Psychiatric Assessment of Children with Constitutional Obesity

...

4-The Depression Scale for Children (Ghareeb, 1995), a 27 Questions scale covering the child's depression symptoms: depression, pessimism, worthlessness, anhedonia, anxiety, helplessness, weeping, suicidal ideation, low frustration tolerance, social isolation, loss of interest, hesitancy, low self-esteem, low motivation, somatic symptoms, poor school achievement and peer relation, and behavioural disturbances (score >50 has significant depression).

5-The Self Concept Scale: (Adel, 1984), 80 questions scale covering 4 domains for self-concept: mental and Academic abilities, body image, social abilities and peer relation, adaptation, feelings of anxiety, depression or satisfaction ( 46 positive self-concept).

6-Eating Disorder Test (EDT): (Shokaire Z. 2000): It is 40 questions subjective test to assess the eating related behavior. The questions are answered by agree (2 marks), to some extent (1 mark) or don't agree (0 mark). It assesses different eating disorder related aspects such as eating behavior, weight, and body shape. Scoring equal to or above 20 marks is considered as a having an eating disorder.

7-Behavioral Checklist for Children: (Achenbach, 1991), it consists of 9 subscales, measuring variable behavioral disorders in children: withdrawal scale, somatic complaints Scale, anxiety/ depression Scale, social problems Scale, thought problems Scale, attention problems Scale, delinquency Scale, aggression Scale and sexual problems Scale,

NB: In all the previous tools validity and reliability were proven, also they were adapted to suit the children in the Egyptian culture and were applied in Arabic language (score T >70 were significant).

Statistical analysis

Data were statistically described in terms of mean ± standard deviation (± SD), median and range, or frequencies (number of cases) and percentages when appropriate. Comparison of numerical variables between the study groups was done using Mann Whitney U test for independent samples. For comparing categorical data, Chi square (χ2) test was performed. Exact test was used instead when the expected frequency is less than 5. p values less than 0.05 was considered statistically significant. All statistical calculations were done using computer programs SPSS (Statistical Package for the Social Science; SPSS Inc., Chicago, IL, USA) version 15 for Microsoft Windows.

Results:

The educational stages of the children are illustrated in (table 1) which shows that 48 (92.3%) of the total 52 children are educated. The stages they presented in were kindergarten, primary and preparatory. Eight (15.4%) were depressed, 16 (30.8%) were moderately anxious and 10 (19.2%) were highly anxious (table 1). Twenty four (46.2%) of the children had a low self-concept and 28 (53.8%) of them had a positive self-concept (table 4). All children had an eating disorder (table 1). From the items of the child checklist no one showed delinquency, or sex preference problems (table 2). Comparative results between males and females showed that all females were in the primary stage, while the males were distributed throughout the stages (table 3). Four (15.4%) of both boys and girls were depressed (table 9). Half of the males were not anxious, 10 (38.5) of the other half were moderately anxious and 4 (15.4%) of them were highly anxious. There were 6 (23.1%) of girls with moderate anxiety and another 6 were highly anxious. Sixteen (61.5%) of girls had low self-concept while only 8 (30.8%) of boys had low self-concept with a statistical significance (p = 0.050) (table 3). All boys and girls had an eating disorder (table 3). Eight (30.8%) of both boys and girls had a withdrawal problem (table 4). The majority of both boys and girls had no somatic symptoms (table 3). Eight (30.8%) of boys scored as anxiety/depressed compared to only 4 (15.4%) girls (table 4).Twenty four (92.3%) of both boys and girls sample showed no social problems (table 5). None of the females showed attention problems, compared to only 2 (7.7%) of the males showed so (table 6). None of the boys or girls showed delinquency (table 6). None of the girls showed aggression, while 2 (7.7%) of boys showed aggression (table 6). None of the whole boys and girls showed sex preference problems (table 6)

Table (1) The educational stages, depression, anxiety, self-concept and eating disorder

Education stage

No

%

Kindergarten

2

4.2

Primary

44

91.7

Preparatory

2

4.2

Depression

Depressed

8

15.4

Not depressed

44

84.6

Anxiety

No

%

No anxiety

26

50

Moderate anxiety

16

30.8

High anxiety

10

19.2

Self-concept

Low self-concept

24

46.2

Positive self-concept

28

53.8

Eating disorder

Eating disorder

52

100

No eating disorder

0

0

Table (2) The results of