Gudelj-Radić Jelena, Davidović Dragana, Avramović Dusan, Backović Dusan, Jorga Jagoda
Srp Arh Celok Lek. 2007 Jan-Feb;135(1-2):61-6. doi: 10.2298/sarh0702061g.
The prevalence of obesity is rising to epidemic proportions at the alarming rate in both developed and underdeveloped countries around the world. Current prevalence data from individual national studies suggest that the obesity prevalence in the European countries ranges from 10% to 20% for men, and 10% to 25% for women. Health consequences of obesity imply both a number of fatal and non-fatal health problems (out of which the most common are cardiovascular problems, non-insulin dependent diabetes mellitus, cancers), and also a wide spectrum of psychological consequences from diminished self-esteem to clinical depression. Causal relationship between obesity and many chronic diseases is evidence-based. At the same time, there are marked differences in research data regarding causal obesity-depression relationship. Several studies have found no direct association between obesity and depression, while in others the prevalence of depression in obese patients was up to 50%. Gender, obesity grade, socioeconomic status and asking for professional help are named as moderators and mediators of this relationship. Among recommended screening methods, BDI-II is the most frequently used in the adult outpatient departments.
The aim of the study was to determine possible risk factors of depression in adult obese patients treated for obesity. Gender, obesity and education level as well as marital status were analyzed as possible moderators of depression-obesity relationship.
The research included 267 patients, 38.0 +/- 14.6 years of age, who referred to the Outpatient Nutrition Department for dietetic consultation or nutritional medical therapy. Nutritional status was assessed by BMI (kg/m2), calculated from measured values of body weight and height according to WHO recommendations. An estimate of the existence and/or depression level was investigated by Beck Depression Inventory--self-administered questionnaire recommended for use in Serbian population.
The results revealed higher average BDI score values in obese patients (F(267,1) = 6.014, p = 0.015) in comparison to their non-obese counterparts. In addition, the percentage of depressive obese patients was significantly higher (55.1%, chi2(267.1) = 22.64, p < 0.001). There was significant correlation of BMI and BDI scores (r = 0.246, p < 0.001). The number of women with depression was significantly higher in comparison to men (chi2(267.1) = 4.261, p = 0.039). Women also had higher average BDI score (p = 0.003). MANOVA showed that BDI score was influenced by gender (F(267.1) = 8.936, p = 0.030) and nutritional status (F(267.1) = 6.115, p = 0.014), but combined effect of the above-mentioned moderators was not significant.
Depression is ten times more frequent in obese patients undergoing the obesity treatment vs. general population and, therefore, screening for depression is needed. Special attention should be paid to women and more obese patients due to higher incidence of depression in these groups.
在全球发达国家和不发达国家，肥胖症的患病率正以惊人的速度上升至流行程度。各国个别研究的当前患病率数据表明，欧洲国家男性肥胖症患病率为10%至20%，女性为10%至25%。肥胖症对健康的影响意味着一系列致命和非致命的健康问题（其中最常见的是心血管问题、非胰岛素依赖型糖尿病、癌症），以及从自尊受损到临床抑郁症等广泛的心理后果。肥胖症与许多慢性疾病之间的因果关系是有循证依据的。与此同时，关于肥胖症与抑郁症因果关系的研究数据存在显著差异。一些研究未发现肥胖症与抑郁症之间有直接关联，而在其他研究中，肥胖患者的抑郁症患病率高达50%。性别、肥胖等级、社会经济地位以及寻求专业帮助被认为是这种关系的调节因素和中介因素。在推荐的筛查方法中，BDI-II是成人门诊最常用的方法。
本研究的目的是确定接受肥胖症治疗的成年肥胖患者患抑郁症的可能风险因素。分析性别、肥胖症、教育水平以及婚姻状况作为抑郁症与肥胖症关系的可能调节因素。
该研究纳入了267名年龄在38.0±14.6岁之间的患者，他们因饮食咨询或营养医学治疗前往门诊营养科就诊。根据世界卫生组织的建议，通过体重和身高测量值计算身体质量指数（BMI，kg/m²）来评估营养状况。通过贝克抑郁量表（一种推荐用于塞尔维亚人群的自填式问卷）来调查抑郁症的存在和/或抑郁程度。
结果显示，肥胖患者的平均BDI得分值高于非肥胖患者（F(267,1)=6.014，p=0.015）。此外，抑郁肥胖患者的百分比显著更高（55.1%，chi2(267.1)=22.64，p<0.001）。BMI与BDI得分之间存在显著相关性（r=0.246，p<0.001）。与男性相比，患抑郁症的女性数量显著更高（chi2(267.1)=4.261，p=0.039）。女性的平均BDI得分也更高（p=0.003）。多变量方差分析表明，BDI得分受性别（F(267.1)=8.936，p=0.030）和营养状况（F(267.1)=6.115，p=0.014）影响，但上述调节因素的综合作用不显著。
接受肥胖症治疗的肥胖患者患抑郁症的频率是普通人群的十倍，因此需要对抑郁症进行筛查。由于这些群体中抑郁症发病率较高，应特别关注女性和肥胖程度更高的患者。
