Abstract
AIM: This study aimed to compare the severity of depressive symptoms of Hong Kong adolescents with and without obesity and to explore the correlates of depressive symptoms using Patient Health Questionnaire-9 (PHQ-9). METHODS: Participants were recruited from the Paediatric Weight Control Clinic of Queen Mary Hospital or mainstream secondary schools in Hong Kong during the period of June 2023 and December 2023. This was a cross-sectional study comparing depression risk among adolescents with and without obesity. Subgroup analysis was conducted to examine the risk factors. RESULTS: A total of 612 adolescents were included for analysis. No significant difference in PHQ-9 scores ≥ 10 was found between normal weight and obesity groups after socio-economic status (SES) adjustment. A positive correlation between BMI z-score and PHQ-9 was observed in adolescents with obesity, especially beyond the 99.6th percentile BMI. BMI ≥ 99.6% was identified as a significant risk factor for depression, without collinearity. CONCLUSION: Using the BMI ≥ 95th percentile to define obesity, no link was found between obesity and depression risk in Hong Kong adolescents. However, our study showed that adolescents with severe obesity (BMI ≥ 99.6th percentile) have a significantly higher risk of depressive symptoms. We recommend routine depression screening for adolescents with severe obesity.