Obezitede gündüz aşırı uyku halinin, anksiyete ve depresyon semptomatolojilerinin değerlendirilmesi
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Dosyalar
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada aile hekimliği polikliniğine başvuran normal fazla kilolu, kilolu ve obez bireylerde gündüz aşırı uyku halinin, anksiyete ve depresyon semptomatolojilerinin değerlendirilmesi ve obezite ile ilişkili faktörlerin araştırılması amaçlanmıştır. Gereç ve Yöntem: 25.11.2020 ile 05.03.2021 tarihleri arasında aile hekimliği polikliniğine başvuran 605 kişi çalışmaya alındı. Katılımcıların sosyodemografik özelliklerini, obezite, uyku ve beslenme durumlarını sorgulayan araştırmacı tarafından oluşturulan anket, anksiyete ve depresyon semptomatolojilerini değerlendirmek için Hastane Anksiyete Depresyon Ölçeği (HAD), gündüz aşırı uyku halini (GAUH) değerlendirmek amacıyla Epworth Uykululuk Ölçeği (ESS) yüz yüze görüşme tekniği ile uygulanmıştır. Tüm veriler SPSS 22.0 istatistik paket programı kullanılarak değerlendirilmiştir. Bulgular: Katılımcıların %50,1'i kadın (n=303), %49,9'u erkek (n=302) idi ve yaş ortalaması 38,79±12,46 idi. Obezlerde fazla kilolulardan, fazla kilolularda da normal kilolulardan daha fazla kronik hastalık mevcuttu (p<0,001). Obezlerde, normal ve fazla kilolulara göre diyabetes mellitus, hipertansiyon, astım/KOAH daha fazla görülmekteydi (sırasıyla; p<0,001, p<0,001, p=0,16). Obezlerde tiroid hastalıkları normal kilolulara göre daha sık görülmekteydi (p=0,034). Obezlerde ve fazla kilolularda psikiyatrik öykü varlığı normal kilolulara göre daha yüksekti (p=0,012). Obezlerin fazla kilolulara göre, fazla kiloluların ise normal kilolulara göre ilkokul çağlarında, lisede/ergenlik döneminde, üniversitede/yirmili yaşlarda kilolu olma durumları yüksekti (p<0,001). Ailede kronik hastalığı olanların olmayanlara kıyasla fazla kilolu olma riski 2,46(1,58-3,83) kat, obez olma riski 3,82(2,47-5,93) kat fazlaydı (sırasıyla p<0,001, p<0,001). Ailesinde şişmanlık olanların olmayanlara kıyasla fazla kilolu olma riski 2,19 (1,43-3,93) kat, obez olma riski 6,07(3,93-9,37) kat yüksekti (sırasıyla p<0,001, p<0,001). Annesinde şişmanlık olanların olmayanlara göre fazla kilolu olma riski 2,51(1,54-4,09) kat, obez olma riski 5,11(3,17-8,23) kat fazlaydı (sırasıyla p<0,001, p<0,001). Babasında şişmanlık olanların olmayanlara göre fazla kilolu olma riski 2,02(1,13-3,61) kat, obez olma riski 4,63(2,68-7,99) kat yüksekti (sırasıyla p=0,018, p<0,001). Kardeşlerinde şişmanlık olanlar olmayanlara göre; 2,59(1,34-5,01) kat fazla kilolu, 5,82 (3,13-10,83) kat obez olma riskine sahipti (sırasıyla p=0,005, p<0,001). Katılımcıların %23,0'ünde (n=139) GAUH varken, bu sıklık kadınlarda %23,4 (n=71), erkeklerde %22,5 (n=68) idi. Kadınlar ve erkekler arasında GAUH durumu için anlamlı bir fark yoktu (p=0,864). Bireylerin %22,0'sinde anksiyete semptomatolojileri saptanırken, kadınlarda bu sıklık %26,7 (n=81), erkeklerde %17,2 (n=52) idi. İki cinsiyet açısından anksiyete semptomatololeri anlamlı derecede farklılık göstermekteydi (p=0,006). Kadınların %40,9'u (n=124), erkeklerin %37,1'i (n=112), tüm katılımcıların ise %39,0'u (n=236) depresyon semptomatolojileri göstermekteydi. Kadınların ve erkeklerin depresyon semptomatolojileri karşılaştırıldığında anlamlı bir fark bulunamadı (p=0,377). GAUH normal kilolulara göre obezlerde 2,95(1,83-4,74) kat daha yüksekti (p<0,001). ESS puanı ortancası; normal kilolu grupta 5 (min:0, maks:21), fazla kilolu grupta 6 (min:0, maks:19), obez grupta 8 (min:0, maks:24) idi. Gruplar arasında istatiksel olarak anlamlı fark vardı (p<0,001). Obez grubun ESS puanı, normal kilolu gruptan ve fazla kilolu gruptan istatiksel olarak daha yüksekti (sırasıyla; p<0,001, p<0,001). Normal kilolu ve fazla kilolu grubun ESS puanları arasında istatiksel olarak anlamlı bir fark yoktu (p=0,055). Anksiyete semptomatolojileri obezlerde normal kilolulara göre 1,97(1,23-3,17) kat daha fazla görülmekteydi (p=0,005). Depresyon semptomatolojileri ise normal kilolulara göre fazla kilolularda 2,77(1,81-4,25) kat, obezlerde 2,99 (1,95-4,60) kat daha fazla görülmekteydi (sırasıyla p<0,001, p<0,001). HAD-Anksiyete puanı ortancası; normal kilolu grubun 6 (min:0, maks:21), fazla kilolu grubun 6 (min:0, maks:21), obez grubun 7 (min:0, maks:21) idi. Gruplar arasında istatiksel olarak anlamlı fark vardı (p=0,017). Obez grupta HAD-Anksiyete puanı normal kilolu gruptan istatiksel olarak anlamlı derecede yüksekti (p=0,005). Fazla kilolu grubun HAD-Anksiyete puanı ile normal kilolu ve obez grup arasında istatiksel olarak anlamlı bir fark yoktu (sırasıyla; p=0,374, p=0,055). HAD-Depresyon puanı ortancası normal kilolu grupta 5 (min:0, maks:17), fazla kilolu grupta 7 (min:0, maks:19), obez grupta 7 (min:0, maks:21) idi. Gruplar arasında istatiksel olarak anlamlı fark vardı (p<0,001). Obez grupta ve fazla kilolu grupta HAD-Depresyon puanı normal kilolu gruptan istatiksel olarak anlamlı derecede yüksekti (sırasıyla; p<0,001, p<0,001). Obez grup ile fazla kilolu grubun HAD-Depresyon puanları arasında istatiksel olarak anlamlı bir fark yoktu (p=0,139). Cinsiyetlere göre depresyon, anksiyete, BKİ ve ESS puanları karşılaştırıldığında; erkek katılımcılarda HAD-Depresyon puanları ile ESS, BKİ ve HAD-Anksiyete puanları arasında istatiksel olarak anlamlı fark vardı (p<0,001). BKİ ortalaması HAD≤7 olanlarda 27,28±5,08 iken HAD-D>7 olanlarda 30,39±6,5 idi. Erkek katılımcıların HAD-Anksiyete puanları ile ESS, BKİ, HAD-Depresyon puanları arasında anlamlı bir fark vardı (p<0,001). BKİ ortalaması HAD-A≤10 olanlarda 27,82±5,02 iken HAD-A>10 olanlarda 31,40±7,79 idi. Kadın katılımcılarda ESS, BKİ ve HAD-Anksiyete puanları ile HAD-Depresyon puanları arasında istatiksel olarak anlamlı fark vardı (sırasıyla; p=0,005, p=0,020, p<0,001). BKİ ortalaması HAD≤7 olanlarda 27,97±6,63 iken HAD-D>7 olanlarda 29,81±6,80 idi. Kadın katılımcılarda BKİ ile HAD-Anksiyete puanları arasında istatiksel olarak anlamlı bir fark bulunamadı (p=0,087). GAUH saptanmayanların HAD-A ortancası 6 (min:0, maks:21) iken, GAUH saptananların HAD-A ortancası 9 (min:0, maks:21) idi. HAD-Anksiyete puanı, GAUH saptananlarda, GAUH saptanmayanların göre daha yüksek bulundu(p<0,001). GAUH saptanmayanların HAD-D ortancası 6 (min:0, maks:20) iken, GAUH saptananların HAD-D ortancası 8 (min:0, maks:21) idi. HAD-Depresyon puanı; GAUH saptananlarda, GAUH saptanmayanlara göre daha yüksek bulunmuştu (p<0,001). Sonuç: Bu çalışma ile bir kez daha görüldü ki çocukluk çağı obezitesi yetişkin obezitesinde önemli bir risk faktörüdür. Depresyon ve anksiyete kişilerin günlük yaşamını olumsuz etkileyen psikiyatrik bozukluklardır ve BKİ artışıyla bu bozuklukların görülme ihtimali de artmaktadır. GAUH ise yaşam kalitesini bozan, iş verimini azaltan bir semptomdur ve obezite ile GAUH artmaktadır. Ayrıca GAUH olanlarda aksiyete ve depresyon semptomatolojileri de daha sık görülmekteydi. Tüm bu sonuçların ışığında obezitenin birçok kronik hastalığı tetikleyici bir halk sağlığı sorunu olduğu düşünüldüğünde obeziteyle mücadelenin ailelerin bilgi düzeylerinin artırılması suretiyle daha çocuk yaşta başlaması gerekmektedir. Aile hekimlerinin de sağlam çocuk izlemlerinde ve erişkin periyodik sağlık muayenesinde obeziteyi ve oluşabilecek komplikasyonları taraması ve hastalarına bu konuda bilgi vermesi önem arz etmektedir.
Aim: In this study, it was aimed to evaluate the excessive daytime sleepiness, anxiety and depression symptomatology in normal weight, overweight and obese individuals who applied to the family medicine outpatient clinic and to investigate the factors related to obesity. Materials and Methods: 605 people who applied to the family medicine outpatient clinic between 25.11.2020 and 05.03.2021 were included in the study. The questionnaire created by the researcher questioning the sociodemographic characteristics, obesity, sleep and nutritional status of the participants, the Hospital Anxiety Depression Scale (HAD) to evaluate the symptoms of anxiety and depression, and the Epworth Sleepiness Scale (ESS) to evaluate excessive daytime sleepiness (EDS) were administered using face-to-face interview technique. All data were evaluated using SPSS 22.0 statistical package program. Results: 50.1% of the participants were female (n=303), 49.9% were male (n=302) and the mean age was 38.79±12.46. There were more chronic diseases in obese than overweight and in overweight than normal weight individuals (p<0.001). Diabetes mellitus, hypertension, asthma/COPD were more common in obese than normal and overweight (p<0.001, p<0.001, p=0.16, respectively). Thyroid diseases were more common in obese patients than in normal weight (p=0.034). Presence of psychiatric disorder history was higher in obese and overweight patients than in normal weight (p=0.012). Overweight status in primary school, high school/adolescence, university/twenties was higher in obese than in overweight compared to normal weight (p<0.001). The risk of being overweight was 2.46 (1.58-3.83) times higher and the risk of being obese was 3.82 (2.47-5.93) times higher in those with a family history compared to those without chronic diseases (p<0.001, p< 0.001, respectively). The risk of being overweight was 2.19 (1.43-3.93) times higher and the risk of being obese was 6.07 (3.93-9.37) times higher than those with obesity in their family with fat compared to those who did not (p<0.001, p<0.001, respectively). The risk of being overweight was 2.51 (1.54-4.09) times higher and the risk of being obese was 5.11 (3.17-8.23) times higher than those with obesity in their mothers (p <0.001, p <0.001, respectively). The risk of being overweight was 2.02 (1.13-3.61) times higher and the risk of being obese was 4.63 (2.68-7.99) times higher than those with obesity in their fathers (p=0.018, p<0.001, respectively). According to those whose siblings do not have obesity; he/she had 2.59 (1.34-5.01) times the risk of being overweight and 5.82 (3.13-10.83) times being obese (p=0.005, p<0.001, respectively). While 23.0% of the participants (n = 139) had EDS, this frequency was 23.4% (n=71) in women and 22.5% (n=68) in men. There was no significant difference for EDS status between men and women (p=0.864). Anxiety symptoms were detected in 22.0% of individuals, while this frequency was 26.7% (n=81) in women and 17.2% (n=52) in men. Anxiety symptoms differed significantly between genders (p=0.006). 40.9% of women (n=124), 37.1% of men (n=112), and 39.0% (n=236) of all participants were showing symptoms of depression. When the depression symptoms of women and men were compared, no significant difference was found (p=0.377). EDS was 2.95 (1.83-4.74) times higher in obese than normal weight (p<0.001). ESS median score; 5 (min:0, max:21) in the normal weight group, 6 (min:0, max:19) in the overweight group, and 8 (min:0, max:24) in the obese group. There was a statistically significant difference between the groups (p<0.001). The ESS score of the obese group was statistically higher than the normal weight group and the overweight group (p<0.001, p<0.001, respectively). There was no statistically significant difference between the ESS scores of the normal weight and overweight group (p=0.055). Anxiety symptoms were 1.97 (1.23-3.17) times more in obese than normal weight (p=0.005). Depression symptoms were 2.77 (1.81-4.25) times more in overweight than in normal weight and 2.99 (1.95-4.60) times more in obese patients (p<0.001, p<0.001, respectively). HAD-Anxiety score median; normal weight group was 6 (min:0, max:21), overweight group 6 (min:0, max:21), obese group was 7 (min:0, max:21). There was a statistically significant difference between the groups (p=0.017). In the obese group, the HAD-Anxiety score was statistically significantly higher than the normal weight group (p=0.005). There was no statistically significant difference between the HAD-Anxiety score of the overweight group and the normal weight and obese group (p=0.374, p=0.055, respectively). The median of HAD-Depression score was 5 (min:0, max:17) in the normal weight group, 7 (min:0, max:19) in the overweight group, 7 (min:0, max:21) in the obese group. There was a statistically significant difference between the groups (p<0.001). The HAD-Depression score in the obese group and the overweight group was statistically significantly higher than the normal weight group (p<0.001, p<0.001, respectively). There was no statistically significant difference between the HAD-Depression scores of the obese group and the overweight group (p=0.139). When depression, anxiety, BMI and ESS scores were compared according to genders; there was a statistically significant difference between HAD-Depression scores and ESS, BMI and HAD-Anxiety scores in male participants (p<0.001). While the mean BMI was 27.28±5.08 in those with HAD≤7, it was 30.39±6.5 in those with HAD-D >7. There was a significant difference between the HAD-Anxiety scores of the male participants and their ESS, BMI, and HAD-Depression scores (p<0.001). While the mean BMI was 27.82±5.02 in those with HAD-A≤10, it was 31.40±7.79 in those with HAD-A>10. There was a statistically significant difference between the ESS, BMI and HADS-Anxiety scores and HAD-Depression scores of the female participants (p=0.005, p=0.020, p<0.001, respectively). While the mean BMI was 27.97±6.63 in those with HAD≤7, it was 29.81±6.80 in those with HAD-D> 7. No statistically significant difference was found between BMI and HAD-Anxiety scores in female participants (p=0.087). The median HAD-A of those without EDS was 6 (min:0, max:21), while the median HAD-A of those with EDS was 9 (min:0, max:21). The HAD-Anxiety score was found to be higher in those with EDS compared to those without EDS (p<0.001). The median HAD-D of those without EDS was 6 (min:0, max:20), while the median HAD-D of those with EDS was 8 (min:0, max:21). HAD-Depression score was found to be higher in those with EDS compared to those without EDS (p<0.001). Conclusion: With this study, it was once again seen that childhood obesity is an important risk factor for adult obesity. Depression and anxiety are psychiatric disorders that negatively affect the daily life of people, and the likelihood of these disorders increases with an increase in BMI. EDS is a symptom that impairs the quality of life and decreases work efficiency, and EDS increases with obesity. In addition, symptoms of anxiety and depression were more common in patients with EDS. In the light of all these results, considering that obesity is a public health problem that triggers many chronic diseases, the fight against obesity should start at a young age by increasing the knowledge level of families. It is also important for family physicians to screen obesity and its possible complications during the follow-up of healthy children and adult periodic health examinations and to inform this issue to their patients.
Aim: In this study, it was aimed to evaluate the excessive daytime sleepiness, anxiety and depression symptomatology in normal weight, overweight and obese individuals who applied to the family medicine outpatient clinic and to investigate the factors related to obesity. Materials and Methods: 605 people who applied to the family medicine outpatient clinic between 25.11.2020 and 05.03.2021 were included in the study. The questionnaire created by the researcher questioning the sociodemographic characteristics, obesity, sleep and nutritional status of the participants, the Hospital Anxiety Depression Scale (HAD) to evaluate the symptoms of anxiety and depression, and the Epworth Sleepiness Scale (ESS) to evaluate excessive daytime sleepiness (EDS) were administered using face-to-face interview technique. All data were evaluated using SPSS 22.0 statistical package program. Results: 50.1% of the participants were female (n=303), 49.9% were male (n=302) and the mean age was 38.79±12.46. There were more chronic diseases in obese than overweight and in overweight than normal weight individuals (p<0.001). Diabetes mellitus, hypertension, asthma/COPD were more common in obese than normal and overweight (p<0.001, p<0.001, p=0.16, respectively). Thyroid diseases were more common in obese patients than in normal weight (p=0.034). Presence of psychiatric disorder history was higher in obese and overweight patients than in normal weight (p=0.012). Overweight status in primary school, high school/adolescence, university/twenties was higher in obese than in overweight compared to normal weight (p<0.001). The risk of being overweight was 2.46 (1.58-3.83) times higher and the risk of being obese was 3.82 (2.47-5.93) times higher in those with a family history compared to those without chronic diseases (p<0.001, p< 0.001, respectively). The risk of being overweight was 2.19 (1.43-3.93) times higher and the risk of being obese was 6.07 (3.93-9.37) times higher than those with obesity in their family with fat compared to those who did not (p<0.001, p<0.001, respectively). The risk of being overweight was 2.51 (1.54-4.09) times higher and the risk of being obese was 5.11 (3.17-8.23) times higher than those with obesity in their mothers (p <0.001, p <0.001, respectively). The risk of being overweight was 2.02 (1.13-3.61) times higher and the risk of being obese was 4.63 (2.68-7.99) times higher than those with obesity in their fathers (p=0.018, p<0.001, respectively). According to those whose siblings do not have obesity; he/she had 2.59 (1.34-5.01) times the risk of being overweight and 5.82 (3.13-10.83) times being obese (p=0.005, p<0.001, respectively). While 23.0% of the participants (n = 139) had EDS, this frequency was 23.4% (n=71) in women and 22.5% (n=68) in men. There was no significant difference for EDS status between men and women (p=0.864). Anxiety symptoms were detected in 22.0% of individuals, while this frequency was 26.7% (n=81) in women and 17.2% (n=52) in men. Anxiety symptoms differed significantly between genders (p=0.006). 40.9% of women (n=124), 37.1% of men (n=112), and 39.0% (n=236) of all participants were showing symptoms of depression. When the depression symptoms of women and men were compared, no significant difference was found (p=0.377). EDS was 2.95 (1.83-4.74) times higher in obese than normal weight (p<0.001). ESS median score; 5 (min:0, max:21) in the normal weight group, 6 (min:0, max:19) in the overweight group, and 8 (min:0, max:24) in the obese group. There was a statistically significant difference between the groups (p<0.001). The ESS score of the obese group was statistically higher than the normal weight group and the overweight group (p<0.001, p<0.001, respectively). There was no statistically significant difference between the ESS scores of the normal weight and overweight group (p=0.055). Anxiety symptoms were 1.97 (1.23-3.17) times more in obese than normal weight (p=0.005). Depression symptoms were 2.77 (1.81-4.25) times more in overweight than in normal weight and 2.99 (1.95-4.60) times more in obese patients (p<0.001, p<0.001, respectively). HAD-Anxiety score median; normal weight group was 6 (min:0, max:21), overweight group 6 (min:0, max:21), obese group was 7 (min:0, max:21). There was a statistically significant difference between the groups (p=0.017). In the obese group, the HAD-Anxiety score was statistically significantly higher than the normal weight group (p=0.005). There was no statistically significant difference between the HAD-Anxiety score of the overweight group and the normal weight and obese group (p=0.374, p=0.055, respectively). The median of HAD-Depression score was 5 (min:0, max:17) in the normal weight group, 7 (min:0, max:19) in the overweight group, 7 (min:0, max:21) in the obese group. There was a statistically significant difference between the groups (p<0.001). The HAD-Depression score in the obese group and the overweight group was statistically significantly higher than the normal weight group (p<0.001, p<0.001, respectively). There was no statistically significant difference between the HAD-Depression scores of the obese group and the overweight group (p=0.139). When depression, anxiety, BMI and ESS scores were compared according to genders; there was a statistically significant difference between HAD-Depression scores and ESS, BMI and HAD-Anxiety scores in male participants (p<0.001). While the mean BMI was 27.28±5.08 in those with HAD≤7, it was 30.39±6.5 in those with HAD-D >7. There was a significant difference between the HAD-Anxiety scores of the male participants and their ESS, BMI, and HAD-Depression scores (p<0.001). While the mean BMI was 27.82±5.02 in those with HAD-A≤10, it was 31.40±7.79 in those with HAD-A>10. There was a statistically significant difference between the ESS, BMI and HADS-Anxiety scores and HAD-Depression scores of the female participants (p=0.005, p=0.020, p<0.001, respectively). While the mean BMI was 27.97±6.63 in those with HAD≤7, it was 29.81±6.80 in those with HAD-D> 7. No statistically significant difference was found between BMI and HAD-Anxiety scores in female participants (p=0.087). The median HAD-A of those without EDS was 6 (min:0, max:21), while the median HAD-A of those with EDS was 9 (min:0, max:21). The HAD-Anxiety score was found to be higher in those with EDS compared to those without EDS (p<0.001). The median HAD-D of those without EDS was 6 (min:0, max:20), while the median HAD-D of those with EDS was 8 (min:0, max:21). HAD-Depression score was found to be higher in those with EDS compared to those without EDS (p<0.001). Conclusion: With this study, it was once again seen that childhood obesity is an important risk factor for adult obesity. Depression and anxiety are psychiatric disorders that negatively affect the daily life of people, and the likelihood of these disorders increases with an increase in BMI. EDS is a symptom that impairs the quality of life and decreases work efficiency, and EDS increases with obesity. In addition, symptoms of anxiety and depression were more common in patients with EDS. In the light of all these results, considering that obesity is a public health problem that triggers many chronic diseases, the fight against obesity should start at a young age by increasing the knowledge level of families. It is also important for family physicians to screen obesity and its possible complications during the follow-up of healthy children and adult periodic health examinations and to inform this issue to their patients.
Açıklama
Anahtar Kelimeler
Obezite, Fazla Kilo, Gündüz Aşırı Uyku Hali, Depresyon, Anksiyete, Obesity, Overweight, Excessive Daytime Sleepiness, Depression, Anxiety
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Şener, Z. E. (2021). Obezitede gündüz aşırı uyku halinin, anksiyete ve depresyon semptomatolojilerinin değerlendirilmesi. (Uzmanlık Tezi). Selçuk Üniversitesi, Tıp Fakültesi, Konya.
