Hasler G, Pine D S, Kleinbaum D G, Gamma A, Luckenbaugh D, Ajdacic V, Eich D, Rössler W, Angst J
Mood and Anxiety Disorders Program, Intramural Research Program, National Institutes of Health, National Institute of Mental Health, Bethesda, MD 20892-2670, USA.
Mol Psychiatry. 2005 Sep;10(9):842-50. doi: 10.1038/sj.mp.4001671.
Depression and obesity have become major health problems with increasing prevalence. Given the limited effectiveness of treatment for weight problems, the identification of novel, potentially modifiable risk factors may provide insights on new preventive approaches to obesity. The purpose of this study was to test the hypothesis that depressive symptoms during childhood are associated with weight gain and obesity during young adulthood. Participants were from a prospective community-based cohort study of young adults (N=591) followed between ages 19 and 40 years. The sample was stratified to increase the probability of somatic and psychological syndromes. Information was derived from six subsequent semistructured diagnostic interviews conducted by professionals over 20 years. The outcome measures were body mass index (BMI) and obesity (BMI>30). Among women, depressive symptoms before age 17 years were associated with increased weight gain (4.8 vs 2.6% BMI increase per 10 years) representing greater risk for adult obesity (hazard ratio=11.52, P<0.05). Among men, only after controlling for confounders, depressive symptoms before age 17 years were associated with increased weight gain (6.6 vs 5.2% BMI increase per 10 years) in adulthood but not with occurrence of obesity. These associations between childhood depressive symptoms and adult body weight were adjusted for baseline body weight, a family history of weight problems, levels of physical activity, consumption of alcohol and nicotine, and demographic variables. As the magnitude of the associations was high, and depression during childhood is a prevalent and treatable condition, this finding may have important clinical implications for the prevention and treatment of obesity. Whether the results of this study are limited to populations with elevated levels of psychopathology remains to be tested.
抑郁症和肥胖症已成为患病率不断上升的主要健康问题。鉴于体重问题的治疗效果有限，识别新的、可能可改变的风险因素可能为肥胖症的新预防方法提供见解。本研究的目的是检验童年期抑郁症状与青年期体重增加和肥胖症相关的假设。参与者来自一项基于社区的前瞻性队列研究，该研究对19至40岁的年轻人（N = 591）进行了随访。对样本进行分层以增加躯体和心理综合征的概率。信息来自专业人员在20多年间进行的六次后续半结构化诊断访谈。结果测量指标为体重指数（BMI）和肥胖症（BMI>30）。在女性中，17岁之前的抑郁症状与体重增加增加相关（每10年BMI增加4.8% 对2.6%），这表明成年肥胖风险更高（风险比 = 11.52，P<0.05）。在男性中，只有在控制混杂因素后，17岁之前的抑郁症状才与成年期体重增加增加相关（每10年BMI增加6.6% 对5.2%），但与肥胖症的发生无关。童年期抑郁症状与成年体重之间的这些关联已根据基线体重、体重问题家族史、身体活动水平、酒精和尼古丁消费以及人口统计学变量进行了调整。由于关联程度较高，且童年期抑郁症是一种普遍且可治疗的疾病，这一发现可能对肥胖症的预防和治疗具有重要的临床意义。本研究结果是否仅限于精神病理学水平较高的人群仍有待检验。
