title: Depressive symptoms in severely obese compared with normal weight adolescents: results from a community-based longitudinal study.
abstract: OBJECTIVE
  Little is known about the relationship between severe obesity and depressive symptoms, particularly in community as opposed to clinic-based samples. This study determined the relationship of severe obesity and depressive symptoms over 3 years in a community-based sample of non-Hispanic black and white adolescents in grades 7-12 at baseline.
  
  
  METHODS
  The nested matched cohort study using data from a longitudinal school-based study of youth followed up for 3 years. A total of 51 severely obese participants (body mass index-for-age ≥99% and a body mass index ≥40 at one or more study visit) were identified and paired with an age-, gender-, and race-matched normal weight subject. Depressive symptoms (Center for Epidemiological Studies Depression [CES-D] scale) were assessed at baseline, 2 and 3 years later. High-depressive symptoms were defined by CES-D score above cut points predictive of major depressive disorder or use of antidepressant medication.
  
  
  RESULTS
  Pairs were 73% non-Hispanic black, 67% females. There was no relationship between weight status and high-depressive symptoms at any assessment point. However, a positive association between weight status and CES-D scores, while not present at baseline or at 2 years, emerged at 3 years (p = .02). This relationship was present only among non-Hispanic whites (p = .006 whites, p = .25 blacks) and did not differ by gender.
  
  
  CONCLUSIONS
  Severely obese youth in this community sample did not have increased likelihood of high levels of depressive symptoms. However, significantly increased depressive symptoms among non-Hispanic white youth at the end of the follow-up period suggests that this racial/ethnic group may be particularly vulnerable to the psychological effects of obesity in late adolescence and/or early adulthood.
authors.affiliation: Center for Child and Adolescent Health Policy, Massachusetts General Hospital for Children, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts 02114, USA. egoodman3@partners.org
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Goodman
authors.forename: Aviva
authors.initials: A
authors.lastname: Must
mesh_terms: D000293:Adolescent; D000928:Antidepressive Agents / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000523:psychology*; D012720:Severity of Illness Index
chemical_list: D000928:Antidepressive Agents