Depressive symptoms during childhood and adult obesity: the Zurich Cohort Study (original) (raw)
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Obesity and depression: results from the longitudinal Northern Finland 1966 Birth Cohort Study
International Journal of Obesity, 2005
Objective: To examine the association between body size and depression in a longitudinal setting and to explore the connection between obesity and depression in young adults at the age of 31 years. Design: This study forms part of the longitudinal Northern Finland 1966 Birth Cohort Study (N ¼ 12 058). The follow-up studies were performed at 14 and 31 years. Data were collected by postal inquiry at 14 years and by postal inquiry and clinical examination at 31 years. Subjects: A total of 8451 subjects (4029 men and 4422 women) who gave a written informed consent and information on depression by three depression indicators at 31 years. Measurements: Body size at 14 (body mass index (BMI) and 31 (BMI and waist-to-hip ratio (WHR)) years and depression at 31 years by three different ways: depressive symptoms by the HSCL-25-depression questionnaire (HSCL-25), the use of antidepressants and self-reported physician-diagnosed depression. Results: Obesity at 14 years associated with depressive symptoms at 31 years; among male subjects using the cutoff point 2.01 in the HSCL-25 (adjusted odds ratio (OR) 1.97, 95% CI 1.06-3.68), among female subjects using the cutoff point 1.75 (adjusted OR 1.64, 95% CI 1.16-2.32). Female subjects who were obese both at baseline and follow-up had depressive symptoms relatively commonly (adjusted OR 1.40, 95% CI 1.06-1.85 at cutoff point 1.75); a similar association was not found among male subjects. The proportion of those who used antidepressants was 2.17-fold higher among female subjects who had gained weight compared to female subjects who had stayed normal-weighted (adjusted OR 2.17, 95% CI 1.28-3.68). In the crosssectional analyses male subjects with abdominal obesity (WHR X85th percentile) had a 1.76-fold risk of depressive symptoms using the cutoff 2.01 in the HSCL-25 (adjusted OR 1.76, 95% CI 1.08-2.88). Abdominally obese male subjects had a 2.07-fold risk for physician-diagnosed depression (adjusted OR 2.07, 95% CI 1.23-3.47) and the proportion of those who used antidepressants was 2.63-fold higher among obese male subjects than among male subjects without abdominal obesity (adjusted OR 2.63, 95% CI 1.33-5.21). Abdominal obesity did not associate with depression in female subjects. Conclusion: Obesity in adolescence may be associated with later depression in young adulthood, abdominal obesity among male subjects may be closely related to concomitant depression, and being overweight/obese both in adolescence and adulthood may be a risk for depression among female subjects.
American Journal of Epidemiology, 2003
Data from the Third National Health and Nutrition Examination Survey (1988)(1989)(1990)(1991)(1992)(1993)(1994) were used to examine the relation between obesity and depression. Past-month depression was defined using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, and was measured with the Diagnostic Interview Schedule. Obesity was defined as a body mass index (weight (kg)/height (m) 2 ) of 30 or higher. The authors compared risks of depression in obese and normal-weight (body mass index 18.5-24.9) persons. Obesity was associated with past-month depression in women (odds ratio (OR) = 1.82, 95% confidence interval (CI): 1.01, 3.3) but was not significantly associated in men (OR = 1.73, 95% CI: 0.56, 5.37). When obesity was stratified by severity, heterogeneity in the association with depression was observed. Class 3 (severe) obesity (body mass index ≥40) was associated with past-month depression in unadjusted analyses (OR = 4.98, 95% CI: 2.07, 11.99); the association remained strong after results were controlled for age, education, marital status, physician's health rating, dieting for medical reasons, use of psychiatric medicines, cigarette smoking, and use of alcohol, marijuana, and cocaine. These findings suggest that obesity is associated with depression mainly among persons with severe obesity. Prospective studies will be necessary to clarify the obesity-depression relation but await the identification of potential risk factors for depression in the obese.
Translational Psychiatry, 2021
Studies considering the causal role of body mass index (BMI) for the predisposition of major depressive disorder (MDD) based on a Mendelian Randomization (MR) approach have shown contradictory results. These inconsistent findings may be attributable to the heterogeneity of MDD; in fact, several studies have documented associations between BMI and mainly the atypical subtype of MDD. Using a MR approach, we investigated the potential causal role of obesity in both the atypical subtype and its five specific symptoms assessed according to the Statistical Manual of Mental Disorders (DSM), in two large European cohorts, CoLaus|PsyCoLaus (n = 3350, 1461 cases and 1889 controls) and NESDA|NTR (n = 4139, 1182 cases and 2957 controls). We first tested general obesity measured by BMI and then the body fat distribution measured by waist-to-hip ratio (WHR). Results suggested that BMI is potentially causally related to the symptom increase in appetite, for which inverse variance weighted, simple ...
Body mass index and psychiatric disorders: a Mendelian randomization study
Scientific Reports, 2016
Obesity is a highly prevalent risk factor for cardiometabolic diseases. Observational studies suggest that obesity is associated with psychiatric traits, but causal inference from such studies has several limitations. We used two-sample Mendelian randomization methods (inverse variance weighting, weighted median and MR-Egger regression) to evaluate the association of body mass index (BMI) with three psychiatric traits using data from the Genetic Investigation of Anthropometric Traits and Psychiatric Genomics consortia. Causal odds ratio estimates per 1-standard deviation increment in BMI ranged from 0.88 (95% CI: 0.62; 1.25) to 1.23 (95% CI: 0.65; 2.31) for bipolar disorder; 0.93 (0.78; 1.11) to 1.41 (0.87; 2.27) for schizophrenia; and 1.15 (95% CI: 0.92; 1.44) to 1.40 (95% CI: 1.03; 1.90) for major depressive disorder. Analyses removing potentially influential SNPs suggested that the effect estimates for depression might be underestimated. Our findings do not support the notion that higher BMI increases risk of bipolar disorder and schizophrenia. Although the point estimates for depression were consistent in all sensitivity analyses, the overall statistical evidence was weak. However, the fact that SNP-depression associations were estimated in relatively small samples reduced power to detect causal effects. This should be re-addressed when SNP-depression associations from larger studies become available. Obesity is a major public health concern with well-established risk-increasing effects on cardiometabolic diseases 1. Given its high prevalence worldwide 1 , investigating if obesity influences additional diseases is relevant for understanding the range of its health consequences. Psychiatric disorders are one of the main causes of years lived with disability globally 2. There is considerable evidence suggesting an association between obesity and psychiatric disorders, including depression 3,4 , bipolar disorder 5,6 and schizophrenia 7,8. Reverse causality could be one of the explanations for this association because increase in body weight is a side effects of some anti-psychotic medications 6,9. Besides treatment, biological, psychological, and sociodemographic variables related to psychiatric disorders may affect lifestyle factors such as physical activity and diet and thus lead to obesity 10,11. Cohort studies provide support that obesity both predicts and can be predicted by depression 3,12,13 and bipolar disorder 14. Moreover, higher frequencies of obesity measures were reported in first episode and/or medication-naive schizophrenia patients 15,16 , although not universally 17,18. A recent instrumental variable analysis supported the hypothesis that obesity influences depression 19. Most of the evidence regarding the association of obesity with psychiatric disorders comes from observational studies, which present several limitations for causal inference, including residual confounding, measurement error and reverse causation 20,21. Using genetic variants as instrumental variables for modifiable disease risk factors or exposures (ie, Mendelian randomization) contributes to overcome such limitations given Mendel's laws, the fact that germline genetic variants are determined at conception and the general lack of association between genetic variants and common confounders of observational associations 21-23. Mendelian randomization relies on assuming that any association between the genetic instrument(s) and the health outcome is entirely mediated by the exposure (ie, vertical pleiotropy) 21-23. However, the polygenic nature of complex traits increases the probability of existing biological links between exposure-associated variants and the outcome not mediated by the exposure itself (ie, horizontal pleiotropy). Indeed, the largest genome-wide
The overweight/obesity - depression links over the life course
Background and aims Worldwide, the prevalence of overweight, obesity and depression are increasing in both males and females and across different age groups. Although an increasing number of studies have examined their association, the results of these studies are mixed and therefore do not allow any firm conclusions to be drawn about either the strength or direction of any associations. One potential explanation is that there are relatively few cohort studies available, with sufficiently long follow-up periods that also have data on both depression and obesity as well as on potential confounding factors. The aim of this study was to examine the longitudinal associations between overweight, obesity and depression, in both adolescents and adults, with a focus on adult women who are increased risk, across their reproductive life course, of overweight, obesity and depression. Methods The first phase of the study comprised two systematic reviews and meta-analyses. Comprehensive computerized literature searches were undertaken using Pubmed (including Medline), PsycINFO, Embase, CINAHL, BIOSIS Preview and the Cochrane Library. A standard data extraction form was used to collect the secondary data for the systematic reviews. For the meta-analyses, a quality effects model was used instead of a random effects
Longitudinal associations between depressive symptoms and body mass index in a 20-year follow-up
International Journal of Obesity, 2013
Longitudinal studies have rarely investigated changes in depressive symptoms and indicators of obesity simultaneously, although it is often proposed that the positive relationship between depression and obesity is bidirectional. The present study examined the reciprocal nature of the relationship between depressive symptoms and body mass index (BMI) in a 20-year follow-up survey. METHODS: Participants of a Finnish cohort study in 1989 at 22 years (N ¼ 1656) were followed up at ages 32 (N ¼ 1262) and 42 (N ¼ 1155) with postal questionnaires. BMI was calculated on the basis of self-reported weight and height, and depressive symptoms were assessed using the short form of the Beck Depression Inventory. Latent growth models (LGM) and cross-lagged autoregressive models were used to determine prospective associations between depressive symptoms and BMI. RESULTS: LGM analyses indicated that men with higher initial levels of depressive symptoms experienced a faster rate of increase in BMI (b ¼ 0.20, Po0.01). Among women, change in BMI or depressive symptoms was not predicted by the other construct, but initial levels of BMI and depressive symptoms as well as their rate of change correlated positively with each other (r ¼ 0.15 and 0.37, respectively). In cross-lagged models, depressive symptoms at age 32 predicted greater BMI at 42 (b ¼ 0.10, Po0.001) among men, whereas women with higher BMI at age 32 were more likely to have more depressive symptoms at 42 (b ¼ 0.08, Po0.05). CONCLUSIONS: Elevated depressive symptoms predicted weight gain in men, while changes in depressive symptoms and body weight occurred concurrently in women. Tentative evidence showed that women with excess body weight were more likely to have increased symptoms of depression 10 years later. More emphasis should be placed on depressive symptoms in weight control programs as well as on reducing weight-based stigmatization and discrimination in society.
Are obese adolescents and young adults at higher risk for mental disorders? A community survey
Obesity, 2002
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.
Molecular Psychiatry, 2006
The association between insulin resistance (IR) and depression is a subject of growing research interest, especially as previous population-based studies have presented conflicting findings. The present study extends our understanding about the putative impact of the severity of depressive symptoms on this association and it provides further epidemiological evidence in support of earlier findings, suggesting that the association between IR and depression is present already in young adult males. To determine the impact of the severity of depressive symptoms on the putative association between IR and depression in young adult males, we were given access to the Northern Finland 1966 Birth Cohort database. During the 31-year follow-up survey of this genetically homogeneous birth cohort, IR was assessed by 'Qualitative Insulin Sensitivity Check Index' (QUICKI), and severity of depressive symptoms by 'Hopkins' Symptom Checklist-25' (HSCL-25). This study involved 2609 male cohort members with complete variable information. In men, the means of the QUICKI-values decreased (i.e., IR increased) in line with the increased severity of depressive symptoms as assessed by HSCL-25 subgroups (analysis of covariance P-value for trend, P = 0.003). In multivariate generalized logistic regression analyses, after adjusting for confounders, IR was positively associated with current severe depressive symptoms, the odds ratio (OR) being over threefold (adjusted OR 3.15, 95% confidence interval 1.48-6.68) and the value of OR increased in parallel with a tighter definition of IR (P-value for trend = 0.007). The results indicate that in young males, a positive association exists specifically with severe depressive symptoms. Molecular Psychiatry (2006) 11, 929-933.