The Hyperphagia Questionnaire: Insights From a Multicentric Validation Study in Individuals With Prader Willi Syndrome

Maria Rosaria Licenziati; Dario Bacchini; Antonino Crinò; Graziano Grugni; Danilo Fintini; Sara Osimani; Letizia Ragusa; Michele Sacco; Lorenzo Iughetti; Luisa De Sanctis; Adriana Franzese; Malgorzata Gabriela Wasniewska; Maria Felicia Faienza; Maurizio Delvecchio; Concetta Esposito; Giuliana Valerio

doi:10.3389/fped.2022.829486

The Hyperphagia Questionnaire: Insights From a Multicentric Validation Study in Individuals With Prader Willi Syndrome

Front Pediatr. 2022 Feb 14:10:829486. doi: 10.3389/fped.2022.829486. eCollection 2022.

Authors

Maria Rosaria Licenziati¹, Dario Bacchini², Antonino Crinò³, Graziano Grugni⁴, Danilo Fintini³, Sara Osimani⁵, Letizia Ragusa⁶, Michele Sacco⁷, Lorenzo Iughetti⁸, Luisa De Sanctis⁹, Adriana Franzese¹⁰, Malgorzata Gabriela Wasniewska¹¹, Maria Felicia Faienza¹², Maurizio Delvecchio¹³, Concetta Esposito², Giuliana Valerio¹⁴

Affiliations

¹ Department of Neurosciences, Obesity and Endocrine Disease Unit, Santobono-Pausilipon Childrens Hospital, Naples, Italy.
² Department of Humanistic Studies, University of Naples "Federico II", Naples, Italy.
³ Reference Center for Prader-Willi Syndrome, Research Institute, Bambino Gesù Hospital, Rome, Italy.
⁴ Department of Auxology, Istituto di Ricerca e Cura a Carattere Scientifico Istituto Auxologico Italiano, Verbania, Italy.
⁵ Department of Pediatrics, Scientific Institute San Raffaele, Milan, Italy.
⁶ Oasi Research Institute-IRCCS, Troina, Italy.
⁷ Pediatric Unit Scientific Institute "Casa Sollievo Della Sofferenza" San Giovanni Rotondo (FG), San Giovanni Rotondo, Italy.
⁸ Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
⁹ Department of Public Health and Pediatric Sciences, University of Torino, Turin, Italy.
¹⁰ Department of Traslational Sciences, University of Naples Federico II, Naples, Italy.
¹¹ Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy.
¹² Department of Biomedical Sciences and Human Oncology, Pediatric Unit, University of Bari "Aldo Moro", Bari, Italy.
¹³ Metabolic Disorders and Genetics Unit, "Giovanni XXIII" Children's Hospital, Azienda Ospedaliera Universitaria (A.O.U.) Policlinico di Bari, Bari, Italy.
¹⁴ Department of Movement Sciences and Wellbeing, Parthenope University of Naples, Naples, Italy.

Abstract

Background/objectives: The present study aimed to validate the Italian version of the Hyperphagia Questionnaire (HQ), a 11-items questionnaire developed to assess hyperphagia in individuals with Prader-Willi syndrome (PWS). This is a complex neurodevelopmental disorder characterized by endocrine dysfunction, hypotonia, intellectual disability, psychiatric disorders and obesity.

Methods: Parents of 219 individuals with PWS (age range 3-54 years; M_age = 17.90; 108 Males), recruited in 12 hospitals in Italy responded to HQ during routine visits. In function of the level of analyses the sample was divided into two subgroups (<18> years) or into four age-subgroups (2.5-4.5; 4.5-8; 8-18; >18 years) corresponding to different clinical stages.

Results: Confirmatory factor analysis (CFA) confirmed the three hyperphagic subdimensions of the original structure (behavior, drive, and severity), but one item was dropped out, reducing the final version to 10 items. Using multi-group CFA, HQ showed satisfactory indexes of measurement invariance by age. Good indexes of internal consistency (Cronbach's alpha and McDonald's Omega coefficients) were found for each subdimension. The three hyperphagia subdimensions positively converged with other food-related measures: emotional overeating, food enjoyment, food responsiveness, and satiety responsiveness. A significant increase of all hyperphagic subdimensions was found across age groups. Higher hyperphagic levels were found in participants with higher body mass index. Hyperphagic drive differently increased in function of the interaction between age and underlying genetic mechanisms.

Conclusion: The Italian version of the HQ is a psychometrically valid and reliable instrument for assessing hyperphagia in individuals with PWS. This tool may prove useful to evaluate the efficacy of pharmacologic and rehabilitative treatments.

Keywords: Genetic Obesity; Prader-Willi syndrome; assessment; hyperphagia; multicentric study; weight status.