title: Food insecurity and mental disorders in a national sample of U.S. adolescents.
abstract: OBJECTIVE
  To examine whether food insecurity is associated with past-year DSM-IV mental disorders after controlling for standard indicators of family socioeconomic status (SES) in a U.S. national sample of adolescents.
  
  
  METHODS
  Data were drawn from 6,483 adolescent-parent pairs who participated in the National Comorbidity Survey Replication Adolescent Supplement, a national survey of adolescents 13 to 17 years old. Frequency and severity of food insecurity were assessed with questions based on the U.S. Department of Agriculture's Food Security Scale (standardized to a mean of 0, variance of 1). DSM-IV mental disorders were assessed with the World Health Organization Composite International Diagnostic Interview. Associations of food insecurity with DSM-IV/Composite International Diagnostic Interview diagnoses were estimated with logistic regression models controlling for family SES (parental education, household income, relative deprivation, community-level inequality, and subjective social status).
  
  
  RESULTS
  Food insecurity was highest in adolescents with the lowest SES. Controlling simultaneously for other aspects of SES, standardized food insecurity was associated with an increased odds of past-year mood, anxiety, behavior, and substance disorders. A 1 standard deviation increase in food insecurity was associated with a 14% increase in the odds of past-year mental disorder, even after controlling for extreme poverty. The association between food insecurity and mood disorders was strongest in adolescents living in families with a low household income and high relative deprivation.
  
  
  CONCLUSIONS
  Food insecurity is associated with a wide range of adolescent mental disorders independently of other aspects of SES. Expansion of social programs aimed at decreasing family economic strain might be one useful policy approach for improving youth mental health.
authors.affiliation: Division of General Pediatrics, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Ave., Boston, MA 02115, USA. Katie.McLaughlin@childrens.harvard.edu
authors.forename: Katie A
authors.initials: KA
authors.lastname: McLaughlin
authors.forename: Jennifer Greif
authors.initials: JG
authors.lastname: Green
authors.forename: Margarita
authors.initials: M
authors.lastname: Alegría
authors.forename: E
authors.initials: E
authors.lastname: Jane Costello
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Gruber
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Sampson
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D008603:Mental Health / Q000706:statistics & numerical data; D012924:Social Conditions / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology