© 2012 S. Karger GmbH, Freiburg
1662–4033/12/0056–0856$38.00/0
Original Article
Obes Facts 2012;5:856–868
The Hyperactivity/Inattention Subscale of
the Strengths and Difficulties Questionnaire
Predicts Short- and Long-Term Weight Loss in
Overweight Children and Adolescents Treated
as Outpatients
Andreas van Egmond-Froehlich
a
Monika Bullinger
b
Reinhard W. Holl
c
Ulrike Hoffmeister
c
Reinhard Mann
d
Cornelia Goldapp
d
Joachim Westenhoefer
e
Ulrike Ravens-Sieberer
f
Martina de Zwaan
g
a
Department of Pediatrics, Medical University of Vienna, Vienna, Austria,
b
Department
for Medical Psychology, University Clinic Hamburg-Eppendorf, Hamburg,
c
Department of
Epidemiology, Ulm University, Ulm,
d
Federal Center for Health Education (BZgA), Cologne,
e
Department of Health Sciences, Hamburg University of Applied Sciences,
f
Research Unit
Child Public Health, University Clinic Hamburg-Eppendorf, Hamburg,
g
Department of
Psychosomatic Medicine and Psychotherapy, Hanover Medical School, Hanover, Germany
Key Words
Overweight Obesity Children Adolescents Prediction Hyperactivity Attention deficit
Weight loss
Abstract
Objective: The success of treatment for pediatric obesity is variable and often unsatisfactory.
This study elucidates the influence of inattention and hyperactivity/impulsivity on short- and
long-term weight loss and maintenance after outpatient treatment. Methods: We included
8- to 16-year-old overweight and obese participants treated in 17 multidisciplinary outpatient
treatment centers in a nationwide observational study. All treatment centers that reported
long-term (1-year) follow-up weight data of at least 60% of the participants were included. At
the beginning and end of treatment and at 1 year follow-up weight and height were measured
at the center. Inattention and hyperactivity/impulsivity were assessed with the hyperactivity/
inattention subscale (HI) of the parent-rated Strengths and Difficulty Questionnaire (SDQ).
General linear models were used with the standard deviation scores of the BMI (BMI-SDS) as
dependent variable and HI scores as main independent variable adjusting for age, sex, base-
line BMI-SDS, and center. Results: 394 participants were included (57% female, age: 11.7 8 2.0
years, baseline BMI-SDS 2.32 8.46 kg/m
2
). HI scores were significantly associated with short-
Received: August 26, 2011
Accepted: June 6, 2012
Published online: December 15, 2012
Dr. Andreas van Egmond-Fröhlich
Department of Pediatrics
SMZ-Ost Donauspital
Langobardenstraße 122, 1220 Vienna (Austria)
a.vanegmond-froehlich @ t-online.de
www.karger.com/ofa
DOI: 10.1159/000346138