PC1164: Relationship Between Executive Dysfunction and Parental Mental Health in a Pediatric Weight Management Clinic

Background: Childhood obesity affects 1 in 3 children in the U.S. and is associated with a myriad of comorbidities. Executive functions (EF), including goal-directed behavior and self-management, are hypothesized to be impaired in obesity. Additionally, parental mental health issues such as depression, anxiety, and ADHD have seen a significant increase during the COVID-19 pandemic. The EF of children living with parents suffering from mental illnesses such as depression is likely to be impaired. To what degree parental mental health issues are associated with executive dysfunction (ED) in treatment seeking children with obesity is yet to be explored. The primary objective of this study was to compare the presence of ED in children with parents who have mental health diagnoses to those with parents who do not.

Methods: This was a double-blinded, cross-sectional study of 11-17 year old patients who were recruited from a multidisciplinary pediatric weight management (PWM) clinic. At initial appointments, all parents were asked about a family history of mental health diagnoses. Parents also completed the Behavior Rating Inventory of Executive Function-2 (BRIEF-2) parent form, to assess for ED in their presenting children. The scores that were analyzed from the BRIEF-2 assessments included the patients’ global executive composite (GEC), inhibit, and shift scores, which provide a global summary of all BRIEF-2 clinical scales, insight into impulsive behavior, and shifting attention between tasks, respectively. These scores were compared utilizing t-tests between the children of parents with and without mental health diagnoses.

Results: Of the 39 participants analyzed, 21 (53.8%) had one parent with a mental health diagnosis and 7 (17.9%) had both parents with a mental health diagnosis. Furthermore, 17 (43.5%) of the children had ED, 14 (35.9%) had problematic inhibit scores, and 19 (48.7%) had problematic shift scores. There were no significant differences in GEC, inhibit, and shift scores between children whose parents did and did not have mental health diagnoses, p = 0.07, 0.09, 0.08, respectively.

Conclusion: This study was underpowered to associate child ED with parental mental health diagnoses. Given that this is an interim analysis of an ongoing study, this association may be proven with a larger cohort. Of interest is that over half of our treatment seeking population had at least one parent with a mental health diagnosis, much higher than a global estimate of 15-23%. This suggests that parental mental health illnesses may be concentrated among children seeking PWM, over 70% of whom have severe obesity. Thus, further investigation is needed on how parental mental health illnesses impact patient PWM outcomes.