title: Do Puerto Rican youth with asthma and obesity have higher odds for mental health disorders?
abstract: BACKGROUND
  Island Puerto Rican (PR) youth experience disproportionately high asthma and obesity rates compared with other racial/ethnic groups on the U.S. mainland. Previous research has demonstrated associations of chronic disease with psychiatric disorders.
  
  
  OBJECTIVE
  We examined the relationship among anxiety/depressive disorders, asthma, and obesity in an epidemiologic community sample of youth.
  
  
  METHODS
  The sample (n = 656) was derived from the second wave of an island-wide probabilistic representative household sample of PR youth stratified and based on whether or not they had a diagnosis of asthma and/or depressive/anxiety disorder. For this study, we used the subpopulation ages 10-19 years.
  
  
  RESULTS
  Asthma and obesity were significantly related to higher odds of depressive/anxiety disorders in youth. Obesity moderated the relationship between asthma attacks and depressive/anxiety disorders. The relationship between asthma attack and higher odds for depressive/anxiety disorders was only present in the non-obese group. Among the obese, females show a significant increase from 11% to 36% in the prevalence of anxiety/depressive disorders. Asthma and obesity were highly prevalent and a significant association was found between asthma attack and depressive/anxiety disorders. The effects of asthma and obesity were not additive; the prevalence for psychiatric disorder for those having both conditions did not increase above the prevalence associated having only one of the conditions.
  
  
  CONCLUSIONS
  Future studies should consider including longitudinal designs and examine the extent to which important variables not included in this study, such as body image dissatisfaction (particularly among females), teasing, and discrimination may moderate the relationship among obesity and depressive and anxiety disorders in youth.
authors.affiliation: Behavioral Science Research Institute, University of Puerto Rico, Medical Science Campus, San Juan, Puerto Rico. edna.acosta2@upr.edu
authors.forename: Edna
authors.initials: E
authors.lastname: Acosta-Pérez
authors.forename: Glorisa
authors.initials: G
authors.lastname: Canino
authors.forename: Rafael
authors.initials: R
authors.lastname: Ramírez
authors.forename: Michael
authors.initials: M
authors.lastname: Prelip
authors.forename: Molly
authors.initials: M
authors.lastname: Martin
authors.forename: Alexander N
authors.initials: AN
authors.lastname: Ortega
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology*; D001249:Asthma / Q000453:epidemiology*; D015992:Body Mass Index; D002648:Child; D002908:Chronic Disease; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D011647:Puerto Rico / Q000453:epidemiology; D012720:Severity of Illness Index; D017678:Sex Distribution; D012737:Sex Factors; D012923:Social Class; D055815:Young Adult