OBJECTIVE: To compare rates of DSM-IV psychiatric disorders between (1) a clinical study group of extremely obese adolescents and young adults, (2) gender-matched population-based obese controls and (3) a population-based control group of the same age range. DESIGN: Rates of psychiatric disorders were assessed in (1) the clinical study group of obese adolescents and (2) the population based sample of obese adolescents, and compared to (3) a large population-based control group using a standardized psychiatric interview. SUBJECTS: (1) Clinical study group: 30 female and 17 male extremely obese adolescents and young adults (age range: 15 ± 21 y; mean BMI : 42.4 kgam 2 ). (2) Thirty females and 17 males with the highest BMI (age range 15 ± 21 y; mean BMI : 29.8 kgam 2 ) of a population-based control group encompassing 1655 (805 males) adolescents and young adults. (3) The population based control group excluding the 30 females and 17 males with the highest BMI (n 1608; 788 males). MEASUREMENTS: Munich-Composite International Diagnostic Interview (M-CIDI) allowing for DSM-IV diagnoses. RESULTS: High rates of mood, anxiety, somatoform and eating disorders were detected in the clinical sample of obese adolescents which exceeded those observed in population controls (all P-values`0.01). Rates between populationbased obese adolescents and young adults and population controls did not differ. In most patients the psychiatric disorders set in after onset of obesity. 57% and 35% of the female and male patients, respectively, reported eating binges with lack of control. However, less than one-half of these patients quali®ed for a DSM-IV diagnosis of an eating disorder. CONCLUSIONS: Extremely obese adolescents and young adults who seek long-term inpatient treatment have a high lifetime prevalence for affective, anxiety, somatoform and eating disorders. Because the mean BMI of the clinical study group was considerably higher than that of the obese population controls, we were not able to clarify whether the high rate of psychopathology in the study group was related to the extreme obesity or to their treatment-seeking behavior.

LAMERTZ, CHRISTINA M., CORINNA JACOBI, ALEXANDER YASSOURIDIS, KLAUS ARNOLD, AND ANDREAS W. HENKEL. Are obese adolescents and young adults at higher risk for mental disorders? A community survey. Obes Res. 2002;10:1152-1160. Objective: Associations between body mass index (BMI) and mental disorders meeting Axis-I diagnoses according to the Diagnostic and Statistical Manual for Mental Disorders IV (DSM-IV) were investigated in The Early Developmental Stages of Psychopathology Study in a large populationbased sample, which included adolescents and young adults of both genders for the first time. Research Methods and Procedures:A total of 3021 German subjects ranging from 14 to 24 years of age were assessed for specific DSM-IV diagnoses derived from a modified version of the standardized Composite International Diagnostic Interview, and general psychological disturbances, using the Symptom Checklist-90-Revised. BMI percentiles for age and gender were calculated to avoid systematic bias in the BMI distribution resulting from the young age range represented in the sample. Additionally, subjects with a lifetime diagnosis of any eating disorder were excluded from statistical analysis to control the confounding effect of body weight-related eating disorders on associations between BMI and psychopathology. Results:The results based on logistic regression analyses and MANOVAs demonstrate that the BMI is not associated with mental disorders or general psychopathologies. There were no significant associations between BMI and mood, anxiety, substance, and somatoform disorders, a result that contrasts with almost all previous clinical studies. Additionally, in contrast to clinical investigations and most epidemiological studies, neither obesity nor underweight was significantly associated with any kind of general psychopathology. Discussion: The overall finding that obesity is not significantly related to marked psychopathology in the general German population of adolescents and young adults has important clinical implications.

This report presents findings of a community survey of 3,021 adolescents and young adults aged 14–24 years in Munich, Germany, carried out to determine the prevalence of use and abuse of and dependence on ecstasy, amphetamines and hallucinogens. The response rate was 71%. Results: (1) In 1995, 4% of the male and 2.3% of the female respondents aged 14–24 reported the use of ecstasy. Ecstasy-related substances (amphetamines and chemically related substances) were reported by 3.6% of men and 1.6% of women. Hallucinogens were reported slightly less frequently by 3% of men and about 2% of women (LSD combined with others). (2) Compared to findings from a 1990 survey this constitutes a substantial, at least twofold, increase in consumption rate of both types of substances. (3) Among lifetime users of both ecstasy and related substances as well as hallucinogens about two thirds could be regarded as regular users. (4) The prevalence of DSM-IV abuse and dependence on ecstasy and related substances is about 1%, identical to rates of hallucinogen abuse and dependence. Findings also point to a significant dependence potential for both substances. (5) Furthermore, considerable overlap between the two substances was found. Conclusion: Our study suggests a substantial increase in both the use of ecstasy and related substances as well as hallucinogens. The data further suggest that the increase is strongest in younger age groups, but the risk of first use of these substances continues to be present up to the age of 24 years. The higher proportion of women contributing to this increase is noteworthy.