Konttinen H, Kiviruusu O, Huurre T, Haukkala A, Aro H, Marttunen M
Department of Social Research, University of Helsinki, Helsinki, Finland.
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
Int J Obes (Lond). 2014 May;38(5):668-74. doi: 10.1038/ijo.2013.151. Epub 2013 Aug 16.
Longitudinal studies have rarely investigated changes in depressive symptoms and indicators of obesity simultaneously, although it is often proposed that the positive relationship between depression and obesity is bidirectional. The present study examined the reciprocal nature of the relationship between depressive symptoms and body mass index (BMI) in a 20-year follow-up survey.
Participants of a Finnish cohort study in 1989 at 22 years (N=1656) were followed up at ages 32 (N=1262) and 42 (N=1155) with postal questionnaires. BMI was calculated on the basis of self-reported weight and height, and depressive symptoms were assessed using the short form of the Beck Depression Inventory. Latent growth models (LGM) and cross-lagged autoregressive models were used to determine prospective associations between depressive symptoms and BMI.
LGM analyses indicated that men with higher initial levels of depressive symptoms experienced a faster rate of increase in BMI (β=0.20, P<0.01). Among women, change in BMI or depressive symptoms was not predicted by the other construct, but initial levels of BMI and depressive symptoms as well as their rate of change correlated positively with each other (r=0.15 and 0.37, respectively). In cross-lagged models, depressive symptoms at age 32 predicted greater BMI at 42 (β=0.10, P<0.001) among men, whereas women with higher BMI at age 32 were more likely to have more depressive symptoms at 42 (β=0.08, P<0.05).
Elevated depressive symptoms predicted weight gain in men, while changes in depressive symptoms and body weight occurred concurrently in women. Tentative evidence showed that women with excess body weight were more likely to have increased symptoms of depression 10 years later. More emphasis should be placed on depressive symptoms in weight control programs as well as on reducing weight-based stigmatization and discrimination in society.
尽管人们常认为抑郁与肥胖之间的正向关系是双向的，但纵向研究很少同时调查抑郁症状和肥胖指标的变化。本研究在一项为期20年的随访调查中检验了抑郁症状与体重指数（BMI）之间关系的相互性质。
1989年对芬兰队列研究中22岁的参与者（N = 1656）进行随访，在32岁（N = 1262）和42岁（N = 1155）时通过邮寄问卷进行。BMI根据自我报告的体重和身高计算得出，抑郁症状使用贝克抑郁量表简版进行评估。使用潜在增长模型（LGM）和交叉滞后自回归模型来确定抑郁症状与BMI之间的前瞻性关联。
LGM分析表明，初始抑郁症状水平较高的男性BMI增长速度更快（β = 0.20，P < 0.01）。在女性中，BMI或抑郁症状的变化无法由另一个因素预测，但BMI和抑郁症状的初始水平及其变化率彼此呈正相关（分别为r = 0.15和0.37）。在交叉滞后模型中，32岁时的抑郁症状预测男性42岁时BMI更高（β = 0.10，P < 0.001），而32岁时BMI较高的女性在42岁时更可能有更多抑郁症状（β = 0.08，P < 0.05）。
抑郁症状升高预测男性体重增加，而女性抑郁症状和体重变化同时发生。初步证据表明，超重女性10年后更可能出现抑郁症状增加。体重控制项目应更重视抑郁症状，同时减少社会中基于体重的污名化和歧视。
