accumulation even after a stress-free recovery period. In this context, we investigated fibroblast growth factor-21 (FGF21) as protective for energy and glucose homeostasis. FGF21 knockout mice (B6.129S6(SJL)-Fgf21tm1.2Djm; FGF21KO) and control mice (C57BL6; WT) were subjected to chronic variable stress. Mice were examined directly after acute intervention (Cvs) and long-term after 3 months of recovery (3mCvs). In WT, Cvs reduced insulin sensitivity and hepatic lipid accumulation, whilst fatty acid uptake increased. FGF21KO mice responded to Cvs with improved glucose tolerance, insulin resistance but liver triglycerides and plasma lipids were unaltered. Hepatic gene expression was specifically altered by genotype and stress e.g. by PPARa and SREBP-1 regulated genes. The stress-induced alteration of hepatic metabolism persisted after stress recovery. In hepatocytes at 3mCvs, differential gene regulation and secreted proteins indicated a genotype specific progression of liver dysfunction. Overall, at 3mCvs FGF21 was involved in maintaining mitochondrial activity, attenuating de novo lipogenesis, increased fatty acid uptake and histone acetyltransferase activity. Glucocorticoid release and binding to the FGF21 promoter may contribute to prolonged FGF21 release and protection against hepatic lipid accumulation. In conclusion, we showed that stress favors fatty liver disease and FGF21 protected against hepatic lipid accumulation after previous chronic stress loading by i) restored physiological function, ii) modulated gene expression via DNA-modifying enzymes, and iii) maintained energy metabolism.
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Affiliation(s)
- Matthias Dille
- Institute for Clinical Biochemistry und Pathobiochemistry, German Diabetes-Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Aleksandra Nikolic
- Institute for Clinical Biochemistry und Pathobiochemistry, German Diabetes-Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Natalie Wahlers
- Institute for Clinical Biochemistry und Pathobiochemistry, German Diabetes-Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Pia Fahlbusch
- Institute for Clinical Biochemistry und Pathobiochemistry, German Diabetes-Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Sylvia Jacob
- Institute for Clinical Biochemistry und Pathobiochemistry, German Diabetes-Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Sonja Hartwig
- Institute for Clinical Biochemistry und Pathobiochemistry, German Diabetes-Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Stefan Lehr
- Institute for Clinical Biochemistry und Pathobiochemistry, German Diabetes-Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Dhiraj Kabra
- Institute for Clinical Biochemistry und Pathobiochemistry, German Diabetes-Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Oleksiy Klymenko
- Institute for Clinical Biochemistry und Pathobiochemistry, German Diabetes-Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Hadi Al-Hasani
- Institute for Clinical Biochemistry und Pathobiochemistry, German Diabetes-Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany; Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Jörg Kotzka
- Institute for Clinical Biochemistry und Pathobiochemistry, German Diabetes-Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Birgit Knebel
- Institute for Clinical Biochemistry und Pathobiochemistry, German Diabetes-Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
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Pyne T, Ghosh P, Dhauria M, Ganguly K, Sengupta D, Nandagopal K, Sengupta M, Das M. Prioritization of human well-being spectrum related GWAS-SNVs using ENCODE-based web-tools predict interplay between PSMC3, ITIH4, and SERPINC1 genes in modulating well-being. J Psychiatr Res 2021; 145:92-101. [PMID: 34883412 DOI: 10.1016/j.jpsychires.2021.11.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/16/2021] [Accepted: 11/21/2021] [Indexed: 11/23/2022]
Abstract
Several traits related to positive and negative affect show a high genetic as well as phenotypic correlation with well-being in humans, and are therefore collectively termed as "Well-being spectrum". Genome-Wide Association studies (GWA studies) on "well-being measurement" have led to identification of several genomic variants (Single Nucleotide Variants - SNVs), but very little has been explained with respect to their functionality and mode of alteration of well-being. Utilizing a pool of 1258 GWA studies based SNVs on "well-being measurement", we prioritized the SNVs and tried to annotate well-being related functionality through several bioinformatic tools to predict whether a protein sequence variation affects protein function, as well as experimentally validated datasets available in ENCODE based web-tools namely rSNPBase, RegulomeDB, Haploreg, along with GTEx Portal and STRING based protein interaction networks. Prioritization yielded three key SNVs; rs3781627-A, rs13072536-T and 5877-C potentially regulating three genes, PSMC3, ITIH4 and SERPINC1, respectively. Interestingly, the genes showed well clustered protein-protein interaction (maximum combined confidence score >0.4) with other well-being candidate genes, namely TNF and CRP genes suggesting their important role in modulation of well-being. PSMC3 and ITIH4 genes are also involved in driving acute phase responses signifying a probable cross-talk between well-being and psychoneuroimmunological system. To best of our knowledge this study is the first of its kind where the well-being associated GWA studies-SNVs were prioritized and functionally annotated, majorly based on functional data available in public domain, which revealed PSMC3, ITIH4 and SERPINC1 genes as probable candidates in regulation of well-being spectrum.
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Affiliation(s)
- Tushar Pyne
- Department of Genetics, University of Calcutta, 35 Ballygunge Circular Road, Kolkata, 700019, India
| | - Poulomi Ghosh
- Department of Genetics, University of Calcutta, 35 Ballygunge Circular Road, Kolkata, 700019, India
| | - Mrinmay Dhauria
- Department of Genetics, University of Calcutta, 35 Ballygunge Circular Road, Kolkata, 700019, India
| | - Kausik Ganguly
- Department of Genetics, University of Calcutta, 35 Ballygunge Circular Road, Kolkata, 700019, India
| | - Debmalya Sengupta
- Department of Genetics, University of Calcutta, 35 Ballygunge Circular Road, Kolkata, 700019, India
| | - Krishnadas Nandagopal
- Department of Genetics, University of Calcutta, 35 Ballygunge Circular Road, Kolkata, 700019, India
| | - Mainak Sengupta
- Department of Genetics, University of Calcutta, 35 Ballygunge Circular Road, Kolkata, 700019, India.
| | - Madhusudan Das
- Department of Zoology, University of Calcutta, 35 Ballygunge Circular Road, Kolkata, West Bengal, 700019, India.
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Lavallee KL, Zhang XC, Schneider S, Margraf J. Obesity and Mental Health: A Longitudinal, Cross-Cultural Examination in Germany and China. Front Psychol 2021; 12:712567. [PMID: 34646201 PMCID: PMC8504480 DOI: 10.3389/fpsyg.2021.712567] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/16/2021] [Indexed: 01/07/2023] Open
Abstract
The present study examines the relationship between obesity and mental health using longitudinal data. Participants with data at baseline and one-year follow-up were included from two countries: Germany (364) and China (9007). A series of structural equation models with three mediators and one moderator were conducted separately for female and male students in Germany and China. Zero-order correlations indicated that overweight/obesity was significantly related to later depression and anxiety in Chinese males. Additional effects of obesity on later mental health flowed through effects on attractiveness (Chinese and German females, and Chinese males), physical health (Chinese males), and life satisfaction (German females). Though overweight/obesity is related to mental health across many other studies, results in this study yield total effects between overweight/obesity and follow-up mental health only in Chinese males. The relationship between overweight/obesity and follow-up mental health was significantly mediated by follow-up attractiveness, or health state, or life satisfaction in German females, Chinese females, and Chinese male students, with no significant indirect effects found in German male students. This highlights the possible importance of culture in examining these effects.
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Affiliation(s)
- Kristen L Lavallee
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Xiao Chi Zhang
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Silvia Schneider
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
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8
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Annesi JJ. Mediators of relations of obesity treatment-associated changes in mood and weight: extending cross-sectional research. Transl Behav Med 2021; 11:2071-2080. [PMID: 34245301 DOI: 10.1093/tbm/ibab074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Significant cross-sectional associations between mood and weight have been made in women; however, data on associated longitudinal effects and their psychological and behavioral mechanisms are required to inform obesity treatments that mostly have limited success beyond the very short term. Women participating in behavioral obesity treatments were assessed on psychological and behavioral measures, and weight change over 12 months. A treatment focused on physical activity and self-regulation (n = 67) had significantly better improvements than a treatment centered around weight-loss education (n = 64) on measures of mood (overall mood, depression, anxiety), self-regulation, emotional eating, eating behaviors, physical activity, and weight in women with obesity. Incorporating a lagged variable design, 12-month weight loss was significantly predicted (separately) by changes in overall negative mood, depression, and anxiety. When changes in measures of self-regulation, emotional eating, and eating behaviors were sequentially entered as mediators, mood change-weight change relationships were rendered non-significant. Significant mediation paths were: mood change→self-regulation change→weight change, and mood change→self-regulation change→eating behavior change→weight change. They were unaffected by the treatment group. Findings contributed to both theory and obesity intervention architectures via a design sensitive to the dynamic psychological and behavioral changes occurring within weight-loss processes.
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Affiliation(s)
- James J Annesi
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
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9
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Mason TB, Naya CH, Schembre SM, Smith KE, Dunton GF. Internalizing symptoms modulate real-world affective response to sweet food and drinks in children. Behav Res Ther 2020; 135:103753. [PMID: 33049549 PMCID: PMC7793613 DOI: 10.1016/j.brat.2020.103753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 07/21/2020] [Accepted: 10/06/2020] [Indexed: 10/23/2022]
Abstract
The purpose of the current study was to examine affective response to sweet foods and drinks as a function of children's internalizing symptoms using ecological momentary assessment (EMA). A sample of 192 8-12-year-old children completed a self-report measure of internalizing symptoms and EMA prompts of affect and food intake for eight days, excluding time at school. There was an interaction between sweet food intake and internalizing symptoms for positive affect and for sweet drink intake and internalizing symptoms for negative affect. Those low in internalizing symptoms had significantly lower positive affect after consumption of sweet foods compared to when they did not consume sweet foods whereas those higher in internalizing symptoms had slightly, but not significantly, higher positive affect after consumption of sweet foods. Those low in internalizing symptoms had significantly higher negtive affect after consumption of sweet drinks compared to when they did not consume sweet drinks whereas those higher in internalizing symptoms had slightly, but not significantly, lower negative affect after consumption of sweet drinks. Findings highlight the ways in which internalizing symptoms may modulate affective response to sweet foods and drinks.
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Affiliation(s)
- Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Christine H Naya
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Susan M Schembre
- Department of Family and Community Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ, USA
| | - Kathryn E Smith
- Department of Psychiatry and Behavioral Science, University of Southern California, Los Angeles, CA, USA
| | - Genevieve F Dunton
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA; Department of Psychology, University of Southern California, Los Angeles, CA, USA
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10
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Labenz C, Huber Y, Michel M, Nagel M, Galle PR, Kostev K, Schattenberg JM. Nonalcoholic Fatty Liver Disease Increases the Risk of Anxiety and Depression. Hepatol Commun 2020; 4:1293-1301. [PMID: 32923833 PMCID: PMC7471420 DOI: 10.1002/hep4.1541] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/16/2020] [Accepted: 05/07/2020] [Indexed: 12/26/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD), depression, and anxiety disorders are frequent diseases, and data on mutual influence are inconsistent. The aim of this study was to explore the incidence of depression and anxiety in a large primary care cohort in Germany and to study the impact of NAFLD over a 10-year time frame. Patients with NAFLD diagnosed between 2010 and 2015 were matched to a cohort without NAFLD controlling for age, sex, physician, index year, and Charlson comorbidity index. The primary outcome of the study was the incidence of depression, anxiety, and first prescription of antidepressant drugs. We compared 19,871 patients with NAFLD to 19,871 matched controls. Within 10 years of the index date, 21.2% of patients with NAFLD and 18.2% of controls were diagnosed with depression (P < 0.001). On regression analysis, the hazard ratio (HR) for incidence of depression was 1.21 (P < 0.001). This association was similar for the endpoint of the first prescription of antidepressant drugs (HR, 1.21; P < 0.001). Anxiety disorders were diagnosed in 7.9% of patients with NAFLD and 6.5% of controls during the observation time (P = 0.003). The HR for incidence of anxiety was 1.23 (P < 0.001). This association remained significant in women (P < 0.001), while there was only a trend in men (HR, 1.15; 95% confidence interval, 0.99-1.34; P < 0.067). The risk of developing anxiety disorders was higher in younger patients. Conclusion: NAFLD constitutes an independent risk factor for emerging depression and anxiety even after controlling for confounding comorbidities.
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Affiliation(s)
- Christian Labenz
- I. Department of Medicine University Medical Center of the Johannes Gutenberg University Mainz Germany.,Metabolic Liver Research Program University Medical Center of the Johannes Gutenberg University Mainz Germany
| | - Yvonne Huber
- I. Department of Medicine University Medical Center of the Johannes Gutenberg University Mainz Germany.,Metabolic Liver Research Program University Medical Center of the Johannes Gutenberg University Mainz Germany
| | - Maurice Michel
- I. Department of Medicine University Medical Center of the Johannes Gutenberg University Mainz Germany.,Metabolic Liver Research Program University Medical Center of the Johannes Gutenberg University Mainz Germany
| | - Michael Nagel
- I. Department of Medicine University Medical Center of the Johannes Gutenberg University Mainz Germany.,Metabolic Liver Research Program University Medical Center of the Johannes Gutenberg University Mainz Germany
| | - Peter R Galle
- I. Department of Medicine University Medical Center of the Johannes Gutenberg University Mainz Germany.,Metabolic Liver Research Program University Medical Center of the Johannes Gutenberg University Mainz Germany
| | | | - Jörn M Schattenberg
- I. Department of Medicine University Medical Center of the Johannes Gutenberg University Mainz Germany.,Metabolic Liver Research Program University Medical Center of the Johannes Gutenberg University Mainz Germany
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11
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Binge eating and social anxiety in treatment-seeking adolescents with eating disorders or severe obesity. Eat Weight Disord 2020; 25:787-793. [PMID: 31020481 DOI: 10.1007/s40519-019-00689-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 04/09/2019] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Binge eating is a common behavior in children and adolescents who suffer from either eating disorders (EDs) or from severe obesity. The purpose of the current study was to explore the association between social anxiety and binge eating and compare prevalence rates of social anxiety between youth with severe obesity or EDs who did or did not engage in binge eating. METHODS Retrospective data on treatment-seeking youth's (n = 490) eating behaviors and social anxiety at assessment were analyzed. RESULTS Results indicate that those who engage in binge eating have higher rates of social anxiety; frequency of binges does not predict severity of social anxiety, though social anxiety predicts presence of binge eating. Adolescents with EDs had higher rates of social anxiety than those with obesity, and for both groups, rates of social anxiety were highest in those who binge. CONCLUSIONS Clinicians who treat youth with EDs and with obesity should be aware of the relationship between binge eating and social anxiety and of the need for treatment to address both these disorders. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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12
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Millard LAC, Davies NM, Tilling K, Gaunt TR, Davey Smith G. Searching for the causal effects of body mass index in over 300 000 participants in UK Biobank, using Mendelian randomization. PLoS Genet 2019; 15:e1007951. [PMID: 30707692 PMCID: PMC6373977 DOI: 10.1371/journal.pgen.1007951] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/13/2019] [Accepted: 01/09/2019] [Indexed: 12/30/2022] Open
Abstract
Mendelian randomization (MR) has been used to estimate the causal effect of body mass index (BMI) on particular traits thought to be affected by BMI. However, BMI may also be a modifiable, causal risk factor for outcomes where there is no prior reason to suggest that a causal effect exists. We performed a MR phenome-wide association study (MR-pheWAS) to search for the causal effects of BMI in UK Biobank (n = 334 968), using the PHESANT open-source phenome scan tool. A subset of identified associations were followed up with a formal two-stage instrumental variable analysis in UK Biobank, to estimate the causal effect of BMI on these phenotypes. Of the 22 922 tests performed, our MR-pheWAS identified 587 associations below a stringent P value threshold corresponding to a 5% estimated false discovery rate. These included many previously identified causal effects, for instance, an adverse effect of higher BMI on risk of diabetes and hypertension. We also identified several novel effects, including protective effects of higher BMI on a set of psychosocial traits, identified initially in our preliminary MR-pheWAS in circa 115,000 UK Biobank participants and replicated in a different subset of circa 223,000 UK Biobank participants. Our comprehensive MR-pheWAS identified potential causal effects of BMI on a large and diverse set of phenotypes. This included both previously identified causal effects, and novel effects such as a protective effect of higher BMI on feelings of nervousness.
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Affiliation(s)
- Louise A. C. Millard
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
- Intelligent Systems Laboratory, Department of Computer Science, University of Bristol, Bristol, United Kingdom
| | - Neil M. Davies
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - Kate Tilling
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - Tom R. Gaunt
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - George Davey Smith
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
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High fat diet induced-obesity facilitates anxiety-like behaviors due to GABAergic impairment within the dorsomedial hypothalamus in rats. Behav Brain Res 2017; 316:38-46. [DOI: 10.1016/j.bbr.2016.08.042] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 08/18/2016] [Accepted: 08/22/2016] [Indexed: 12/24/2022]
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Ma K, Zhang H, Baloch Z. Pathogenetic and Therapeutic Applications of Tumor Necrosis Factor-α (TNF-α) in Major Depressive Disorder: A Systematic Review. Int J Mol Sci 2016; 17:ijms17050733. [PMID: 27187381 PMCID: PMC4881555 DOI: 10.3390/ijms17050733] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 04/29/2016] [Accepted: 05/06/2016] [Indexed: 02/07/2023] Open
Abstract
Major depressive disorder (MDD) is characterized by mood, vegetative, cognitive, and even psychotic symptoms and signs that can cause substantial impairments in quality of life and functioning. Up to now, the exact pathogenesis of MDD remains poorly understood. Recent research has begun to reveal that the pro-inflammatory cytokines, particularly, tumor necrosis factor-α (TNF-α), play an integral role in the pathophysiology of depressive disorders and the mechanism of antidepressant treatment. On the base of several observations: it is found that subsets of MDD patients have enhanced plasma levels TNF-α; antidepressant treatments had linked with the decline of TNF-α; central administration of TNF-α gives rise to sickness behavior which shares features with depression; and a blockade of it can ameliorate depressive symptomatology in animal models and clinical trials. In this review article, we focus on recent evidence linking TNF-α and MDD looking at data from animal and clinical studies, illustrating the pathophysiological role, susceptibility and its therapeutic application in depression. We conclude by discussing future directions for research, in particular the opportunities for the development of novel therapeutics that target TNF-α. This will be very important for designing preventative strategies and for the identification of new drug targets and preventative strategies.
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Affiliation(s)
- Ke Ma
- Department of Physiology, Medical College of Qingdao University, Qingdao 266071, China.
| | - Hongxiu Zhang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China.
| | - Zulqarnain Baloch
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China.
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McLean RC, Morrison DS, Shearer R, Boyle S, Logue J. Attrition and weight loss outcomes for patients with complex obesity, anxiety and depression attending a weight management programme with targeted psychological treatment. Clin Obes 2016; 6:133-42. [PMID: 26842226 DOI: 10.1111/cob.12136] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The objective of the study is to investigate the effect of baseline anxiety and depression, using different definitions for caseness, on attrition and weight outcomes following a multidisciplinary weight management programme. The study design is a prospective observational study. The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression with 'caseness' scoring ≥11 and severity ≥14. The participants were all patients who began a weight management programme between 1 October 2008 and 30 September 2009 (n = 1838). The setting was the Glasgow and Clyde Weight Management Service (GCWMS), a specialist multidisciplinary service, which aims to achieve a minimum of ≥5 kg weight loss. The results were as follows: patients with HADS score ≥14 were referred to the integrated psychology service for psychological assessment or intervention. Patients with caseness (HADS ≥11) for anxiety (33%) and depression (27%) were significantly younger, heavier, more socio-economically deprived and a higher proportion was female. There was a significant positive correlation between HADS anxiety and depression scores and increasing body mass index (r(2) = 0.094, P < 0.001 and r(2) = 0.175, P < 0.001, respectively). Attendance and completion was lower throughout follow-up amongst patients with anxiety or depression. More patients with HADS score ≥11 achieved ≥5 kg or ≥5% weight loss and by 12 months those with anxiety had a significantly higher mean weight loss (P = 0.032). Participants who scored for severe anxiety (HADS ≥14) achieved similar weight loss to those without, whilst participants who scored for severe depression achieved significantly greater weight loss than non-cases at 3, 6 and 12 months of follow-up (P < 0.01). Despite a less favourable case-mix of risk-factors for poor weight loss, patients who scored caseness for severe anxiety or depression and were offered additional psychological input achieved similar or better weight loss outcomes.
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Affiliation(s)
- R C McLean
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - D S Morrison
- West of Scotland Cancer Surveillance Unit, 1 Lilybank Gardens, Glasgow, UK
| | - R Shearer
- Glasgow and Clyde Weight Management Service, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - S Boyle
- Glasgow and Clyde Weight Management Service, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - J Logue
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
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Stewart KE, Haller DL, Sargeant C, Levenson JL, Puri P, Sanyal AJ. Readiness for behaviour change in non-alcoholic fatty liver disease: implications for multidisciplinary care models. Liver Int 2015; 35:936-43. [PMID: 24521540 PMCID: PMC4266620 DOI: 10.1111/liv.12483] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 01/31/2014] [Indexed: 12/28/2022]
Abstract
BACKGROUND & AIMS Weight management is a cornerstone of treatment for overweight/obese persons with non-alcoholic fatty liver disease (NAFLD). This exploratory study sought to: (i) evaluate readiness to change weight-related behaviours; (ii) assess psychosocial characteristics that may interfere with weight loss; and (iii) evaluate how baseline psychosocial features associate with 6-month change in weight in persons with NAFLD receiving standard medical care. The purpose of this investigation was to develop hypotheses regarding relationships between psychosocial factors and weight for use in future fully powered studies and clinical interventions METHODS Fifty-eight overweight/obese participants with NAFLD completed baseline measures of personality, psychiatric symptoms and readiness for behaviour change and were followed up for 6 months in standard care. RESULTS One-third of participants (31.0%) were not interested in making weight-related behaviour changes; 58.6% were considering making a change, and 10.4% of individuals were actively working on or preparing to change. Six-month change in weight was non-significant and was not associated with baseline readiness for change. Depression, low conscientiousness and high neuroticism were associated with higher weight at 6-month follow-up with small to large effect sizes. CONCLUSIONS Although participants received nutritional education and guidance, very few individuals presented in the active stage of change. Although readiness for change did not predict subsequent change in weight, personality factors and psychiatric symptoms were associated with weight outcomes. Integrated multidisciplinary approaches that address psychiatric needs and provide behavioural support for weight loss may help patients with NAFLD implement sustained lifestyle changes.
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Affiliation(s)
- Karen E. Stewart
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University School of Medicine, Richmond, VA, USA,Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | | | - Carol Sargeant
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - James L. Levenson
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Puneet Puri
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Arun J. Sanyal
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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17
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de Winter CF, Hermans H, Evenhuis HM, Echteld MA. Associations of symptoms of anxiety and depression with diabetes and cardiovascular risk factors in older people with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:176-185. [PMID: 23627768 DOI: 10.1111/jir.12049] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/04/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Depression, anxiety, diabetes and cardiovascular risk factors are frequent health problems among older people with intellectual disability (ID). These conditions may be bidirectionally related. Depression and anxiety may have biological effects causing glucose intolerance, fat accumulation and also lifestyle changes causing metabolic syndrome. But also the effects of diabetes, metabolic syndrome and subsequent cardiovascular disease may affect mood and anxiety. This study investigated the association between depression, anxiety and diabetes and cardiovascular risk factors in older people with ID. METHODS The healthy ageing in intellectual disability-study (HA-ID study) is a cross-sectional study among people aged 50 years and over with ID, receiving formal ID care. Screening instruments for symptoms of anxiety and depression were completed and physical examination and vena-puncture were performed to establish components of the metabolic syndrome, peripheral arterial disease and c-reactive protein. RESULTS Of the 990 people who participated, 17% had symptoms of depression and 16% had symptoms of anxiety. Type I diabetes was present in 1%, type II diabetes in 13% of the study population. Metabolic syndrome, central obesity, hypercholesterolemia and hypertension were present in 45%, 48%, 23% and 53% respectively. In a multivariate logistic regression analysis a significant association was found between increased anxiety symptoms and diabetes only (OR 2.4, 95%CI 1.2-4.9). CONCLUSIONS Increased anxiety symptoms and diabetes are related in older people with ID. This association may be bidirectional. No other associations of depression and anxiety symptoms with cardiovascular risk factors could be proven to be significant. Therefore, more research is needed to unravel the mechanisms of stress, mood disorders and cardiovascular disease in older people with ID. To provide comprehensive care for older people with ID, screening for diabetes and components of the metabolic syndrome in people with anxiety or mood disorders, and screening for symptoms of anxiety or depression in people with diabetes is warranted.
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Affiliation(s)
- C F de Winter
- Intellectual Disability Medicine, Erasmus Medical Center Rotterdam, Department of General Practice, Rotterdam, The Netherlands; Reinaerde, Den Dolder, The Netherlands
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18
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Walter S, Glymour MM, Koenen K, Liang L, Tchetgen Tchetgen EJ, Cornelis M, Chang SC, Rewak M, Rimm E, Kawachi I, Kubzansky LD. Do genetic risk scores for body mass index predict risk of phobic anxiety? Evidence for a shared genetic risk factor. Psychol Med 2015; 45:181-191. [PMID: 25065638 PMCID: PMC4387884 DOI: 10.1017/s0033291714001226] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Obesity and anxiety are often linked but the direction of effects is not clear. METHOD Using genetic instrumental variable (IV) analyses in 5911 female participants from the Nurses' Health Study (NHS, initiated 1976) and 3697 male participants from the Health Professional Follow-up Study (HPFS, initiated 1986), we aimed to determine whether obesity increases symptoms of phobic anxiety. As instrumental variables we used the fat mass and obesity-associated (FTO) gene, the melanocortin 4 receptor (MC4R) gene and a genetic risk score (GRS) based on 32 single nucleotide polymorphisms (SNPs) that significantly predict body mass index (BMI). 'Functional' GRSs corresponding with specific biological pathways that shape BMI (adipogenesis, appetite and cardiopulmonary) were considered. The main outcome was phobic anxiety measured by the Crown Crisp Index (CCI) in 2004 in the NHS and in 2000 in the HPFS. RESULTS In observational analysis, a 1-unit higher BMI was associated with higher phobic anxiety symptoms [women: β = 0.05, 95% confidence interval (CI) 0.030-0.068; men: β = 0.04, 95% CI 0.016-0.071). IV analyses showed that BMI was associated with higher phobic anxiety symptoms in the FTO-instrumented analysis (p = 0.005) but not in the GRS-instrumented analysis (p = 0.256). Functional GRSs showed heterogeneous, non-significant effects of BMI on phobic anxiety symptoms. CONCLUSIONS Our findings do not provide conclusive evidence in favor of the hypothesis that higher BMI leads to higher levels of phobic anxiety, but rather suggest that genes that influence obesity, in particular FTO, may have direct effects on phobic anxiety, and hence that obesity and phobic anxiety may share common genetic determinants.
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Affiliation(s)
- S Walter
- Department of Social and Behavioral Sciences,Harvard School of Public Health,Boston, MA,USA
| | - M M Glymour
- Department of Social and Behavioral Sciences,Harvard School of Public Health,Boston, MA,USA
| | - K Koenen
- Mailman School of Public Health,Columbia University,New York, NY,USA
| | - L Liang
- Department of Epidemiology,Harvard School of Public Health,Boston, MA,USA
| | | | - M Cornelis
- Department of Nutrition,Harvard School of Public Health,Boston, MA,USA
| | - S-C Chang
- Department of Social and Behavioral Sciences,Harvard School of Public Health,Boston, MA,USA
| | - M Rewak
- Department of Social and Behavioral Sciences,Harvard School of Public Health,Boston, MA,USA
| | - E Rimm
- Department of Epidemiology,Harvard School of Public Health,Boston, MA,USA
| | - I Kawachi
- Department of Social and Behavioral Sciences,Harvard School of Public Health,Boston, MA,USA
| | - L D Kubzansky
- Department of Social and Behavioral Sciences,Harvard School of Public Health,Boston, MA,USA
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Yates KF, Larr AS, Sweat V, Maayan L, Siegel C, Convit A. Hispanic Youth With Excess Weight Display Psychological Distress. HISPANIC JOURNAL OF BEHAVIORAL SCIENCES 2014. [DOI: 10.1177/0739986314522111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adolescent overweight/obesity (OW/O) has reached epidemic proportions. The Youth Self-Report (YSR) was administered to 514 primarily Hispanic urban high school students to examine the relationship between weight and psychological distress. YSR and study population-specific norms were used to assess risk on Anxious/Depressed, Withdrawn/Depressed, Somatic Complaints, and Social Problems scales. OW/O status increased Social Problems regardless of norms. OW/O students endorsed greater Withdrawn/Depressed symptoms with YSR norms; greater Anxious/Depressed and Somatic Complaints were endorsed with population-specific norms. Females drive results. Findings suggest norms need to incorporate minority and economically disadvantaged groups.
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Affiliation(s)
- Kathy F. Yates
- New York University School of Medicine, USA
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Allison S. Larr
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | | | - Lawrence Maayan
- New York University School of Medicine, USA
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Carole Siegel
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Antonio Convit
- New York University School of Medicine, USA
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
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20
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Suicidal ideation in Korean persons with spinal cord injury. Spinal Cord 2013; 51:789-93. [PMID: 23999107 DOI: 10.1038/sc.2013.92] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 07/17/2013] [Accepted: 07/24/2013] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Cross-sectional survey. OBJECTIVES To investigate the prevalence of suicidal ideation and attempt in Korean persons with spinal cord injury (SCI) and the factors related with suicidal ideation in comparison with a control group (CG). SETTINGS Community-dwelling persons with chronic SCI in Korea. METHODS A total of 382 persons with chronic SCI and 1104 able-bodied persons randomly selected from the general population and matched for age, sex and education level were compared. Suicidal ideation and attempt were recorded positive if the subjects had that experience during the past year. Psychosocial variables and injury-related factors were also evaluated. RESULTS Suicidal ideation was found in 34.8% (127/365) of SCI persons and 10.4% (115/1104) in the CG (P<0.001). The rate of suicidal attempt among those with suicidal ideation was 17.3% (22/127) in SCI and 8.7% (10/115) in CG (P=0.048). Multiple logistic regression revealed that SCI itself (odds ratio (OR) 2.865) was a significant risk factor of suicidal ideation. However, completeness of injury and injury level were not significantly associated with suicidal ideation. Depressive mood (OR 11.194, P<0.001) and female gender (OR 3.706, P<0.001) were significant risk factors of suicidal ideation in the SCI group with a predictive percentage of 77.5%. CONCLUSION Suicidal ideation was more frequent among Korean persons with SCI compared with able-bodied peers and closely related to psychosocial adjustment. The results support the need for active intervention to prevent suicide regardless of injury severity.
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Brumpton B, Langhammer A, Romundstad P, Chen Y, Mai XM. The associations of anxiety and depression symptoms with weight change and incident obesity: The HUNT Study. Int J Obes (Lond) 2012; 37:1268-74. [PMID: 23229732 DOI: 10.1038/ijo.2012.204] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 10/16/2012] [Accepted: 11/08/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate the associations of anxiety and depression symptoms with weight change and incident obesity in men and women. DESIGN We conducted a prospective cohort study using the Norwegian Nord-Trøndelag Health Study (HUNT). SUBJECTS The study cohort included 25 180 men and women, 19-55 years of age from the second survey of the HUNT (1995-1997). MEASUREMENTS Anxiety and depression symptoms were measured using the Hospital Anxiety and Depression Scale. Weight change was determined for the study period of an average 11 years. Incident obesity was new-onset obesity classified as having a body mass index of 30.0 kg m(2) at follow-up. The associations of anxiety or depression with weight change in kilograms (kg) was estimated using linear regression models. Risk ratios (RRs) for incident obesity associated with anxiety or depression were estimated using log-binomial regression. RESULTS In men, any anxiety or depression was associated with an average 0.81 kg (95% confidence interval (CI) 0.27-1.34) larger weight change after 11 years compared with those without such symptoms (mean weight change: 5.04 versus 4.24 kg). Women with any anxiety or depression had an average 0.98 kg (95% confidence interval (CI) 0.49-1.47) larger weight change compared with those without such symptoms (mean weight change: 5.02 versus 4.04 kg). Participants with any anxiety or depression had a significantly elevated cumulative incidence of obesity (men: RR 1.37, 95% CI 1.13-1.65; women: RR 1.18, 95% CI 1.00-1.40). CONCLUSION We found that symptoms of anxiety and depression were associated with larger weight change and an increased cumulative incidence of obesity in both men and women.
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Affiliation(s)
- B Brumpton
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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22
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Stewart KE, Levenson JL. Psychological and psychiatric aspects of treatment of obesity and nonalcoholic fatty liver disease. Clin Liver Dis 2012; 16:615-29. [PMID: 22824484 PMCID: PMC4843993 DOI: 10.1016/j.cld.2012.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Chronic illnesses incur a tremendous cost to American lives in dollars and quality of life. Outcomes in these illnesses are often affected by psychological, behavioral, and pharmacologic issues related to mental illness and psychological symptoms. This article focuses on psychological and psychiatric issues related to the treatment of obesity and nonalcoholic fatty liver disease (NAFLD), including available weight-loss interventions, the complex relationship between psychiatric disorders and obesity, and special considerations regarding use of psychiatric drugs in patients with or at risk for NAFLD and obesity. Recommendations for collaborative care of individuals with comorbid NAFLD and psychological disorders/symptoms are discussed.
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