Rates of psychiatric disorders in a clinical study group of adolescents with extreme obesity and in obese adolescents ascertained via a population based study

OBJECTIVE: To compare rates of DSM-IV psychiatric disorders between (1) a c linical study group of extremely obese adolescents and young adults, (2) ge nder-matched population-based obese controls and (3) a population-based con trol group of the same age range. D DESIGN: Rates of psychiatric disorders were assessed in (1) the clinical st udy group of obese adolescents and (2) the population based sample of obese adolescents, and compared to (3) a large population-based control group us ing a standardized psychiatric interview. SUBJECTS: (1) Clinical study group: 30 female and 17 male extremely obese a dolescents and young adults (age range: 15-21 y; mean BMI : 42.4 kg/m(2)). (2) Thirty females and 17 males with the highest BMI (age range 15-21 y; me an BMI : 29.8 kg/m(2)) of a population-based control group encompassing 165 5 (805 males) adolescents and young adults. (3) The population based contro l group excluding the 30 females and 17 males with the highest BMI (n = 160 8; 788 males). MEASUREMENTS: Munich-Composite International Diagnostic Interview (M-CIDI) allowing for DSM-IV diagnoses. RESULTS: High rates of mood, anxiety, somatoform and eating disorders were detected in the clinical sample of obese adolescents which exceeded those o bserved in population controls (all P-values < 0.01). Rates between populat ion-based obese adolescents and young adults and population controls did no t differ. In most patients the psychiatric disorders set in after onset of obesity, 57% and 35% of the female and male patients, respectively, reporte d eating binges with lack of control. However, less than one-half of these patients qualified for a DSM-IV diagnosis of an eating disorder. CONCLUSIONS: Extremely obese adolescents and young adults who seek long-ter m inpatient treatment have a high lifetime prevalence for affective, anxiet y, somatoform and eating disorders. Because the mean BMI of the clinical st udy group was considerably higher than that of the obese population control s, we were not able to clarify whether the high rate of psychopathology in the study group was related to the extreme obesity or to their treatment-se eking behavior.