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      Adaptação Psicossocial na Obesidade Pediátrica: Um Estudo com Pais, Crianças e Adolescentes Translated title: Psychosocial Adjustment in Pediatric Obesity: A Study With Parents, Children and Adolescents

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          Abstract

          Objetivo

          Os objetivos do presente estudo são 1) comparar a qualidade de vida (QdV) e os problemas psicológicos de crianças/adolescentes com obesidade, excesso de peso e peso saudável, e a QdV e sintomas de depressão e ansiedade dos seus pais; 2) averiguar se a adaptação psicossocial dos pais está associada à QdV das crianças/adolescentes através dos seus problemas psicológicos e se estas associações são moderadas pela idade da criança/adolescente.

          Método

          A amostra foi constituída por 264 díades pais-filhos divididas em 3 grupos (peso saudável, excesso de peso e obesidade).

          Resultados

          As crianças/adolescentes com obesidade reportaram pior QdV e maiores níveis de problemas psicológicos do que as crianças/adolescentes com peso saudável. Os adolescentes reportaram pior QdV do que as crianças. Os pais das crianças/adolescentes com obesidade reportaram pior QdV e mais sintomas ansiosos e depressivos comparativamente aos pais das crianças/adolescentes com peso saudável. A associação entre ansiedade dos pais e a QdV das crianças/adolescentes foi mediada pelos problemas psicológicos dos adolescentes.

          Conclusão

          É fundamental a implementação de intervenções multidisciplinares focadas na família, que visem a perda de peso da criança/adolescente, mas também a promoção da saúde mental e da QdV das crianças/adolescentes e dos seus pais.

          Translated abstract

          Aim

          This study aims to 1) compare the quality of life (QoL) and psychological problems of children/adolescents with obesity, overweight and healthy weight, as well as the QoL and depressive and anxiety symptoms of their parents; and 2) investigate if parental psychosocial adaptation is associated with the QoL of children/adolescents through their psychological problems, and whether these associations are moderated by the age of the child/adolescent.

          Method

          The sample comprised 264 dyads (parent-child) divided into 3 groups (healthy weight, overweight and obesity).

          Results

          Children/adolescents with obesity reported worse QoL and more psychological problems than children/adolescents with healthy weight. Adolescents reported worse QoL than children. Parents of children/adolescents with obesity reported worse QoL and more anxiety and depressive symptoms compared to parents of normal-weight children/adolescents. The association between parental anxiety and the QoL of children/adolescents was mediated by psychological problems of adolescents.

          Conclusion

          It is fundamental to implement multidisciplinary family focused interventions, aiming not only at the weight loss of children/adolescents with obesity, but also at the promotion of mental health and QoL of these children/adolescents and of their parents.

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          Most cited references30

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          The hospital anxiety and depression scale.

          A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
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            The Strengths and Difficulties Questionnaire: a research note.

            R. Goodman (1997)
            A novel behavioural screening questionnaire, the Strengths and Difficulties Questionnaire (SDQ), was administered along with Rutter questionnaires to parents and teachers of 403 children drawn from dental and psychiatric clinics. Scores derived from the SDQ and Rutter questionnaires were highly correlated; parent-teacher correlations for the two sets of measures were comparable or favoured the SDQ. The two sets of measures did not differ in their ability to discriminate between psychiatric and dental clinic attenders. These preliminary findings suggest that the SDQ functions as well as the Rutter questionnaires while offering the following additional advantages: a focus on strengths as well as difficulties; better coverage of inattention, peer relationships, and prosocial behaviour; a shorter format; and a single form suitable for both parents and teachers, perhaps thereby increasing parent-teacher correlations.
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              Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies.

              Association between obesity and depression has repeatedly been established. For treatment and prevention purposes, it is important to acquire more insight into their longitudinal interaction. To conduct a systematic review and meta-analysis on the longitudinal relationship between depression, overweight, and obesity and to identify possible influencing factors. Studies were found using PubMed, PsycINFO, and EMBASE databases and selected on several criteria. Studies examining the longitudinal bidirectional relation between depression and overweight (body mass index 25-29.99) or obesity (body mass index > or =30) were selected. Unadjusted and adjusted odds ratios (ORs) were extracted or provided by the authors. Overall, unadjusted ORs were calculated and subgroup analyses were performed for the 15 included studies (N = 58 745) to estimate the effect of possible moderators (sex, age, depression severity). Obesity at baseline increased the risk of onset of depression at follow-up (unadjusted OR, 1.55; 95% confidence interval [CI], 1.22-1.98; P or =60 years) but not among younger persons (aged <20 years). Baseline depression (symptoms and disorder) was not predictive of overweight over time. However, depression increased the odds for developing obesity (OR, 1.58; 95% CI, 1.33-1.87; P < .001). Subgroup analyses did not reveal specific moderators of the association. This meta-analysis confirms a reciprocal link between depression and obesity. Obesity was found to increase the risk of depression, most pronounced among Americans and for clinically diagnosed depression. In addition, depression was found to be predictive of developing obesity.
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                Author and article information

                Contributors
                maria.rgouveia@gmail.com
                helena.tcmoreira@gmail.com
                mccanavarro@fpce.uc.pt
                Journal
                PCH
                Psychol Community Health
                Psychology, Community & Health
                Psychol. Community Health
                PsychOpen
                2182-438X
                08 August 2016
                : 5
                : 2
                : 85-101
                Affiliations
                [a ]Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Coimbra, Portugal
                [2]William James Center for Research, ISPA – Instituto Universitário de Ciências Psicológicas, Socias e da Vida, Lisbon, Portugal
                [3]ISCTE - Instituto Universitário de Lisboa, Lisbon, Portugal
                Author notes
                [* ]Grupo de Investigação “Relações, Desenvolvimento e Saúde”, CINEICC - Centro de Investigação do Núcleo de Estudos e Intervenção Cognitivo-Comportamental, Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Rua do Colégio Novo, 3000-115 Coimbra, Portugal. roberta_frontini@ 123456hotmail.com
                Article
                pch.v5i2.182
                10.5964/pch.v5i2.182
                ccdc4e42-d461-4fd9-be6a-05dcb26058fa
                Copyright @ 2016

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 05 January 2016
                : 16 June 2016
                Categories
                Empirical Articles

                Psychology
                família,problemas psicológicos,qualidade de vida,excesso de peso,obesidade,family,psychological problems,quality of life,overweight,obesity

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