The Importance of Assessing for Depression with HRQOL in Treatment Seeking Obese Youth and Their Caregivers

Purpose: The purpose of this manuscript is to (1) explore the health-related quality of life (HRQOL) of youth attending a tertiary obesity treatment center compared to healthy population reference data; (2) compare the congruence between the HRQOL of youth self-reports and caregiver proxy reports; and (3) examine the associations between youth HRQOL and (a) teen and (b) caregiver depression.

Methods: The sample included 267 youth and caregiver dyads. A cross-sectional descriptive design was used. Analyses included paired t tests, analyses of variance, correlations, and Chi-square cross-tabulations.

Results: Overweight youth reported significantly (P < 0.001) lower scores than a previously published healthy sample on all totals and subscales of the PedsQL. For younger overweight children and caregivers, there was closer agreement on social (r = 0.45) and emotional functioning (r = 0.32); whereas teens and caregivers agreed most on school functioning (r = 0.47) and emotional functioning (r = 0.44). Regardless of age, youth and caregivers disagreed most on physical functioning. Caregivers who reported higher depressive symptoms had less agreement with their child on their perceived HRQOL; however, teens with more depressive symptoms had stronger agreement with their caregivers on their previewed HRQOL.

Conclusions: Based on our findings, there is not consistent agreement between youth and caregiver perceptions of youth HRQOL domains (physical, emotional, social, and school) and inconsistency in age groups (children and teens). Depressive symptoms in caregivers and teens can provide mechanistic insights into youth and caregiver HRQOL congruence. These findings underscore the importance of a comprehensive biopsychosocial assessment when providing treatment to overweight youth and their families.