The atypical subtype of major depressive disorder is linked to greater risk of obesity, and this link is not found in other subtypes of the illness, a recent study shows.
"For the clinician, the atypical subtype deserves particular attention, because this subtype is a strong predictor of adiposity," Dr. Aurélie M. Lasserre of Lausanne University Hospital in Prilly, Switzerland, and her associates reported online. "Accordingly, the screening of atypical features and, in particular, increased appetite in individuals with depression is crucial," they wrote (JAMA Psychiatry 2014 June 4 [doi:10.1001/jamapsychiatry.2014.411]).
Dr. Aurélie M. Lasserre
After tracking 3,054 participants in Lausanne, Switzerland, for a mean 5.5 years starting in 2003, Dr. Lasserre’s team found that those with melancholic, combined, or unspecified major depressive disorder (MDD) showed no greater risk for fat-mass gain or obesity than did those without MDD.
However, individuals with atypical MDD had nearly four times greater odds of obesity (odds ratio, 3.75), with increased body mass index (BMI) and waist circumference in both sexes, and increased fat mass in men, compared with those without MDD. The researchers found no evidence for medication or physical activity affecting the link between adiposity and atypical MDD.
Of the total sample, 7.6% of the participants met criteria for MDD at baseline, and 36.7% had a previous major depressive episode. The subtypes among those with current MDD included 10% atypical and melancholic combined, 14% atypical, 29% melancholic, and 48% unspecified.
The researchers took into account participants’ sociodemographic characteristics as well as their alcohol and tobacco use, amount of physical activity, and medication use. Baseline mean BMI was 25.3 kg/m2, and those with current or previous atypical MDD or atypical and melancholic combined MDD tended to have a higher baseline BMI than did those who were never depressed.
Among the limitations cited is that the sociodemographic characteristics of participants and nonparticipants differed at the physical follow-up, "suggesting that individuals with a less-healthy lifestyle were less likely to participate," Dr. Lasserre and her colleagues wrote.
This study was supported by the Swiss National Science Foundation. Dr. Lasserre had no disclosures; three coauthors used research grants from GlaxoSmithKline for the study.