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Treviño-Alvarez AM, Sánchez-Ruiz JA, Barrera FJ, Rodríguez-Bautista M, Romo-Nava F, McElroy SL, Cuéllar-Barboza AB. Weight changes in adults with major depressive disorder: A systematic review and meta-analysis of prospective studies. J Affect Disord 2023; 332:1-8. [PMID: 36963517 DOI: 10.1016/j.jad.2023.03.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/04/2023] [Accepted: 03/18/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Major Depressive Disorder (MDD) and obesity are bidirectionally related, but the amount of weight-gain secondary to MDD is unknown. We aimed to estimate the adjusted effect of MDD on weight-change in prospective studies compared to individuals without MDD. METHODS Scopus/MEDLINE, PsycInfo, Web of Science and Cochrane were systematically searched for prospective observational studies of participants with a diagnosis of MDD. We included studies that conducted regression analyses on weight-variables. We searched for weight-variables reported at baseline, follow-up, and regression analyses. A meta-analysis of the odds ratios reported in logistic regression models was performed using the generic inverse weight variance method. RESULTS Eight studies were included with a total of 60,443 subjects; 56.8 % with MDD. Weight-variables included weight, BMI, waist circumference, fat mass, and obesity incidence. In three follow-up reports, weight-variables increased more in participants with MDD and its subphenotypes than in control subjects, except for one MDD subphenotype. Meta-analysis of three eligible studies (n = 21,935) showed a significantly greater likelihood of incident obesity in participants with MDD (OR:1.48, 95%CI 1.03-2.13). MDD subphenotype reports might suggest a greater risk for atypical MDD. LIMITATIONS Heterogeneity in weight related variables, follow-ups, and regression models; scarcity of follow-up data; and limited studies eligible for meta-analysis. CONCLUSIONS Despite previous associations between MDD and obesity, current prospective evidence on MDD related weight-change is scarce and heterogeneous. Our findings suggest a need to standardize weight-change assessment in MDD trials. Moreover, careful weight tracking and management should be incorporated in clinical settings. PROSPERO registration CRD42020214427.
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Affiliation(s)
- Andrés Marcelo Treviño-Alvarez
- Department of Psychiatry, University Hospital and School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | | | - Francisco J Barrera
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mario Rodríguez-Bautista
- Plataforma INVEST UANL - KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Francisco Romo-Nava
- Lindner Center of Hope, Mason, OH, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Susan L McElroy
- Lindner Center of Hope, Mason, OH, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Alfredo Bernardo Cuéllar-Barboza
- Department of Psychiatry, University Hospital and School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
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Cattane N, Räikkönen K, Anniverno R, Mencacci C, Riva MA, Pariante CM, Cattaneo A. Depression, obesity and their comorbidity during pregnancy: effects on the offspring's mental and physical health. Mol Psychiatry 2021; 26:462-481. [PMID: 32632208 PMCID: PMC7850968 DOI: 10.1038/s41380-020-0813-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/20/2020] [Accepted: 06/05/2020] [Indexed: 02/08/2023]
Abstract
Depression and obesity represent two of the most common complications during pregnancy and are associated with severe health risks for both the mother and the child. Although several studies have analysed the individual effects of depression or obesity on the mothers and their children, the effects associated with the co-occurrence of both disorders have so far been poorly investigated. The relationship between depression and obesity is very complex and it is still unclear whether maternal depression leads to obesity or vice versa. It is well known that the intrauterine environment plays an important role in mediating the effects of both depression and obesity in the mother on the fetal programming, increasing the child's risk to develop negative outcomes.
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Affiliation(s)
- Nadia Cattane
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Roberta Anniverno
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Claudio Mencacci
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Marco A Riva
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Carmine M Pariante
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
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3
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Individual differences in within-subject weight variability: There's a signal in the noise. Physiol Behav 2020; 226:113112. [DOI: 10.1016/j.physbeh.2020.113112] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 07/06/2020] [Accepted: 07/28/2020] [Indexed: 11/19/2022]
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4
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Desai R, Valaparla VL, Fong HK, Gandhi Z, Varma Y, Varma K, Ali Khan MZ, Dawood B, Desai V, Savani S, Doshi R, Mansuri Z. Nationwide Trends in Cardiovascular and Cerebrovascular Diseases and Outcomes Among Young Adults (18-39 years) Hospitalized With Comorbid Depression. Cureus 2020; 12:e10640. [PMID: 33133810 PMCID: PMC7586370 DOI: 10.7759/cureus.10640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Gijzen MWM, Creemers DHM, Rasing SPA, Smit F, Engels RCME. Evaluation of a multimodal school-based depression and suicide prevention program among Dutch adolescents: design of a cluster-randomized controlled trial. BMC Psychiatry 2018; 18:124. [PMID: 29747618 PMCID: PMC5946540 DOI: 10.1186/s12888-018-1710-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 05/01/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since 2010, suicide has been the most important cause of mortality in youth aged 15 to 29 years in the Netherlands. Depression is an important risk factor for suicidal behaviors (i.e., suicide ideation, deliberate self-harm, planning, and suicide attempts) in adolescents. Adolescents who develop depressive symptoms, are also at risk for adult depression. This developmental continuity is especially noticeable in adolescents compared to other age groups; therefore, it is necessary to develop preventive strategies for teens. This study will test a multimodal school-based approach to suicide and depression prevention, which integrates universal and targeted approaches and includes various stakeholders (schools, adolescents, parents, and mental health professionals) simultaneously. METHODS We will perform a cluster randomized controlled trial (RCT) with an intervention and control condition to test the effectiveness of a school-based multimodal stepped-prevention program for depression and suicidal behaviors in adolescents. Adolescents in their second year of secondary education will participate in the study. The participants in the intervention condition will receive the entire multimodal stepped-preventive program comprising early screening and detection of suicidal behaviors and depressive symptoms, a safety net consisting of gatekeepers at school, followed by universal and indicated prevention. The participants in the control condition will undergo only the screening and the safety net of gatekeepers at schools. They will complete assessments at baseline, post-intervention, and 6, 12, and 24-month follow-up. Primary outcome will be suicidal behaviors measured at 12-months follow-up. Additionally, the present study will identify mechanisms that mediate and moderate the program effects and test the effect of the program on various secondary outcomes. DISCUSSION If the school-based multimodal stepped-prevention program proves to be effective, it could be implemented in schools on a large scale. TRIAL REGISTRATION The study is registered in the Dutch Trial Register ( NTR6622 ).
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Affiliation(s)
- Mandy W. M. Gijzen
- 0000 0001 0835 8259grid.416017.5Trimbos Institute (Netherlands Institute of Mental Health and Addiction), P.O. Box 725, 3500 AS Utrecht, The Netherlands ,0000000092621349grid.6906.9Erasmus School of Social and Behavioural Sciences, Erasmus University, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands ,0000 0004 0377 6226grid.476319.eGGZ Oost Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands
| | - Daan H. M. Creemers
- 0000 0004 0377 6226grid.476319.eGGZ Oost Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands ,0000000122931605grid.5590.9Behavioral Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
| | - Sanne P. A. Rasing
- 0000 0004 0377 6226grid.476319.eGGZ Oost Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands ,0000000120346234grid.5477.1Child and Adolescent Studies, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands
| | - Filip Smit
- 0000 0001 0835 8259grid.416017.5Trimbos Institute (Netherlands Institute of Mental Health and Addiction), P.O. Box 725, 3500 AS Utrecht, The Netherlands ,0000 0004 0435 165Xgrid.16872.3aDepartment of Clinical, Neuro and Developmental Psychology and Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Rutger C. M. E. Engels
- 0000000092621349grid.6906.9Erasmus School of Social and Behavioural Sciences, Erasmus University, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
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Zhu Y, Kim MH, Banerjee S, Deferio J, Alexopoulos GS, Pathak J. Understanding the research landscape of major depressive disorder via literature mining: an entity-level analysis of PubMed data from 1948 to 2017. JAMIA Open 2018; 1:115-121. [PMID: 31984323 PMCID: PMC6951824 DOI: 10.1093/jamiaopen/ooy001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 01/22/2018] [Accepted: 01/24/2018] [Indexed: 11/27/2022] Open
Abstract
Objective To analyze literature-based data from PubMed to identify diseases and medications that have frequently been studied with major depressive disorder (MDD). Materials and methods Abstracts of 23 799 research articles about MDD that have been published since 1948 till 2017 were analyzed using data and text mining approaches. Methods such as information extraction, frequent pattern mining, regression, and burst detection were used to explore diseases and medications that have been associated with MDD. Results In addition to many mental disorders and antidepressants, we identified several nonmental health diseases and nonpsychotropic medications that have frequently been studied with MDD. Our results suggest that: (1) MDD has been studied with disorders such as Pain, Diabetes Mellitus, Wounds and Injuries, Hypertension, and Cardiovascular Diseases; (2) medications such as Hydrocortisone, Dexamethasone, Ketamine, and Lithium have been studied in terms of their side effects and off-label uses; (3) the relationships between nonmental disorders and MDD have gained increased attention from the scientific community; and (4) the bursts of Diabetes Mellitus and Cardiovascular Diseases explain the psychiatric and/or depression screening recommended by authoritative associations during the periods of the bursts. Discussion and conclusion This study summarized and presented an overview of the previous MDD research in terms of diseases and medications that are highly relevant to MDD. The reported results can potentially facilitate hypothesis generation for future studies. The approaches proposed in the study can be used to better understand the progress and advance of the field.
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Affiliation(s)
- Yongjun Zhu
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA.,Department of Library and Information Science, Sungkyunkwan University, Seoul, South Korea
| | - Min-Hyung Kim
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Samprit Banerjee
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Joseph Deferio
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - George S Alexopoulos
- Department of Psychiatry, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Jyotishman Pathak
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA
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Saito Y, Takahashi O, Arioka H, Kobayashi D. Associations between body fat variability and later onset of cardiovascular disease risk factors. PLoS One 2017; 12:e0175057. [PMID: 28369119 PMCID: PMC5378370 DOI: 10.1371/journal.pone.0175057] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 03/20/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE There is current debate regarding whether body weight variability is associated with cardiovascular events. Recently, high body fat percentage (BF%) has been shown to be a cardiovascular risk factor. We therefore hypothesized that BF% variability would present a stronger cardiovascular risk than body weight variability. METHODS A single-center retrospective cohort study of medical check-up examinees aged 20 years or older at baseline (2005) was performed. Examinees were followed in 2007, 2009, and 2013-2014. BF% variability in 2005, 2007 and 2009 was calculated as the root-mean square error (RMSE) using a simple linear regression model. Multiple logistic regression models estimated the association between BF%-RMSE and new diagnoses of cardiovascular risk factors occurring between the 2009 and 2013-2014 visits. RESULTS In total, 11,281 participants (mean age: 51.3 years old, 48.8% were male) were included in this study. The average BF%-RMSE of our subjects was 0.63, and the average BMI-RMSE was 0.24. The high BF%-RMSE group (76-100th percentile) had a higher incidence of hypertension and a lower incidence of diabetes mellitus than the low BF%-RMSE group (1-25th percentile). This tendency was particularly evident in male participants. BMI-RMSE was not associated with any cardiovascular risks in our study. CONCLUSIONS This study indicates that body fat variability has contrasting effects on cardiovascular risk factors, while body weight variability has no significant effects.
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Affiliation(s)
- Yuki Saito
- Division of General Internal Medicine, Department of Medicine, St. Luke’s International Hospital, Tokyo, Japan
- * E-mail:
| | - Osamu Takahashi
- Division of General Internal Medicine, Department of Medicine, St. Luke’s International Hospital, Tokyo, Japan
- Center for Clinical Epidemiology, St. Luke's Life Science Institute, Tokyo, Japan
| | - Hiroko Arioka
- Division of General Internal Medicine, Department of Medicine, St. Luke’s International Hospital, Tokyo, Japan
| | - Daiki Kobayashi
- Division of General Internal Medicine, Department of Medicine, St. Luke’s International Hospital, Tokyo, Japan
- Center for Clinical Epidemiology, St. Luke's Life Science Institute, Tokyo, Japan
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Stanton MV, Matsuura J, Fairchild JK, Lohnberg JA, Bayley PJ. Mindfulness as a Weight Loss Treatment for Veterans. Front Nutr 2016; 3:30. [PMID: 27574603 PMCID: PMC4983552 DOI: 10.3389/fnut.2016.00030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 07/29/2016] [Indexed: 01/23/2023] Open
Abstract
Despite substantial evidence for their effectiveness in treating disordered eating and obesity, mindfulness-based treatments have not been broadly implemented among Veterans. A number of reviews have reported mindfulness to be beneficial in promoting healthy eating behaviors and weight loss among non-Veteran samples. We discuss this approach in the context of the Veterans Affairs system, the largest integrated healthcare provider in the U.S. and in the context of Veterans, among whom obesity is at epidemic proportions. In this article, we discuss what is known about treating obesity using a mindfulness approach, mindfulness interventions for Veterans, a new pilot mindfulness-based weight loss program designed for Veterans, and future directions for this type of obesity treatment in Veterans. We conclude that this population may be uniquely poised to benefit from mindfulness-based treatments.
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Affiliation(s)
- Michael V Stanton
- Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Justin Matsuura
- US Army Health Clinic Schofield Barracks Brain Injury Clinic , Schofield Barracks, HI , USA
| | | | | | - Peter J Bayley
- Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
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9
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Kamel A, Abuhegazy H, Ismaila A, Sherra K, Ramadan M, Mekky A, Al Nabawy A. The prevalence of obesity in a sample of Egyptian psychiatric patients. ACTA ACUST UNITED AC 2016. [DOI: 10.4103/1110-1105.195546] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Steele TO, Mace JC, DeConde AS, Xiao CC, Storck KA, Gudis DA, Schlosser RJ, Soler ZM, Smith TL. Does comorbid obesity impact quality of life outcomes in patients undergoing endoscopic sinus surgery? Int Forum Allergy Rhinol 2015. [PMID: 26201473 DOI: 10.1002/alr.21599] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Both obesity and chronic rhinosinusitis (CRS) are characterized by inflammation. Furthermore, both disease processes are independently associated with decreases in quality-of-life (QOL). We sought to investigate the role of comorbid obesity in QOL outcomes in CRS patients undergoing endoscopic sinus surgery (ESS). METHODS Adult patients with medically refractory CRS (n = 241) were prospectively enrolled into a multi-institutional treatment outcomes investigation. Body mass index (BMI) calculations were used to differentiate patient weight groups (normal weight: 18.5 to 24.9, overweight: 25.0 to 29.9; and obese: ≥30.0). Preoperative and postoperative QOL (Rhinosinusitis Disability Index [RSDI] and the 22-item Sino-Nasal Outcome Test [SNOT-22]) were evaluated compared across BMI groups and obesity subclasses. RESULTS The prevalence of comorbid obesity was 41% (n = 99). Higher prevalence of comorbid disease was found across increasing BMI groups including diabetes mellitus, asthma, and depression. No significant differences were found in mean preoperative QOL measures between any BMI groups. Significant improvement between preoperative and postoperative QOL mean scores (p ≤ 0.050) was found for all BMI groups. Despite no significant difference in mean QOL improvement between BMI groups (p ≥ 0.142), overweight and obese patients reported reduced relative mean percentage (%) improvement compared to normal weight participants on the RSDI total score (33% and 37% vs 55%, respectively) and SNOT-22 total score (29% and 40% vs 48%, respectively). CONCLUSION Patients with comorbid obesity experience significant improvement in average QOL gains following ESS though the percentage of relative improvement in QOL may be decreased in patients with comorbid obesity and CRS as compared to those without.
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Affiliation(s)
- Toby O Steele
- Division of Rhinology and Sinus/Skull Base Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery; Oregon Health and Science University, Portland, OR
| | - Jess C Mace
- Division of Rhinology and Sinus/Skull Base Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery; Oregon Health and Science University, Portland, OR
| | - Adam S DeConde
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, CA
| | - Christopher C Xiao
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Sinus Surgery, Medical University of South Carolina, Charleston, SC
| | - Kristina A Storck
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Sinus Surgery, Medical University of South Carolina, Charleston, SC
| | - David A Gudis
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Sinus Surgery, Medical University of South Carolina, Charleston, SC
| | - Rodney J Schlosser
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Sinus Surgery, Medical University of South Carolina, Charleston, SC
| | - Zachary M Soler
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Sinus Surgery, Medical University of South Carolina, Charleston, SC
| | - Timothy L Smith
- Division of Rhinology and Sinus/Skull Base Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery; Oregon Health and Science University, Portland, OR
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Fear conditioning and extinction across development: evidence from human studies and animal models. Biol Psychol 2014; 100:1-12. [PMID: 24746848 DOI: 10.1016/j.biopsycho.2014.04.001] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 04/07/2014] [Accepted: 04/07/2014] [Indexed: 01/13/2023]
Abstract
The ability to differentiate danger and safety through associative processes emerges early in life. Understanding the mechanisms underlying associative learning of threat and safety can clarify the processes that shape development of normative fears and pathological anxiety. Considerable research has used fear conditioning and extinction paradigms to delineate underlying mechanisms in animals and human adults; however, little is known about these mechanisms in children and adolescents. The current paper summarizes the empirical data on the development of fear conditioning and extinction. It reviews methodological considerations and future directions for research on fear conditioning and extinction in pediatric populations.
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12
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Milos GF, Baur V, Muehlebach S, Spindler A. Axis-I comorbidity is linked to prospective instability of diagnoses within eating disorders. BMC Psychiatry 2013; 13:295. [PMID: 24199632 PMCID: PMC3875352 DOI: 10.1186/1471-244x-13-295] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 08/21/2013] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Eating disorders (ED) are classified into Anorexia Nervosa, Bulimia Nervosa, and eating disorder not otherwise specified. Prospectively, the diagnostic instability within ED is high, but it is not clear which factors may account for this instability. So far, there is no evidence of whether psychiatric comorbidity may play a role in ED diagnostic crossover. We sought to determine possible influences of comorbidities of axis I and II on diagnostic crossover within ED. METHODS Longitudinal data of 192 female patients were collected. All patients had a diagnosis of a current ED at study entry (baseline, T0). Diagnoses were re-established both 12 months (T1) and 30 months (T2) after T0. Comorbid psychiatric diagnoses were grouped into axis I and axis II according to DSM-IV. RESULTS Patients with instable ED diagnoses had lifetime axis-I comorbidity more frequently than patients with stable ED diagnoses (χ2 = 4.74, df = 1, p < 0.05). Post-hoc exploratory tests suggested that the effect was mainly driven by affective disorders like major depression. There was no difference for axis-II comorbidity between stable and instable diagnostic profiles. CONCLUSIONS Following previous reports of diagnostic crossover in ED, the present investigation points to an influence of a life-time psychiatric comorbidity, in particular of axis I, on follow-up diagnoses of ED. Comorbid affective disorders like major depression might facilitate a switching between clinical phenotypes. The understanding of mechanisms and causes of the symptoms fluctuation will be subject of future studies.
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Affiliation(s)
- Gabriella F Milos
- Centre for Eating Disorders, Department of Psychiatry and Psychotherapy, University Hospital Zurich, Culmannstr. 8, CH-8091 Zurich, Switzerland
| | - Volker Baur
- Centre for Eating Disorders, Department of Psychiatry and Psychotherapy, University Hospital Zurich, Culmannstr. 8, CH-8091 Zurich, Switzerland
- Division Neuropsychology, Institute of Psychology, University of Zurich, Binzmuhlestr 14/25, Zurich CH-8050, Switzerland
| | - Sabina Muehlebach
- Centre for Eating Disorders, Department of Psychiatry and Psychotherapy, University Hospital Zurich, Culmannstr. 8, CH-8091 Zurich, Switzerland
| | - Anja Spindler
- Centre for Eating Disorders, Department of Psychiatry and Psychotherapy, University Hospital Zurich, Culmannstr. 8, CH-8091 Zurich, Switzerland
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Remigio-Baker RA, Diez Roux AV, Szklo M, Crum RM, Leoutsakos JM, Franco M, Schreiner PJ, Carnethon MR, Nettleton JA, Mujahid MS, Michos ED, Gary-Webb TL, Golden SH. Physical environment may modify the association between depressive symptoms and change in waist circumference: the multi-ethnic study of atherosclerosis. PSYCHOSOMATICS 2013; 55:144-54. [PMID: 24388121 DOI: 10.1016/j.psym.2013.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 10/25/2013] [Accepted: 10/28/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although the bidirectional association between depressive symptoms and adiposity has been recognized, the contribution of neighborhood factors to this relationship has not been assessed. OBJECTIVE This study evaluates whether physical and social neighborhood environments modify the bidirectional relationship between depressive symptoms and adiposity (measured by waist circumference and body mass index). METHODS Using data on 5,122 men and women (ages 45 to 84 years) from the Multi-Ethnic Study of Atherosclerosis (MESA) we investigated whether neighborhood physical (i.e., walking environment and availability of healthy food) and social (i.e., safety, aesthetics, and social coherence) environments modified the association between the following: (1) baseline elevated depressive symptoms (Center for Epidemiologic Study Depression Scale score ≥ 16) and change in adiposity (as measured by waist circumference and body mass index) and (2) baseline overweight/obesity (waist circumference > 102 cm for men and >88 cm for women, or body mass index ≥ 25 kg/m(2)) and change in depressive symptoms using multilevel models. Neighborhood-level factors were obtained from the MESA Neighborhood Study. RESULTS A greater increase in waist circumference in participants with vs without elevated depressive symptoms was observed in those living in poorly-rated physical environments but not in those living in better-rated environments (interaction p = 0.045). No associations were observed with body mass index. Baseline overweight/obesity was not associated with change in depressive symptoms and there was no modification by neighborhood-level factors. CONCLUSIONS Elevated depressive symptoms were associated with greater increase in waist circumference among individuals living in poorly-rated physical environments than in those in better-rated physical environments. No association was found between overweight/obesity and change in depressive symptoms.
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Affiliation(s)
- Rosemay A Remigio-Baker
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
| | - Ana V Diez Roux
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
| | - Moyses Szklo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Rosa M Crum
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Jeannie-Marie Leoutsakos
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | - Manuel Franco
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jennifer A Nettleton
- Department of Nutrition and Obesity, The University of Texas School of Public Health, Houston, TX
| | - Mahasin S Mujahid
- Department of Epidemiology, University of California, Berkeley School of Public Health, Berkeley, CA
| | - Erin D Michos
- Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Tiffany L Gary-Webb
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
| | - Sherita H Golden
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of Endocrinology and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD.
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Taylor VH, Forhan M, Vigod SN, McIntyre RS, Morrison KM. The impact of obesity on quality of life. Best Pract Res Clin Endocrinol Metab 2013; 27:139-46. [PMID: 23731876 DOI: 10.1016/j.beem.2013.04.004] [Citation(s) in RCA: 160] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
An important association exists between obesity and mental illness that impacts all aspects of an individual's quality of life. This association can begin early in the developmental trajectory and we do not yet completely understand all the mechanisms linking obesity and mental illness. What we e do know is that physical health factors that often occur secondary to obesity, combined with societal attitudes toward those that are obese coupled with iatrogenic treatment factors linked to psychiatric pharmacotherapy and a number of biologic mediators result in an important and increasing common comorbidity. Recognizing this association is essential for the proper management of both conditions. The following review addresses this issue and provides clinical pearls to help deal with this issue.
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Jacobson IG, Horton JL, Smith B, Wells TS, Boyko EJ, Lieberman HR, Ryan MAK, Smith TC. Bodybuilding, energy, and weight-loss supplements are associated with deployment and physical activity in U.S. military personnel. Ann Epidemiol 2012; 22:318-30. [PMID: 22445519 DOI: 10.1016/j.annepidem.2012.02.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 01/31/2012] [Accepted: 02/27/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE The characteristics of U.S. military personnel who use dietary supplements have not been well described. This study aimed to determine whether deployment experience and physical activity were associated with the use of bodybuilding, energy, or weight-loss supplement among U.S. military personnel. METHODS Self-reported data from active-duty, Reserve, and National Guard participants of the Millennium Cohort Study collected from 2007-2008 (n = 106,698) on supplement use, physical activity, and other behavioral data were linked with deployment and demographic data. We used multivariable logistic regression sex-stratified models to compare the adjusted odds of each type of supplement use among those with deployment experience in support of operations in Iraq or Afghanistan and those engaged in aerobic or strength-training activities. RESULTS Overall, 46.7% of participants reported using at least one type of supplement, and 22.0% reported using multiple supplements. Male deployers were more likely to use bodybuilding supplements, whereas female deployers were more likely to use weight-loss supplements. Physically active and younger subjects reported all types of supplement use. Men and women reporting 5 or less hours of sleep per night were more likely to use energy supplements. CONCLUSIONS The high prevalence of supplement use and important characteristics found to be associated with their use, including deployment, physical activity, and suboptimal sleep, suggest focus areas for future research and adverse event monitoring.
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Affiliation(s)
- Isabel G Jacobson
- Deployment Health Research Department, Naval Health Research Center, San Diego, CA 92106-3521, USA.
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16
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Pickering RP, Goldstein RB, Hasin DS, Blanco C, Smith SM, Huang B, Pulay AJ, Ruan WJ, Saha TD, Stinson FS, Dawson DA, Grant BF. Temporal relationships between overweight and obesity and DSM-IV substance use, mood, and anxiety disorders: results from a prospective study, the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2011; 72:1494-502. [PMID: 21457678 PMCID: PMC3227748 DOI: 10.4088/jcp.10m06077gry] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Accepted: 05/18/2010] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To present nationally representative findings on the prospective relationships between overweight and obesity and DSM-IV substance use, mood, and anxiety disorders. METHOD A nationally representative sample of 34,653 US adults was interviewed in Wave 1 (2001-2002) and Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. The target population was the civilian population residing in households and group quarters, with gathered data adjusted to be representative of the civilian population of the United States on the basis of the 2000 Decennial Census. The main outcome measures were the incidence of DSM-IV substance use, mood, and anxiety disorders and changes in body mass index status during the 3-year follow-up period. RESULTS Regression analyses that controlled for a wide array of covariates showed that overweight and obese women were at increased risk (P < .05) for incident major depressive disorder during the follow-up period (adjusted OR [AOR] = 1.3 [95% CI, 1.02-1.56] and AOR = 1.2 [95% CI, 1.02-1.51], respectively). Overweight men and obese men were at decreased risk (P < .05) of incident drug abuse and alcohol dependence (AOR = 0.7 [95% CI, 0.44-0.96] and AOR = 0.7 [95% CI, 0.52-0.97]), respectively. Obese women had a decreased risk (P < .05) of incident alcohol abuse and drug dependence (AOR = 0.6 [95% CI, 0.45-0.88] and AOR = 0.4 [95% CI, 0.21-0.91], respectively). Men with drug dependence and women with specific phobia had a decreased risk (P < .05) of becoming overweight or obese during the follow-up period (AOR = 0.4 [95% CI, 0.19-0.99] and AOR = 0.8 [95% CI, 0.66-0.95], respectively). CONCLUSIONS Increased risk of major depressive disorder among overweight and obese women could be attributed to stigma and greater body dissatisfaction among women in Western cultures. Overweight and obesity may serve as protective factors against developing incident substance use disorders, possibly due to shared neural functions in the brain underlying addictions to numerous substances. Results are discussed in terms of their clinical implications, including the need to update treatment guidelines for the management of overweight, obesity, and major depressive disorder.
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Affiliation(s)
- Roger P. Pickering
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, 20892, U.S.A
| | - Risë B. Goldstein
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, 20892, U.S.A
| | - Deborah S. Hasin
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032
| | - Carlos Blanco
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032
| | - Sharon M. Smith
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, 20892, U.S.A
| | - Boji Huang
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, 20892, U.S.A
| | - Attila J. Pulay
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, 20892, U.S.A
| | - W. June Ruan
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, 20892, U.S.A
| | - Tulshi D. Saha
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, 20892, U.S.A
| | - Frederick S. Stinson
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, 20892, U.S.A
| | - Deborah A. Dawson
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, 20892, U.S.A
| | - Bridget F. Grant
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, 20892, U.S.A
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Variations in tryptophan hydroxylase 2 linked to decreased serotonergic activity are associated with elevated risk for metabolic syndrome in depression. Mol Psychiatry 2010; 15:736-47. [PMID: 19125159 DOI: 10.1038/mp.2008.142] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Major depression and the metabolic syndrome (MetS) are interacting clinical conditions influenced by genetic susceptibility. For both disorders, impaired serotonergic neurotransmission in specific brain areas has been suggested. This led us to investigate whether variants in the gene coding for tryptophan hydroxylase 2 (TPH2), the brain-specific and rate-limiting enzyme for serotonin biosynthesis, might be predictive for an increased liability for the development of MetS in depressed patients. In a case-control study consisting of 988 patients with recurrent unipolar depression (RUD) and 1023 psychiatric healthy controls, MetS components were ascertained according to the International Diabetes Foundation criteria. A total of 41 single nucleotide polymorphisms fully covering the TPH2 gene region were genotyped in stage 1 (300 patients/300 controls), resulting in significant genetic associations of polymorphisms located in exon 7 and intron 8 of TPH2 and the occurrence of MetS in depressed patients after correction for age, gender and multiple testing (51 RUD-MetS/179 RUD-non-MetS). We were able to confirm the significant association of rs17110690 in stage 2 (688 patients/723 controls; 110 RUD-MetS/549 RUD-non-MetS) and to link risk-genotypes and risk-haplotypes for MetS to lower TPH2 mRNA expression and to lower 5-hydroxyindoleacetic acid levels in cerebrospinal fluid previously reported in functional studies. Our findings suggest that TPH2 polymorphisms characterize a subgroup of depressed patients who are especially prone to develop metabolic disorders induced by a genotype-dependent impairment of serotonergic neurotransmission. Identifying depressed patients at high risk for MetS using genetic variants could have direct clinical impact on individualized disease management and prevention strategies.
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Williams LJ, Pasco JA, Henry MJ, Jacka FN, Dodd S, Nicholson GC, Kotowicz MA, Berk M. Lifetime psychiatric disorders and body composition: a population-based study. J Affect Disord 2009; 118:173-9. [PMID: 19249106 DOI: 10.1016/j.jad.2009.02.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 02/01/2009] [Accepted: 02/02/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study aimed to investigate the relationship between depressive and anxiety disorders and indices of adiposity, including body fat mass and percent body fat, as measured by dual energy X-ray absorptiometry. METHODS In this observational study of 979 randomly-selected women aged 20-93 years, psychiatric history was ascertained using a structured clinical interview (SCID-I/NP). Total body fat was assessed using dual-energy X-ray absorptiometry and weight, height and waist circumference were measured. Medication use and lifestyle factors were self-reported. RESULTS Those with a lifetime history of depression had increased fat mass (+7.4%) and percent body fat (+4.3%), as well as greater mean weight (+3.3%), waist circumference (+2.9%) and BMI (+3.5%) after adjustment for age, anxiety, alcohol consumption, physical activity and past smoking. Furthermore, those meeting criteria for a lifetime history of depression had a 1.7-fold increased odds of being overweight or obese (BMI>or=25), a 2.0-fold increased odds of being obese (BMI>or=30) and a 1.8-fold increased odds of having a waist circumference >or=80 cm. These patterns persisted after further adjustment for psychotropic medication use, smoking status and energy intake. No differences in any measures of adiposity were observed among those with anxiety disorders compared to controls. LIMITATIONS There is potential for unrecognised confounding, interpretations are limited to women and a temporal relationship could not be inferred. CONCLUSIONS Depression was associated with greater adiposity. The difference in body fat mass was numerically greater than differences in indirect measures of adiposity, suggesting that the latter may underestimate the extent of adiposity in this population.
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Affiliation(s)
- Lana J Williams
- Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, PO Box 281, Geelong 3220, Australia.
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Fuemmeler BF, Agurs-Collins T, McClernon FJ, Kollins SH, Garrett ME, Ashley-Koch AE. Interactions between genotype and depressive symptoms on obesity. Behav Genet 2009; 39:296-305. [PMID: 19337825 PMCID: PMC2884968 DOI: 10.1007/s10519-009-9266-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Accepted: 03/18/2009] [Indexed: 01/08/2023]
Abstract
Depression and Genetic variation in serotonin and monoamine transmission have both been associated with body mass index (BMI), but their interaction effects are not well understood. We examined the interaction between depressive symptoms and functional polymorphisms of serotonin transporter (SLC6A4) and monoamine oxidase A (MAOA) on categories of BMI. Participants were from the National Longitudinal Study of Adolescent Health. Multiple logistic regression was used to investigate interactions between candidate genes and depression on risk of obesity (BMI > or = 30) or overweight + obese combined (BMI > or = 25). Males with an MAOA active allele with high depressive symptoms were at decreased risk of obesity (OR 0.22; 95% CI 0.06-0.78) and overweight + obesity (OR 0.48; 95% CI 0.26-0.89). No similar effect was observed among females. These findings highlight that the obesity-depression relationship may vary as a function of gender and genetic polymorphism, and suggest the need for further study.
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Jacobson IG, Smith TC, Smith B, Keel PK, Amoroso PJ, Wells TS, Bathalon GP, Boyko EJ, Ryan MAK. Disordered eating and weight changes after deployment: longitudinal assessment of a large US military cohort. Am J Epidemiol 2009; 169:415-27. [PMID: 19193718 DOI: 10.1093/aje/kwn366] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The effect of military deployments to combat environments on disordered eating and weight changes is unknown. Using longitudinal data from Millennium Cohort Study participants who completed baseline (2001-2003) and follow-up (2004-2006) questionnaires (n=48,378), the authors investigated new-onset disordered eating and weight changes in a large military cohort. Multivariable logistic regression was used to compare these outcomes among those who deployed and reported combat exposures, those who deployed but did not report combat exposures, and those who did not deploy in support of the wars in Iraq and Afghanistan. Deployment was not significantly associated with new-onset disordered eating in women or men, after adjustment for baseline demographic, military, and behavioral characteristics. However, in subgroup comparison analyses of deployers, deployed women reporting combat exposures were 1.78 times more likely to report new-onset disordered eating (95% confidence interval: 1.02, 3.11) and 2.35 times more likely to lose 10% or more of their body weight compared with women who deployed but did not report combat exposures (95% confidence interval: 1.17, 4.70). Despite no significant overall association between deployment and disordered eating and weight changes, deployed women reporting combat exposures represent a subgroup at higher risk for developing eating problems and weight loss.
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Affiliation(s)
- Isabel G Jacobson
- Department of Defense Center for Deployment Health Research, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA.
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Abstract
To evaluate the causal effects of depression on obesity, longitudinal tests of the effect of depression on follow-up obesity status were meta-analyzed. Combining data from 16 studies the results confirmed that, after controlling for potential confounding variables, depressed compared to nondepressed people were at significantly higher risk for developing obesity. The risk among depressed people for later obesity was particularly high for adolescent females (odds ratio: 2.57, 95% CI: 2.27, 2.91). These findings highlight the importance of depression screening and treatment programs, especially among adolescents, to assist in the prevention of adult obesity.
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Adipositas ist mehr als eine Essstörung - die multidimensionale Betrachtung einer Pandemie. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2008; 54:4-31. [DOI: 10.13109/zptm.2008.54.1.4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Scott KM, Bruffaerts R, Simon GE, Alonso J, Angermeyer M, de Girolamo G, Demyttenaere K, Gasquet I, Haro JM, Karam E, Kessler RC, Levinson D, Medina Mora ME, Oakley Browne MA, Ormel J, Villa JP, Uda H, Von Korff M. Obesity and mental disorders in the general population: results from the world mental health surveys. Int J Obes (Lond) 2008; 32:192-200. [PMID: 17712309 PMCID: PMC2736857 DOI: 10.1038/sj.ijo.0803701] [Citation(s) in RCA: 287] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES (1) To investigate whether there is an association between obesity and mental disorders in the general populations of diverse countries, and (2) to establish whether demographic variables (sex, age, education) moderate any associations observed. DESIGN Thirteen cross-sectional, general population surveys conducted as part of the World Mental Health Surveys initiative. SUBJECTS Household residing adults, 18 years and over (n=62 277). MEASUREMENTS DSM-IV mental disorders (anxiety disorders, depressive disorders, alcohol use disorders) were assessed with the Composite International Diagnostic Interview (CIDI 3.0), a fully structured diagnostic interview. Obesity was defined as a body mass index (BMI) of 30 kg/m(2) or greater; severe obesity as BMI 35+. Persons with BMI less than 18.5 were excluded from analysis. Height and weight were self-reported. RESULTS Statistically significant, albeit modest associations (odds ratios generally in the range of 1.2-1.5) were observed between obesity and depressive disorders, and between obesity and anxiety disorders, in pooled data across countries. These associations were concentrated among those with severe obesity, and among females. Age and education had variable effects across depressive and anxiety disorders. CONCLUSIONS The findings are suggestive of a modest relationship between obesity (particularly severe obesity) and emotional disorders among women in the general population. The study is limited by the self-report of BMI and cannot clarify the direction or nature of the relationship observed, but it may indicate a need for a research and clinical focus on the psychological heterogeneity of the obese population.
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Affiliation(s)
- K M Scott
- Wellington School of Medicine and Health Sciences, Otago University, Wellington, New Zealand.
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