Psychiatric diagnosis in children and adolescents with obesity-related health conditions

Objective: Childhood obesity is linked with a number of problematic health conditions. While data suggest that children who are obese are at increased risk of psychosocial distress relative to nonobese peers, there are limited data outlining the rates of psychiatric diagnoses in children with obesity-related health conditions such as type 2 diabetes and the metabolic syndrome. Methods: This study used Medicaid claims data from the State of Florida to compare the rates of psychiatric diagnoses for children with obesity-related health conditions, aged 5 to 18 years, to those of children with comparison chronic health conditions. Results: Overall, 35% of children with an obesity-related diagnosis had a psychiatric diagnosis. While controlling for age, gender, and race, youths with type 2 diabetes, the metabolic syndrome, and dyslipidemia had higher rates of International Classification of Disease, Ninth Revision (ICD-9) psychiatric diagnoses than children with cystic fibrosis, sickle cell disease, and juvenile rheumatoid arthritis (p < .001), but similar to those of children with asthma. Non-Hispanic white children with an obesity-related health condition had greater odds of receiving a psychiatric diagnosis than African American (odds ratio [OR] = 0.54, p < .001) or Hispanic (OR = 0.41, p < .001) children. Males and females differed in rates of externalizing and internalizing diagnoses. Conclusions:The data suggest that children with an obesity-related health condition have higher rates of internalizing and externalizing mental health conditions relative to children with other chronic health conditions. Prospective, longitudinal research is needed to further confirm these findings and examine factors that affect this association and potential impacts on the health care system.