The Impact of Obesity on Treatment for Depression in Youth
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The relationship between weight status and depression in children and adolescents was examined through an analysis of pooled data from three studies of Major Depressive Disorder in youth. Participants included 434 youth, ages 8 to 17. During the acute phase of treatment (0 to 12 weeks), youth received open treatment with fluoxetine. Participants were divided into three groups: normal weight, overweight, and obese. This study examined the association between weight status and various baseline characteristics of depression. The associations of weight status with depression severity (as measured by the Children’s Depression Rating Scale-Revised), remission status (defined as a score of ≤ 28 on the Children’s Depression Rating Scale-Revised and a Clinical Global Impressions-Improvement score of 1 or 2 following 12 weeks of acute treatment with fluoxetine), and time to remission were examined. Weight status was associated with ethnicity, such that African American participants were more highly represented in the obese group than in normal and overweight groups. Additionally, obesity status (obese, not obese) was associated with ethnicity, such that Caucasians were more highly represented in the nonobese group than in the obese group. Obesity status was also found to be significantly associated with a family history of depression, such that those with a positive family history of depression were more likely to be categorized as obese. Change in depressive symptoms over time and time to remission were not found to be associated with weight status as hypothesized. Remission status was found to be associated with weight status, age, and family history of depression. Results suggest that youth with normal weight may have a better response to depression treatment. Further research is needed in the area of obesity and depression in youth as it relates to outcomes for depression treatment to better understand this complex relationship.