Synthesis Matrix/Critical Appraisal 1

Author/Date	Aim of Study	Type of literature + type of method	Result /Conclusion	Strengths + limitations	Thematic codings	Setting/ Context
1 Clavarino, 2015	The associations between depression and obesity	Lit review	Depression Leading to Obesity: adolescents who were depressed at baseline were at 70% higher risk of obesity compared to those who did not experience depression. Obese adolescents had a 40% greater risk of being depressed. Shows a bidirectional association between both disorders.   Females tend to be more at risk for obesity and depression during these ages due to puberty.	The strengths of this article is that they have information on how depression and obesity are together. The limitations are that it is mostly on just females, it mainly focuses on the caucasian population and are all longitudinal studies. The longitudinal study is both a strength and limitation because it allows us to see which symptom leads to the other but they retest when they are young adult; which is not the age group i,m looking for.	Strong connection between obesity and depression, bidirectional	Computerized literature search
2 Bove, 2014	The associations between obesity and depression.	Case control	The two groups filled out the CDI which is used in italy to find depressive symptoms within the age of 8-17.  The higher the score the more depressive symptom the adolescence content. The scores showed that obese children had a significant difference compared to the control group (16.82+- 7.73 compared to 8.2+-2.9). Pervanidou Et al reported that the imbalance in hypothalamic-pituitary-adrenal axis is involved in depression and obesity.	The strengths are that it gives more information on the genetic and psychological factors for the two disorders such as depression symptoms such as anhedonia causing kids not to be active leading to obesity. The weakness is that that it shows a small study group and the psychological factors have not been tested but just brought up.	Showed correlation of obesity and depression. Linear relationship with obesity and depression scores (more obese, more depressed)	148 obese subjects referred from clinical pediatricians and compared to 273 healthy children enrolled in school in italy.
3 Buchholz, 2010	Body dissatisfaction, dietary restraint, depression	Cohort	This article get kids in different age groups comparing levels of depression. It separates the kids into obese, overweight and normal body weights. The results showed that children who are obese will have more symptoms of depression compared to the other two groups. This shows that obesity can lead to depression.	The strengths of this article is that it helps with one of my topics, being which disorder comes first. The weakness of this article is it doesn't give clear data of how much of a difference there is between the groups.	Those who are obese are also known to have greater dissatisfaction with body. Obesity leads to depression.	Survey  was conducted on 1,490 youth attending grades 7-12.
4 Keck, 2004	The association between obesity and mental disorders.	Lit. Review	This article shows how multiple mental disorders are related with obesity. This is shows that obesity and depression are clearly related giving multiple studies on the correlation.	The strengths of this article are that they give multiple studies and results linking obesity and depression together. The weakness is that since this article is a lit. review it does not give detailed information on exactly how the info was found.	Obesity has high rates of mental disorders.	Document search online for keywords of obesity and mental disorders.
5 (Goodman, 2002)	This article first test kids to see if they have symptoms of depression and comes back after a certain period of time. When they come back they test to see if depression has progressed but also test BMI scores to see if they gain more weight.	Cohort Study	This article test to see if adolescents with depressive symptoms gain more weight compared to those who don't. The results showed that depression is known to lead to excess weight gain compared to those who don’t have depression.	The strengths is that it will help with my topic on which disease leads to which and how this is actually a bidirectional morbidity. The weakness is that it is a study only done on females.	Bidirectional obese children leads to obese adults	This is a cohort study of 9374 adolescents in grades 7-12 who completed in home surveys and were followed up 1 year after completion.

Journal entry 3 pics

Journal Entry 3 audio

Journal Entry 3

Article 1 (twin Study)

Afari, N., Noonan, C., Goldberg, J., Roy-Byrne, P., Schur, E., Golnari, G., & Buchwald, D. (2010). Depression and obesity: do shared genes explain the relationship? Depression and Anxiety,27(9), 799-806. doi:10.1002/da.20704

This article is directly relevant to my topic (twin Study) and this is proven by the title itself but also the information given throughout the article. I chose this article because the past five article I had in Journal entry 2 are based on if there is a relationship of obesity and depression. According to all five article they are related and it was proven that the cause is bidirectional for both, meaning that both disorders are known to increase the chance of the second disorder. This research is looking in more of what specifically is causing depression and obesity to occur. This twin study is used to compare genetics of monozygotic twins to see if they will get the symptoms because they have the exact same genes. I will be using this in the results section because part of my question is how are we able to help the problem so if we know that it is genetic then we know to keep a close eye on a child whose parents may be obese or may have depression. Early detection would help the problem significantly and would allow the adolescent to be prepared. The only downside to this article is that it is based on females only but I did learn females are at higher risk for depression than males. One interesting thing I found in this article is that if your parents are obese or have Depression than the child is more likely to gain the same disorder.

Article 2 (Cohort)

Goodman, E., Slap, G. B., & Huang, B. (2003). The Public Health Impact of Socioeconomic Status on Adolescent Depression and Obesity. American Journal of Public Health, 93(11), 1844-1850. doi:10.2105/ajph.93.11.1844

This article is directly relevant to my topic (twin Study) and this is proven because it test the Socioeconomic status (SES) and rates of depression and obesity in adolescents. I chose this article for the same reason as above. I wanted more info on what could be causing the disorders since it is known that obesity and depression lead to each other as a second disorder. So to help fix the problem we need to know what is causing it. This research looks into household income and also parent education, separating them into five different categories. It was proven for parents who had lower income that obesity and depression  are both higher factors in those areas. I will be using this in my result section to help show that lower income areas are at more risk and for me to look into what could be done to help in this area. If it is for lack of grocery store, lack of education on healthy lifestyles or even higher amount of stress since low income areas tend not to be the safest as well. The downsides to this article is that it just give us the information on if SES is a factor, but it doesn’t give us reasons on what could be causing this. I did find it interesting that depression is a big factor in lower incomes, but it does make sense if you think about all the factors I earlier in this paragraph.

Article 3

Fletcher, J. M., & McLaughlin, S. M. (2015). Neighborhood factors during adolescence: Modest effects on cardiovascular risk, small impact on obesity and depression. Health Affairs, 34(9), 1472-2A. doi:http://dx.doi.org.unr.idm.oclc.org/10.1377/hlthaff.2015.0292

This article is directly relevant to my topic (cohort study) and this is proven because it shows the relationship of obesity and depression in certain neighborhoods. I chose this article for the same reason as the last two, just to get further information on what are possible causes for these disorders to come up. I will be using this in my result section to show further proof that where a person lives increases their chances of getting these disorders. I will most likely still use this info in my paper but it is similar to article 2, where it just gives me the result of it, but no actual info on why or what characteristics of living in these neighborhoods cause this to happen. This is why I will still be looking for another article to take the place of this one. I didn’t find anything interesting in this article because as I stated it just gave me the same results as the last article.

Article 4

Ortega, F. B., Ruiz, J. R., Castillo, M. J., & Sjostrom, M. (2008). Physical fitness in childhood and adolescence: a powerful marker of health. International Journal of Obesity, 32(1), 1+. Retrieved from http://go.galegroup.com.unr.idm.oclc.org/ps/i.do?p=HRCA&sw=w&u=reno&v=2.1&it=r&id=GALE%7CA190151552&sid=summon&asid=9dd3d7c3150fac76996c4627e79a6c4f

This article is indirectly relevant to my topic (Lit. Review) because it is a study based on physical fitness and how it helps with multiple disorders. Obesity and depression are two of the disorders mentioned, but these disorders aren't the main topic. I will mainly use this in my results but more on what could help with the current problem. This was a great article because it does show that it helps with both adiposity and depression, but they measure for abdominal adiposity, not BMI obesity. I found it interesting that cardiorespiratory fitness has been shown to have both short- term and long-term effect on psychological outcomes.  

Article 5

Schafft, K. A., Jensen, E. B., & Hinrichs, C. C. (2009). Food deserts and overweight schoolchildren: Evidence from pennsylvania*. Rural Sociology, 74(2), 153-177. Retrieved from http://unr.idm.oclc.org/login?url=http://search.proquest.com.unr.idm.oclc.org/docview/199367471?accountid=452

This article is indirectly relevant to my topic (Cohort Study) because it is a study done only on obesity rates in food deserts. I chose to research this more because I have enough information on if Obesity and depression are common together but I need more info on what causes these. As we know now that obesity is a cause of depression, if a food desert is a cause of obesity than it can  easily help lead to depression as well. I like this article because it shows longitudinal studies on how many obese kids there are in food deserts compared to none food deserts but also the rates they increase.  I find it interesting that both food deserts and non food deserts both have increased obesity since 1991 but also that the rate is still higher in food deserts. The positives of this journal article is that it gives great detail of the results and also possible reasons on why this is happening, but the negative is that it is a study only done in Pennsylvania making it a smaller study group than I would like.

Types of Literature

1. How do you reference this journal in an APA work cited?

armorstein, N. R., Iacono, W. G., & Legrand, L. (2014). Obesity and depression in adolescence and beyond: reciprocal risks. International Journal of Obesity, 38(7), 906+. Retrieved from http://go.galegroup.com/ps/i.do?p=HRCA&sw=w&u=reno&v=2.1&it=r&id=GALE%7CA377531025&sid=summon&asid=175ca23f80a0dadae78e1277cb8992bb

2. What method is being used?

Cross sectional

3. How do the authors use the method? What do they use it for? What specifically does the method enable them to do? Why did they choose this method rather than another? What was it about this research agenda/topic that led them to choose this particular method? Answer a handful of these. They all get at similar thing. But I want blocks of texts.
1. Authors use this method because they select a group of people found in the Minnesota twin study, allowing them the us just obese children.
2. They chose this method because they are specifically using obese children.
3. The research was created to see if obese children are at greater risk for anxiety or depression.
4. What is the conclusion of the study? And how did the method enable them to reach that particular conclusion?

The results showed a correlation between obesity with young adults and adolescents. It showed that there was a correlation with early adolescent obesity and later adolescent depression. They were able to do this question because they based it off of just obese children to see if obesity was a cause of MDD.

5. What was one interesting thing you discovered by leafing through this article?

It was interesting finding out that Women were at higher risk of for depression cause obesity or obesity causing depression, while there was no significant findings when it came to males.

1. How do you reference this journal in an APA work cited?

Gallai, B., Esposito, M., Roccella, M., Marotta, R., Lavano, F., Lavano, S. M., . . . Carotenuto, M. (2014). Anxiety and depression levels in prepubertal obese children: a case-control study. Neuropsychiatric Disease and Treatment, 1897. doi:10.2147/ndt.s69795

2. What method is being used?

Case Control

3. How do the authors use the method? What do they use it for? What specifically does the method enable them to do? Why did they choose this method rather than another? What was it about this research agenda/topic that led them to choose this particular method? Answer a handful of these. They all get at similar thing. But I want blocks of texts.
1. They use the method by testing the correlation of obesity with depression and anxiety, while comparing the results to a group of children who aren't obese.
2. They use it to compare if obese children have a higher prevalence rate of becoming depressed or having anxiety compared to healthy individuals.
3. The method gives them two test groups that they can compare, allowing them to see if the prevalence rate of the disorder is higher in one group than the other.   
4. What is the conclusion of the study? And how did the method enable them to reach that particular conclusion?
1. This showed that the obese children had a correlation with depressed symptoms, while the healthy children didn’t have as significant of a relationship with obesity.
5. What was one interesting thing you discovered by leafing through this article?
1. I found it interesting that  Pervanidou et al reported that the imbalance in hypothalamic-pituitary-adrenal axis was involved in anxiety disorders, depression, and obesity. This meaning that all could be a genetic cause

1. How do you reference this journal in an APA work cited?
1. Hammerton, G., Thapar, A., & Thapar A.K. (2014). Association between obesity and depressive disorder in adolescents at high risk for depression. International Journal of Obesity, 38(4), 513+. Retrieved from http://go.galegroup.com/ps/i.do?p=HRCA&sw=w&u=reno&v=2.1&it=r&id=GALE%7CA367197592&sid=summon&asid=397b83440ddbfcab48142972920dae62
2. What method is being used?
1. Prospective study
3. How do the authors use the method? What do they use it for? What specifically does the method enable them to do? Why did they choose this method rather than another? What was it about this research agenda/topic that led them to choose this particular method? Answer a handful of these. They all get at similar thing. But I want blocks of texts.
1. They use it by having two follow up interviews after the original baseline interview. The interview was separated by 16 months from interview 1 and 2, while interview 2 and 3 were separated by 12 months.
2. It enables them to see the progression of the adolescents obesity and depression.
3. They did this study so they could see if depression would lead to obesity by following families that have depression, since it is known to be genetic.  
4. What is the conclusion of the study? And how did the method enable them to reach that particular conclusion?
1. The conclusion was that there is no correlation of obesity leading to depression with offsprings of parents who do have depression but they have been known to have a higher BMI
5. What was one interesting thing you discovered by leafing through this article?
1. I found it interesting that they had a high BMI than the average population because some articles I have read said that this can lead to depression when they become young adults.

1. How do you reference this journal in an APA work cited?
1. Afari, N., Noonan, C., Goldberg, J., Roy-Byrne, P., Schur, E., Golnari, G., & Buchwald, D. (2010). Depression and obesity: do shared genes explain the relationship?. Depression & Anxiety (1091-4269), 27(9), 799-806. doi:10.1002/da.20704
2. What method is being used?
1. Twin study
3. How do the authors use the method? What do they use it for? What specifically does the method enable them to do? Why did they choose this method rather than another? What was it about this research agenda/topic that led them to choose this particular method? Answer a handful of these. They all get at similar thing. But I want blocks of texts.
1. They use this method to test if there is a genetic link by comparing monozygotic twins as they age.
2. The twin study allows them to see if genetics has a factor because monozygotic twins have the exact same DNA so if they both end up getting depression and obesity then there is most likely a link.
3. They chose this method because there is no truly other way to compare genetics with a different literature study.  
4. What is the conclusion of the study? And how did the method enable them to reach that particular conclusion?
1. The conclusion of the study shows there is a genetic link between depression and obesity. It also shows there there is an increased chance of getting these disorders if your parents have them as well. They reached these conclusions by compare monozygotic twin and dizygotic twins.
5. What was one interesting thing you discovered by leafing through this article?
1. I found it interesting that the heritability of major depression disorder is 38% but is higher in females than in males.  

Journal entry 2 audio

Journal entry 2

What is your topic? Or what are your key words thus far?

My topic is about the relationship of obesity and depression in adolescent children.

My keywords thus far are relationships, cohort study, longitudinal studies

What is your research question? Have you decided to change it at all? And, if you have, how do I know that the way in which this question is formulated is appropriate to conduct a literature review with a systematic approach?

My research question is: Is there a prevalence of comorbid  obesity and depression in adolescent and what can be done to help if there is a problem?

I did change my question because it was originally talking about depression and suicide with obesity but there is plenty of info given on just depression itself.

This question will work because it is more specific allowing me to stay on topic but there is still plenty of info given on the topic.

And what are the definitions on which it depends?

My question depends on five terms, all of which are linked to the literature. Those terms are:

Prevalence: the proportion of disease found to be affecting a particular population

Comorbid: the simultaneous presence of two chronic diseases or conditions in a patient.

Obesity: A BMI of 30 or greater

Depression: a persistent feelings of sadness and worthlessness and a lack of desire to engage in formerly pleasurable activities.

Adolescent: the period following the onset of puberty during which a young person develops from a child into an adult.

What is your hierarchy of evidence? And how do I know you going about finding the most appropriate evidence/method for your research question?

Since my question is on finding out if there is a relationship between obesity and depression my articles are most likely going to be cohort studies. There will also be multiple studies showing if obesity leads to depression or if depression leads to obesity so i expect to find articles on both and also for them to be longitudinal studies showing how the second symptom grows over time. After finding out if there is a relationship i will need to find articles on what could cause the main symptom and how the symptom could be fixed or improved.

Cohort

Case control

Longitudinal

Expert opinion

Studies on how effective treatments are.

How do I know that the remit of the method itself is selecting the research, rather than just you on a whim? + 1 thing you found interesting + how you imagine using the source

Article 1 (cohort)

Goldfield, G. S., Moore, C., Henderson, K., Buchholz, A., Obeid, N., & Flament, M. F. (2010). Body Dissatisfaction, Dietary Restraint, Depression, and Weight Status in Adolescents. Journal of School Health, 80(4), 186-192. doi:10.1111/j.1746-1561.2009.00485.x

This article is directly relevant to my topic (Cohort study) and this is proven in the introduction on how they talk about the relationship of obesity with symptoms. It then goes on talking about how depression is a key symptom . The study will then interview children who are obese, overweight and normal body weight. The results show how obese adolescents have more symptoms of depression than others and also discuss more discomfort of their body. This info will most likely be used on proving that obesity can lead to depression in my results section and also shows that if there isn't a comorbidity as adolescence it shows that it leads to it. I found it interesting that in this study emotional eating wasn’t different between obese, overweight and normal weight adolescents meaning that obesity is more the cause of depression.

Article 2 (Lit review)

Mannan, M., Mamun, A., Doi, S., & Clavarino, A. (2016). Prospective Associations between Depression and Obesity for Adolescent Males and Females- A Systematic Review and Meta-Analysis of Longitudinal Studies. Plos One, 11(6). doi:10.1371/journal.pone.0157240

This article is directly relevant to my topic (lit review) and this is proven from the introduction giving many different reasons of possible causes. This could be used all throughout my papers from the introduction; showing how it's relevant in our society, results; how depressions may cause obesity or obesity may cause depressions, and I can compare the conclusion from this paper compared to the information I find. I found it interesting that they found similar facts but also that there is a possible of genetic factors. Inflammations, impaired glycaemic control, dysregulation of the hypothalamic-pituitary-adrenocortical axis can cause both obesity and depression.

Article 3 (prospective cohort study)

Goodman, E., & Whitaker, R. C. (2002). A Prospective Study of the Role of Depression in the Development and Persistence of Adolescent Obesity. Pediatrics, 110(3), 497-504. doi:10.1542/peds.110.3.497

This article is directly relevant to my topic (cohort) and this is proven from the results section and the main topic. This article picks adolescence and has them do a survey testing for depression and comes back after a certain period of time and retest for depression and BMI scores. This article is based on if depression will lead adolescence into obesity and this info could be used in the results section when trying to determine which symptom cause the other or if both can lead to the co-morbidity. I found it interesting that females are at most risk for these problems and that psychosocial events are the cause for both depression and obesity.  

Article 4 (Case Control study)

Gallai, B., Esposito, M., Roccella, M., Marotta, R., Lavano, F., Lavano, S. M., . . . Carotenuto, M. (2014). Anxiety and depression levels in prepubertal obese children: a case-control study. Neuropsychiatric Disease and Treatment, 1897. doi:10.2147/ndt.s69795

This article directly works with my topic by comparing both obese children and healthy children. They gave both groups surveys to help determine if the children have depressive or anxiety symptoms. The result showed that inside the groups there was no difference between male or female, but when comparing the two groups there showed a significant difference with obese children showing more depressive symptoms. I will use this in the results section as well to just show that there is a relationship and it shows that the CDI score; the test for depressive symptoms, was linear with the BMI of the children. This could probably help with showing that obesity will lead to depression. I did find it interesting that poorer quality of life, social issues and increased behavioral problems have a negative impact on obesity and depression.

Article 5 (lit review)

Mcelroy, S. L., Kotwal, R., Malhotra, S., Nelson, E. B., Keck, P. E., & Nemeroff, C. B. (2004). Are Mood Disorders and Obesity Related? A Review for the Mental Health Professional. The Journal of Clinical Psychiatry, 65(5), 634-651. doi:10.4088/jcp.v65n0507

This article directly works with my topic because it shows data of many articles relating obesity and mental disorders. In the reading there is plenty of data relating depression and obesity in kids. This is great for my intro and also for my result section. My intro I can use facts showing how obesity is known to have mental illnesses that come with it. For my results it shows information on both depression leading to obesity and obesity leading to depression. I did find it interesting that these are both known to be genetic factors and also patients that are depressed or have high stress levels tend to have higher cortisol levels, leading to increase weight gain.

Anything else interesting happen?

I changed my question, making it more clear on what my search is.