Depressive symptoms, overweight/obesity, and ADHD from childhood to adolescence: a cross-cohort study of cultural and timing effects

Abstract

Background: Children who are persistently overweight/obese have a higher risk of ADHD symptoms. Comorbid ADHD increases psychosocial challenges that could worsen mental health problems in children with overweight/obesity. This study analyzed data from England and Hong Kong to examine whether, and why, comorbid ADHD and persistent overweight/obesity is associated with depressive symptoms during the transition into adolescence. Methods: Body mass index and ADHD symptoms were measured in childhood (T1) and early adolescence (T2) on 4340 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC) in England and 184 individuals of the Healthy Kids cohort in Hong Kong. Depressive symptoms were also measured at T2. Moderated mediation analysis was conducted to examine whether early (T1 & T2) ADHD accounted for the association between persistent overweight/obesity (T1 & T2) and depressive symptoms at T2. Results: In Hong Kong, risk of depression in adolescence was highest among children with both conditions of early ADHD and persistent overweight/obesity. Also, persistent overweight/obesity was associated with depressive symptoms in adolescence only among children with early ADHD; and this was primarily explained by persistence of ADHD into adolescence (β = 1.66, 95 %CI [0.44, 3.36]). These findings were not replicated in the England cohort. Conclusions: In some cultural settings, persistent ADHD symptoms have the potential to exacerbate depressive symptoms in adolescence. Early detection and intervention of ADHD symptoms is crucial for promoting long-term mental well-being