Synthesis Matrix/Critical Appraisal 2

Author/Date	Aim of Study	Type of literature + type of method	Result /Conclusion	Strengths + limitations	Thematic codings	Setting/ Context
6 Afari, 2010	This article was created to test how much of an impact genetics plays with depression.	Twin study	The results of this paper showed that there is a correlation with inheriting these disorders from one's parents. The test is comparing monozygotic twins to dizygotic twins. The reason for this is because if genes are a big player than the monozygotic twins will have more of an impact because they have the exact same genes.	The strengths for this is that it is a twin study, which is specifically used for testing genetics, it uses over 700 monozygotic twins compared to 300 dizygotic twins. The reason for this is a strength as well because it also test if shared genetics are what make these two disorders common. The weakness is that is only uses females but that is because females have a higher rate of depression as well.	Correlations of depression and obesity, shared genetics, females have a high probability of disorders.	Files used from the University of Washington Twin registry.
7 Goodman, 2003	This article is about testing how one's environment can lead to the creation of the disorder. This study specifically looks into Socioeconomic Status or SES	Cohort	This study looks into parents income and education , separating them into 5 different categories. It was proven for parents who had lower income that obesity and depression are greater factors in these areas. It doesn't specify why but from recent classes i known that stress and food availability can have an impact in these areas.	The strengths of this article is that covers an needed risk factor for this paper, it uses a large sample of about 19,000 subjects. The weakness of this study is that it doesn't say what are possible cause just that it is a problem in our youth. Weakness is that the adolescents self reported height and weight, meaning it could be false.	Low-income cause higher rates, problem to today's youth, correlation of obesity and depression, chronic disease that track into adulthood, increase mortality and other morbidities.	15,484 parents completed interview and adolescents did self reported height and weight and also completed a survey (CES-D) to assess depressive symptoms.
8 Fletcher, 2015	The study test correlations of diseases or disorders within schools and comparing them to other schools.	cohort	They calculated the BMI and had the students take the CES-D to test for depressive symptoms. The results showed that neighborhoods and parenting have a major factor on these diseases.	The strengths is that it shows a different perspective of the topic, uses school attained info but weakness is that this article has very little information.	Correlation, impact of community and parenting, health issue, can develop into adulthood.	BMI and CES-D done for obesity and over 1500 and were surveyed over 4 waves from 1994-2009. .
9 Castillo, 2008	This is a study done to see the positive effects of physical fitness. It talks about many disorders not only obesity and depression.	Lit. Review	The results showed because it does prove to help both obesity with decreased adiposity and also decreased depression.	The strength is that it goes over so many different studies on one topic, goes on what can help both obesity and depression. The weakness is that it is a Lit. Review.	Lowers adiposity, improves health, cardiorespiratory fitness has shown a stronger association with total adiposity. Decreases depression and increases self-esteem	Lit. Review
10 Hinrichs, 2009	This is a study done on only obesity rates and food deserts. This	Cohort study	The results showed that people who do live in a food desert do have a higher rate of obesity as a community.	The strength is that this is another risk factor that will be used in my paper but the weakness is that it only works for obesity. I think this will be ok because it has already been proven that obesity can lead to depression.	Food desert, obesity, both food deserts and non have increased obesity rates	Looked at rural areas in Pennsylvania, found food deserts and then did BMI on high school students to determine obesity rates for different areas.

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.