Are increased weight and appetite useful indicators of depression in children and adolescents?

Open Journal of Psychiatry, 2017

Objectives: This study investigated the relationship between depression and obesity in severely obese retired individuals using the case-control method. Methods: The subject group consisted of 112 individuals receiving a permanent disability pension primarily due to obesity. The prevalence of depression was measured with a personal psychiatric interview and the Beck Depression Inventory (21). Male and female controls were selected separately, with five controls for male subjects and three controls for female subjects. The controls were matched with the subjects according to place of residence, age, time that pension was granted, and occupation. The statistical analyses included χ 2 tests, means, t-tests for paired variables, a conditional logistic linear model, correlation coefficients and the percent distributions. Results: Depression was diagnosed more often in the subject group than in the control group according to the psychiatric interview. Based on the conditional logistic linear model, individuals with severe obesity had a higher risk of depression than those in the control group. The most common disturbance was chronic depression in both groups. Additionally, there were significant findings regarding the outcome of depression for every classification in the psychiatric interview. According to the Beck Depression Inventory, depression was more common in subjects than in controls. However, slight depression was most common in the study group. Seven percent of the subjects had masked depression. The questions on the Beck Depression Inventory that measure irritability, indecisiveness, body image and ability to work were nearly significant. Regarding weight changes, the Beck Depression Inventory questions on both weight loss (p = 0.014) and weight gain (p = 0.017) were statistically significant. In the study group, individuals with BMI over 40 kg/m 2 gained the most weight; however, weight loss was very low overall. Regarding changes in appetite, the majority of the study group responded that they had a poorer appetite than previously. Conclusion:

International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 1998

To investigate the relationship of symptoms of depression to weight changes in healthy individuals of normal weight across a follow-up of over 20 y. College students (3885 men and 841 women) were administered a self-report depression measure in the mid-1960s. Their baseline body mass index (BMI) was calculated from their college medical records. Participants were contacted by mail in the late 1980s and asked to report their current height and weight as well as their smoking and exercise habits. Another measure of depressive symptoms was obtained from 3560 individuals at follow-up. Multiple regression models were used to relate changes in weight to depression scores while controlling for background (gender, baseline BMI and the gender by BMI interaction) and behavioral (exercise and smoking) predictors. The relationship between depressive symptoms and body weight change took the form of an interaction with baseline BMI (P < 0.001). Those with high baseline depression scores gained...

JAMA Psychiatry, 2014

and obesity are 2 prevalent disorders that have been repeatedly shown to be associated. However, the mechanisms and temporal sequence underlying this association are poorly understood. OBJECTIVE To determine whether the subtypes of major depressive disorder (MDD; melancholic, atypical, combined, or unspecified) are predictive of adiposity in terms of the incidence of obesity and changes in body mass index (calculated as weight in kilograms divided by height in meters squared), waist circumference, and fat mass. DESIGN, SETTING, AND PARTICIPANTS This prospective population-based cohort study, CoLaus (Cohorte Lausannoise)/PsyCoLaus (Psychiatric arm of the CoLaus Study), with 5.5 years of follow-up included 3054 randomly selected residents (mean age, 49.7 years; 53.1% were women) of the city of Lausanne, Switzerland (according to the civil register), aged 35 to 66 years in 2003, who accepted the physical and psychiatric baseline and physical follow-up evaluations. EXPOSURES Depression subtypes according to the DSM-IV. Diagnostic criteria at baseline and follow-up, as well as sociodemographic characteristics, lifestyle (alcohol and tobacco use and physical activity), and medication, were elicited using the semistructured Diagnostic Interview for Genetic Studies. MAIN OUTCOMES AND MEASURES Changes in body mass index, waist circumference, and fat mass during the follow-up period, in percentage of the baseline value, and the incidence of obesity during the follow-up period among nonobese participants at baseline. Weight, height, waist circumference, and body fat (bioimpedance) were measured at baseline and follow-up by trained field interviewers. RESULTS Only participants with the atypical subtype of MDD at baseline revealed a higher increase in adiposity during follow-up than participants without MDD. The associations between this MDD subtype and body mass index (β = 3.19; 95% CI, 1.50-4.88), incidence of obesity (odds ratio, 3.75; 95% CI, 1.24-11.35), waist circumference in both sexes (β = 2.44; 95% CI, 0.21-4.66), and fat mass in men (β = 16.36; 95% CI, 4.81-27.92) remained significant after adjustments for a wide range of possible cofounding. CONCLUSIONS AND RELEVANCE The atypical subtype of MDD is a strong predictor of obesity. This emphasizes the need to identify individuals with this subtype of MDD in both clinical and research settings. Therapeutic measures to diminish the consequences of increased appetite during depressive episodes with atypical features are advocated.

Obesity, 2012

Appetite, 2014

Depressive symptoms in youth may be a risk factor for obesity, with altered eating behaviors as one possible mechanism. We tested whether depressive symptoms were associated with observed eating patterns expected to promote excessive weight gain in two separate samples. In Study 1, 228 nontreatment-seeking youth, ages 12-17 y (15.3 ± 1.4 y; 54.7% female), self-reported depressive symptoms using the Beck Depression Inventory. Energy intake was measured as consumption from a 10,934-kcal buffet meal served at 11:00 am after an overnight fast. In Study 2, 204 non-treatment-seeking youth, ages 8-17 y (13.0 ± 2.8 y; 49.5% female), self-reported depressive symptoms using the Children's Depression Inventory. Energy intake was measured as consumption from a 9835-kcal buffet meal served at 2:30 pm after a standard breakfast. In Study 1, controlling for body composition and other relevant covariates, depressive symptoms were positively related to total energy intake in girls and boys. In Study 2, adjusting for the same covariates, depressive symptoms among girls only were positively associated with total energy intake. Youth high in depressive symptoms and dietary restraint consumed the most energy from sweets. In both studies, the effects of depressive symptoms on intake were small. Nevertheless, depressive symptoms were associated with significantly greater consumption of total energy and energy from sweet snack foods, which, over time, could be anticipated to promote excess weight gain.

Journal of Adolescent Health, 2014

The purpose of this study was to examine the association between depressive symptoms and subsequent body mass index (BMI) z scores among early-to-mid adolescents, extending previous research by using objectively measured weight and height data. Methods: Latent growth curve analysis was used to examine whether growth parameters of zBMI could be predicted by depressive symptoms (n ¼ 2,051 adolescents, 48.5% female, at baseline; 1,465 with data at all three time points). Specifically, we tested whether depressive symptoms were associated with the initial assessment of BMI (intercept) as well as with changes in BMI over time (slope). Analyses were performed for the total group, and separately for boys and girls. Results: Depressive symptoms were not associated with the slope of zBMI. In girls, but not boys, depressive symptoms were positively associated with the intercept of zBMI. Conclusions: Findings suggest that although depressive symptoms among females are associated with a higher zBMI, they do not predict excessive weight gain during early-to-mid adolescence.

Journal of Child and Adolescent Behaviour, 2014

Depression has a significant prospective association with overweight and obese status in children and adolescents; however, the mechanisms for or mediators of this relation are unclear. In this review, we examine four possible mediators of the depression to obesity relation: physical activity, binge eating, body dissatisfaction, and cortisol levels. Theory and evidence for the relation between depression and the potential mediator are discussed first, followed by examination of the relation between each potential mediator and weight gain, overweight status, or obesity. The research examined in this review suggests that depression may lead to weight gain by decreasing likelihood of children's and adolescents' being physically active. The literature also suggests that binge eating to cope with depressive symptoms may be another mechanism through which depression leads to weight gain in youths. More longitudinal work is needed to assess the viability of body dissatisfaction and cortisol levels as mediators of this relation. Methodological considerations and clinical implications of the literature are also discussed.

Psychosomatics, 2008

The authors asked which obesity measurements were associated with depressive symptoms, whether this relationship differed by gender, and whether controlling for fatigue and response bias affected the relationship. A sample of 129 subjects (66 men, 63 women), with a mean age of 36.9 years and a mean Body Mass Index (BMI) of 26.4 participated in the study. Depressive symptoms, levels of fatigue, response bias, and anthropometrics were assessed. In women, but not men, BMI and percent of ideal body weight were related to depression. However, percent of body fat did not show a relationship with depression after controlling for fatigue and response bias. These findings suggest that women's depressive symptoms are more influenced by body size than body fat composition, whereas men's depressive symptoms seem to be unrelated to obesity.

Child Psychiatry and Human Development, 2009

Adult mood disturbances are highly correlated with obesity, although little is known about the developmental relationship between mood disorders and weight. This study investigated the relationship between childhood psychopathology and weight over the course of 3 years. Body Mass Index (BMI) percentiles and demographic data of children (ages 8-18) with depression (n = 143) or anxiety (n = 43) were compared to healthy controls (n = 99). Both childhood depression (χ 2 = 4.6, p = 0.03) and anxiety (χ 2 = 6.0, p = 0.01) were associated with increased BMI percentiles. Compared to controls, BMI percentiles of depressed females over the course of the study differed profoundly (χ 2 = 7.0, p = 0.01) and BMI percentiles of anxious females approached significance (χ 2 = 3.7, p = 0.06). Males with anxiety showed a greater trend towards overweight (χ 2 = 3.3, p = 0.07) in comparison to controls. The major finding that depression and anxiety are associated with increased BMI percentiles in a non-obese sample suggests that childhood psychopathology is an important factor that should be carefully monitored.

Nutrition journal, 2014

Depression may lead to obesity, just as obesity can contribute to the disease; yet, changes in the dietary pattern and food habits in depressive syndromes have been scantily investigated. We aimed to identify possible associations between nutritional factors and depressive disorder. This cross sectional study included 127 consecutive ambulatory adult patients with depression (DSM-IV), under psychiatric treatment. All study parameters were classified according to sex & age: BMI, waist circumference, %fat mass, food intake & physical activity. Patients' mean age was 48 ± 13 (18-81) yrs, 94% were women. Overweight/obesity was found in 72% of the cohort, 72% had excessive fat mass & 69% had a waist circumference above the maximum cut-off value. Longer disease was associated with higher BMI +%fat mass, p < 0.003. Weight gain during illness was registered in 87%; just 12% lost weight, though undernutrition did not occur. Weight gain and greater fat mass were related with higher BMI...