Of approximately 500 children invited to take part in the study, only 264 (53%) completed the questionnaire. Table 1 shows the socio-demographic characteristics as reported on the questionnaire which was completed by the children, and on the data collection form which was completed by the parents/guardians. 146 (55.3%) of the children were female.
Table 1
Socio-demographic characteristics of the 264 children (44.7% male; 55.3% female)
|
Frequency
|
Percentage (%)
|
Gender of child
|
Male
|
118
|
44.7%
|
Female
|
146
|
55.3%
|
Gender of the parent or guardian
|
Male
|
16
|
13.9%
|
|
Female
|
99
|
86.1%
|
Age of parent or guardian answering the questions*
|
Below 21 years
|
11
|
9.6%
|
21–30 years
|
10
|
8.7%
|
31–40 years
|
48
|
41.7%
|
41–50 years
|
44
|
38.3%
|
More than 50 years
|
2
|
1.7%
|
Parent or guardian highest
level of education
|
No qualification
|
9
|
8.2%
|
Vocational qualification
|
10
|
9.1%
|
GCSEs/O-levels
|
39
|
35.5%
|
A-levels/Diploma
|
32
|
29.1%
|
University degree
|
20
|
18.2%
|
Occupation of the main household earner
|
Unemployed
|
7
|
6.5%
|
Unskilled labourer
|
10
|
9.3%
|
Skilled labourer
|
24
|
22.2%
|
Professional job
|
65
|
60.2%
|
Own business
|
2
|
1.9%
|
Ethnicity
|
White British
|
110
|
96.5%
|
Asian
|
1
|
0.9%
|
White Irish
|
1
|
0.9%
|
White other
|
1
|
0.9%
|
Black
|
1
|
0.9%
|
Table 2 compares actual weight status of children determined from the NCMP data and child’s perceived weight status.
Table 2
Body weight status of the sample, compared with the ‘ideal’ range and the average for best comparison from UK data.
|
Mean
|
Range
|
Ideal
|
UK average (benchmark)
|
|
Actual BMI1(Kg/m2)
|
19.43
|
12.60–30.69
|
*
|
*
|
|
|
Perceived weight status of children2
|
|
Underweight
|
Normal
|
Overweight
|
Very overweight
|
Total
|
Chi-Square
(χ2)
|
Sig.
(p)
|
N (Row %)
|
N (Row %)
|
N (Row %)
|
N (Row %)
|
N (Table %)
|
|
Actual weight status1
|
Ideal weight
|
7(14.3%)
|
38(77.6%)
|
4(8.2%)
|
0(0.0%)
|
49(59.8%)
|
22.18
|
0.008
|
Overweight
|
1(5.1%)
|
13(76.5%)
|
3(17.6%)
|
0(0.0%)
|
17(20.7%)
|
Underweight
|
0(0.0%)
|
4(100.0%)
|
0(0.0%)
|
0(0.0%)
|
4(4.9%)
|
Obese
|
0(0.0%)
|
5(41.7%)
|
6(50.0%)
|
1(8.3%)
|
12(14.6%)
|
Total
(Table %)
|
8(9.8%)
|
60(73.2%)
|
13(15.9%)
|
1(1.2%)
|
82(100.0%)
|
1 = BMI calculated from height and weight measured as part of the NCMP, and weight status calculated using UK90 charts.
2 = collected from child
*No known figure
About 1 in 10 children who were subsequently adjudged to be ideal weight by the Primary Care Trust (PCT) reported figures (8.2%) wrongly perceived themselves as overweight. Of particular interest, however, is the finding that, over three quarters of children considered overweight by the PCT reported figures perceived themselves to be of ideal weight (76.5%) and only 17.6% of these overweight children actually perceived themselves as overweight. All the underweight children according to the PCT figures perceived themselves as having an ideal weight, and just less than half of the obese children (41.7%) perceived themselves as having an ideal weight. A chi-square test identified a statistical difference between actual weight status of children and perceived weight status (χ2 = 22.18, df = 9, p < 0.01). Table 3 shows the distribution of mental wellbeing scores as measured from the SDQ and the GHQ-12.
Table 3
Mental wellbeing by different mental health indicators compared with the ‘ideal’ range and the average for best comparison from UK data.
Mental wellbeing of children by SDQ scores
|
|
Mean
|
Range
|
UK average1 (benchmark)
|
Total difficulties (Mental wellbeing)2
|
11.41
|
0–33
|
8.4
|
Emotional problems
|
2.84
|
0–9
|
1.9
|
Conduct problems
|
2.54
|
0–9
|
1.6
|
Hyperactivity problems
|
3.86
|
0–10
|
3.5
|
Peer problems
|
2.17
|
0–10
|
1.5
|
Prosocial behaviour
|
7.75
|
2–10
|
8.6
|
Mental Wellbeing of children by percentage prevalence
|
|
Current study
|
UK average1 (benchmark)
|
N
|
%
|
%
|
Overall Mental health status by SDQ total score
|
Abnormal
|
21
|
8
|
9.8
|
Borderline
|
42
|
15.9
|
8.2
|
Normal
|
201
|
76.1
|
82.1
|
Emotional problems status
|
Abnormal
|
19
|
7.2
|
11.4
|
Borderline
|
17
|
6.4
|
7.8
|
Normal
|
228
|
86.4
|
80.8
|
Conduct problems status
|
Abnormal
|
45
|
17
|
12.7
|
Borderline
|
32
|
12.1
|
10.9
|
Normal
|
187
|
70.8
|
76.4
|
Hyperactivity status
|
Abnormal
|
35
|
13.3
|
14.7
|
Borderline
|
24
|
9.1
|
7.4
|
Normal
|
205
|
77.7
|
77.9
|
Peer problems status
|
Abnormal
|
11
|
4.2
|
11.7
|
Borderline
|
44
|
16.7
|
10.2
|
Normal
|
209
|
79.2
|
78.0
|
Socio relations problems
|
Abnormal
|
13
|
4.9
|
2.3
|
Borderline
|
22
|
8.3
|
2.7
|
Normal
|
229
|
86.7
|
95.0
|
Mental wellbeing by GHQ scores
|
|
Mean
|
Range
|
UK Average
|
GHQ score (Mental wellbeing)2
|
1.48
|
0–11
|
*
|
|
N
|
(%)
|
|
Mental health status by GHQ
total score
|
Morbid
|
37
|
14
|
*
|
Normal
|
227
|
86
|
*
|
1UK averages derived from a nationally representative sample [29]
*No known figures
The total difficulties score of the SDQ categorised the majority of children (76.1%) as normal and about 15.9% of children as borderline while just under 1 in 10 children were categorised as abnormal, meaning they had, in all likelihood, clinically diagnosable mental health problems.
The relationship between mental wellbeing and perceived or actual weight status was of particular importance in this study. Results of a Chi-square test for the association between mental wellbeing and actual weight status are indicated in Table 4.
Table 4
The test of association between indicators of mental wellbeing and actual weight status
|
Actual weight status of children from NCMP data
(N = 82)
|
Chi-square (χ2)
|
Sig.
(p)
|
Under-weight
|
Ideal weight
|
Overweight
|
Obese
|
|
Indicators of child mental health
|
Count (C%)
|
Count (C%)
|
Count (C%)
|
Count (C%)
|
|
Total difficulties
|
Normal
|
4(4.9)
|
34(41.5)
|
13 (15.9)
|
9(11.0)
|
7.533
|
0.274
|
Borderline
|
0(0.0)
|
11(13.4)
|
2 (2.4)
|
0(0.0)
|
Abnormal
|
0(0.0)
|
4(4.9)
|
2 (2.4)
|
3(3.7)
|
Emotional problems
|
Normal
|
4(4.0)
|
38(46.3)
|
16 (19.5)
|
9(11.0)
|
4.486
|
0.611
|
Borderline
|
0(0.0)
|
6(7.3)
|
0(0.0)
|
1(1.2)
|
Abnormal
|
0(0.0)
|
5(6.1)
|
1(1.2)
|
12(14.6)
|
Conduct problems
|
Normal
|
3(3.7)
|
34(41.5)
|
13(15.9)
|
8(9.8)
|
3.065
|
0.801
|
Borderline
|
0(0.0)
|
9(11.0)
|
2(2.4)
|
1(1.2)
|
Abnormal
|
1(1.2)
|
6(7.3)
|
2(2.4)
|
3(3.7)
|
Hyper-activity problems
|
Normal
|
4(4.9)
|
39(47.6)
|
13(15.9)
|
8(9.8)
|
2.940
|
0.820
|
Borderline
|
0(0.0)
|
1(1.2)
|
1(1.2)
|
1(1.2)
|
Abnormal
|
0(0.0)
|
9(11.0)
|
3(3.7)
|
3(3.7)
|
Peer problems
|
Normal
|
3(3.7)
|
38(46.3)
|
11(13.4)
|
9(11)
|
3.625
|
0.727
|
Borderline
|
1(1.2)
|
9(11)
|
6(7.3)
|
2(2.4)
|
Abnormal
|
0(0.0)
|
2(2.4)
|
0(0.0)
|
1(1.2)
|
Prosocial behaviour
|
Normal
|
0(0.0)
|
4(4.9)
|
1(1.2)
|
0(0.0)
|
4.362
|
0.628
|
Borderline
|
1(1.2)
|
5(6.1)
|
1(1.2)
|
0(0.0)
|
Abnormal
|
3(3.7)
|
40(48.8)
|
15(18.3)
|
12(14.6)
|
GHQ-12 scores
|
Normal
|
4(4.9)
|
41(50)
|
15(18.3)
|
10(12.2)
|
0.950
|
0.813
|
Morbid
|
0(0.0)
|
8(9.8)
|
2(2.4)
|
2(2.4)
|
The test shows that there was no significant relationship between any of the indicators of mental wellbeing (total difficulties, emotional symptoms, conduct problems, hyperactivity, and prosocial behaviours) and actual body weight status of children. Total difficulties were not significantly associated with the PCT reported weight status (χ2 = 7.533, df = 6, p > 0.05). This was similar for emotional problems (χ2 = 4.486, df = 6, p > 0.05), conduct problems (χ2 = 3.065, df = 6, p > 0.05), hyper-activity problems (χ2 = 2.940, df = 6, p > 0.05), peer problems (χ2 = 3.625, df = 6, p > 0.05), and pro-social behaviour (χ2 = 4.362, df = 6, p > 0.05).
However conducting the same test using perceived weight status, the test reveals a strong relationship between mental wellbeing and perceived weight status of the children (P < 0.001) as indicated by Table 5.
Table 5
The test of association between indicators of mental wellbeing and perceived weight status
|
Perceived weight status of the children
N = 263
|
Chi-square (χ2)
|
Sig.
(p)
|
Underweight
|
Ideal weight
|
Overweight
|
Very overweight
|
|
|
Indicators of child mental health
|
Count
(C%)
|
Count (C%)
|
Count
(C%)
|
Count
(C%)
|
Total difficulties
|
Normal
|
17(60.7)
|
159(82.0)
|
25(67.6)
|
0(0.0)
|
33.96
|
0.000
|
Borderline
|
7(25.0)
|
28(14.4)
|
4(10.8)
|
2(50.0)
|
Abnormal
|
4(14.3)
|
7(3.6)
|
8(21.6)
|
2(50.0)
|
Emotional symptoms
|
Normal
|
25(89.3)
|
175(90.2)
|
26(70.3)
|
2(50.0)
|
20.50
|
0.002
|
Borderline
|
0(0.0)
|
12(6.2)
|
4(10.8)
|
1(25.0)
|
Abnormal
|
3(10.7)
|
7(3.6)
|
7(18.9)
|
1(25.0)
|
Conduct problems
|
Normal
|
15(53.6)
|
145(74.7)
|
26(70.3)
|
0(0.0)
|
17.95
|
0.011
|
Borderline
|
4(14.3)
|
22(11.3)
|
5(13.5)
|
1(25.0)
|
Abnormal
|
9(32.1)
|
27(13.9)
|
6(16.2)
|
3(75.0)
|
Hyper-
activity problems
|
Normal
|
16(57.1)
|
163(84.0)
|
25(67.6)
|
0(0.0)
|
41.85
|
0.000
|
Borderline
|
1(3.6)
|
15(7.7)
|
7(18.9)
|
1(25.0)
|
Abnormal
|
11(39.3)
|
16(8.2)
|
5(13.5)
|
3(75.0)
|
Peer problems
|
Normal
|
21(75.0)
|
164(84.5)
|
22(59.5)
|
2(50.0)
|
36.58
|
0.000
|
Borderline
|
6(21.4)
|
26(13.4)
|
12(32.4)
|
0(0.0)
|
Abnormal
|
1(3.6)
|
4(2.1)
|
3(8.1)
|
2(50.0)
|
Prosocial behaviour
|
Abnormal
|
3(10.7)
|
8(4.1)
|
2(5.4)
|
0(0.0)
|
7.103
|
0.311
|
Borderline
|
5(17.9)
|
15(7.7)
|
2(5.4)
|
0(0.0)
|
Normal
|
20(71.4)
|
171(88.1)
|
33(89.2)
|
4(100.0)
|
GHQ-12 Score
|
Normal
|
19(67.9)
|
178(91.8)
|
29(78.4)
|
1(25.0)
|
27.631
|
0.000
|
Morbid
|
9(32.1)
|
16(8.2)
|
8(21.6)
|
3(75.0)
|
Results indicated that children who perceived themselves to be overweight, obese and underweight were less likely to have total difficulties scores in the ‘normal’ range, whereas children who perceived themselves as ideal weight were more likely to have total difficulties scores in the normal range (χ2 = 33.96, df = 6, p < 0.001). There is a significant relationship between emotional symptoms and perceived weight status of children (χ2 = 20.50, df = 6, p < 0.01); likewise there is a significant relationship between conduct problems and perceived weight status of children (χ2 = 17.95, df = 6, p < 0.05). There is also a significant relationship between hyper-activity problems and perceived weight status of children (χ2 = 41.85, df = 6, p < 0.001) and Peer problems were also significantly associated with perceived weight status of children (χ2 = 36.58, df = 6, p < 0.001). Figure 1 shows the error bars between some indicators of child mental health and perceived and actual weight status.
The 95% confidence intervals on the error bars indicate significant differences among mean mental health scores of the children perceiving themselves to be overweight and obese compared to those perceiving themselves to be of ideal weight. However with actual weight status, there is no significant difference among the mean mental health scores for the different categories of weight status. Mental health scores are significantly higher among children perceiving themselves to be overweight and obese compared to the children who are actually overweight and obese.