Increased BMI Velocity is Associated with Elevated Patient Health Questionnaire-9 Scores in Adolescents with Obesity

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Abstract
Existing studies that have demonstrated a positive association between obesity and depression have been among adults, did not utilize the Patient Health Questionnaire (PHQ), or were conducted in a homogenous patient population. In this retrospective longitudinal cohort study of patients >11 and <18 years old with obesity in one health system we analyzed associations between change in BMI between two BMI measurements and PHQ-9 scores using chi-square and Kruskal-Wallis tests. We used PHQ-9 scores dichotomized at </≥5 as the outcome in logistic regression models to calculate the adjusted odds of having a higher PHQ-9 score for each increase in BMI per month. One-unit higher BMI change per month was associated with 2.52 times higher odds of PHQ-9 score over 5 (95% CI: 1.57-4.05) after adjusting for sex, baseline BMI, age, race, ethnicity, language, and insurance. BMI changes are associated with an increased risk of higher PHQ-9 scores. Close attention to depression screening in this population may be an important addition to other routine screening in pediatric patients with obesity.

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