Anxiety, Family Functioning and Neuroendocrine Biomarkers in Obese Children

Introduction: This observational study explores potential links between obese children's cortisol, and parental mental state, family functioning, and the children's symptoms of anxiety and depression. Material and Methods: A non-random sample of 104 obese children (55 boys), mean age 10.9 years (standard deviation 1.76), was recruited from a childhood obesity clinic. Obesity was defined as body mass index above the 95th age-and gender-specific percentiles. Neuroendocrine biomarkers were measured. Symptoms of anxiety and depression were assessed with self and parent-reported questionnaires (Anxiety, Depression and Stress Scales; Child Behaviour Checklist). Family functioning was assessed with parent-reported questionnaires (Family Adaptation and Cohesion Scales-III). Results: A significant, negative correlation (r(s) = -0.779; p = 0.003) between girls' cortisol and their parents' anxiety symptoms was found, limited to high functioning families. Boys scored significantly higher than girls on parent-reported internalizing symptoms but not on self-report. No association was found between cortisol in children and parental depressive symptoms. Discussion: Whether the association between cortisol levels in obese children and parental mental health is effectively restricted to girls from high functioning families or is due to study limitations, requires further research. The lack of associations between cortisol in children and parental depressive symptoms, suggests a specific association between cortisol and parental anxiety symptoms. Conclusion: These results highlight the importance of taking into account family functioning, parental mental state and gender, when investigating neuroendocrine biomarkers in obese children associated with symptoms of anxiety and depression.