Longitudinal associations between depressive symptoms and body mass index in a 20-year follow-up.

OBJECTIVE: Longitudinal studies have rarely investigated changes in depressive symptoms and indicators of obesity simultaneously, although it is often proposed that the positive relationship between depression and obesity is bidirectional. The present study examined the reciprocal nature of the relationship between depressive symptoms and body mass index (BMI) in a 20-year follow-up survey. METHODS: Participants of a Finnish cohort study in 1989 at 22 years (N=1656) were followed up at ages 32 (N=1262) and 42 (N=1155) with postal questionnaires. BMI was calculated on the basis of self-reported weight and height, and depressive symptoms were assessed using the short form of the Beck Depression Inventory. Latent growth models (LGM) and cross-lagged autoregressive models were used to determine prospective associations between depressive symptoms and BMI. RESULTS: LGM analyses indicated that men with higher initial levels of depressive symptoms experienced a faster rate of increase in BMI (ß=0.20, P<0.01). Among women, change in BMI or depressive symptoms was not predicted by the other construct, but initial levels of BMI and depressive symptoms as well as their rate of change correlated positively with each other (r=0.15 and 0.37, respectively). In cross-lagged models, depressive symptoms at age 32 predicted greater BMI at 42 (ß=0.10, P<0.001) among men, whereas women with higher BMI at age 32 were more likely to have more depressive symptoms at 42 (ß=0.08, P<0.05). CONCLUSIONS: Elevated depressive symptoms predicted weight gain in men, while changes in depressive symptoms and body weight occurred concurrently in women. Tentative evidence showed that women with excess body weight were more likely to have increased symptoms of depression 10 years later. More emphasis should be placed on depressive symptoms in weight control programs as well as on reducing weight-based stigmatization and discrimination in society.

Long-term psychosocial effects of persistent chronic illness. A follow-up study of Finnish adolescents aged 16 to 32 years.

Adolescents reporting persistent chronic illness at ages 16, 22, and 32 years (n = 296, limiting in daily life n = 52, non-limiting n = 244) were compared with those without any chronic illness (n = 401) in their life situation, psychosocial well-being and health habits at age 32 years. The data were drawn from a follow-up survey of a Finnish urban age cohort from age 16 until age 32 years. The group of persistent chronic illnesses included allergies (n = 249, 84%), non-allergic skin conditions (n = 10), migraine (n = 29), diabetes mellitus (n = 5), and others (n = 9). Results indicated that adults with persistent chronic illness limiting their daily life reported more depression and lower self-esteem than those with non-limiting chronic illness or healthy controls. Daily smoking was more common among females with any chronic illness than among healthy controls. No significant differences were found between adults with any persistent chronic illness (mainly non-severe allergic conditions) and healthy controls in psychosocial well-being. More attention in health care should be paid to psychological well-being in persons with limiting chronic illness. The study also raises the question how to improve health habit counselling within health care among females with chronic illness.

Psychosocial development among adolescents with visual impairment.

The psychosocial development of adolescents with visual impairment was studied in a group of 54 adolescents (40 boys, 14 girls) attending Finnish regular schools. Mean age was 14.0 (SD 0.87). The control group consisted of normally sighted adolescents of the same age level (N=385, 172 boys, 213 girls). Data were collected with self-report questionnaires. Results indicated that the adolescent group with visual impairment did not differ from the control group in the frequency of depression, distress symptoms or in their relations with parents and siblings. Adolescents with visual impairment less often had many friends and dates with other young people than those without visual impairment. They also reported more often feelings of loneliness and difficulties in making friends. Self-esteem, school achievement and social skills were lower in girls with visual impairment than in the control girls. In summary, our results showed that the psychosocial developmental outcomes of many adolescents with visual impairment were similar to their peers without visual impairment. However, some adolescents with visual impairment, especially girls, need more support in their psychosocial development.