青少年體重狀態與憂鬱症狀之關係：體重認知、體重關心以及節食行為之角色

背景與目標：青少年肥胖和憂鬱症在近年都有明顯增加的趨勢，並對健康造成不少的危害。對於兩者之間是否相關，過去雖有許多研究，但未有明確的結論。本研究主要是探討青少年體重狀態(體重正常、過重、肥胖)和憂鬱症狀之間是否有相關，並試圖找出可能的媒介因子(體重認知、體重關心、節食行為)。方法：我們以隨機抽樣的方式在台北市選出了兩所國中、兩所高中，總共收集了869位學生的問卷資料來進行統計分析。身體質量指數主要是根據受試者自行填答的身高體重來計算，再依據同年齡、同性別的標準區分為體重正常、過重和肥胖。憂鬱症狀分數的測量則是根據CESD (Center for Epidemiologic Studies Depression Scale)來評估，CESD≧29定義為憂鬱症狀。我們使用卡方檢定、羅吉斯迴歸和結構方程式等方法來分析兩者之間的相關。結果：我們總共收集了869位青少年的資料(其中女性樣本佔47%)。體重狀態和憂鬱症狀之間是有顯著相關的(P=0.02)，當以性別進行分層之後，發現這相關在女性樣本消失了(P=0.37)，但在男性樣本依然存在(P=0.01)。體重狀態和體重認知、體重關心、節食行為皆有相關；而體重認知、體重關心、節食行為和憂鬱症狀之間也都有相關。體重狀態和憂鬱症狀之間的相關(OR=1.4, 95％CI: 1.1, 1.8)，在控制了體重認知、體重關心和節食行為等因子後，就變得不顯著了(OR=1.1, 95％CI: 0.7, 1.5)。結論：研究的結果顯示體重狀態和憂鬱症狀之間的相關，是藉由體重認知、體重關心和節食行為等因子所媒介的。將來需要更大型、追蹤型的世代研究，進一步探討兩者之因果關係和其可能的機轉。

關鍵字

青少年；肥胖；憂鬱症狀；體重認知；體重關心；節食行為；結構方程式

並列摘要

Background and Objectives: The prevalence of adolescent obesity and depression increased recently, and both caused hazards to adolescent health. Many researchers studied the association between obesity and depression and the results were inconsistent. We examined the association between adolescent weight status (normal weight, overweight, obesity) and depressive symptoms, and tried to find possible mediators (weight perception, weight concern and dietary restrain). Methods: We randomly selected two junior and two senior high schools in Taipei city, and totally collected eight hundred and sixty nine questionnaires. Body mass index (kg/m2) was calculated from self-reported height and weight. They were further classified as normal weight, overweigh and obesity according to age and gender specified standards. Depressive symptom score was assessed with the CESD (Center for Epidemiologic Studies Depression Scale), and CESD≧29 was defined as depressive symptoms. We analyzed the association with Chi-square test, logistic regression and structural equation modeling. Results: Totally, we collected 869 adolescents (47% girls) for data analysis. Weight status was significantly associated with depressive symptoms (P=0.02). After we striated by gender, the association in girls disappeared (P=0.37), and in boys it remained (P=0.01). Weight status was strongly associated with weight perception, weight concern and dietary restrain. Weight perception, weight concern and dietary restrain were also strongly associated with depressive symptoms. The association between weight status and depressive symptoms (OR=1.4, 95％CI: 1.1, 1.8) disappeared after controlling for weight perception, weight concern and dietary restrain (OR=1.1, 95％CI: 0.7, 1.5). Conclusions: The association between weight status and depressive symptoms were mediated by weight perception, weight concerns and dietary restrain. We need further prospective cohort study to explore the association between weight status and depressive symptoms and find possible mechanism.

並列關鍵字

Adolescents ； obesity ； depressive symptoms ； weight perception ； weight concern ； dieting ； structural equation modeling

參考文獻

17. Huang YC. Growth charts of elementary and high school students in Taiwan. 2002; http://140.122.72.62/EDU7663001/health/hplan.htm. Accessed 17th, May, 2011.

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青少年體重狀態與憂鬱症狀之關係：體重認知、體重關心以及節食行為之角色

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