Ma Jun, Xiao Lan, Lv Nan, Rosas Lisa G, Lewis Megan A, Goldhaber-Fiebert Jeremy D, Venditti Elizabeth M, Snowden Mark B, Lesser Lenard, Ward Elizabeth
Institute for Health Research and Policy and Department of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States.
Palo Alto Medical Foundation Research Institute, Sutter Health, Palo Alto, CA, United States.
Prev Med Rep. 2017 Aug 5;8:42-50. doi: 10.1016/j.pmedr.2017.07.010. eCollection 2017 Dec.
The objective of this study is to characterize profiles of obese depressed participants using baseline data collected from October 2014 through December 2016 for an ongoing randomized controlled trial ( = 409) in Bay Area, California, USA. Four comorbidity severity categories were defined by interaction of the binary levels of body mass index (BMI) and depression Symptom Checklist 20 (SCL20) scores. Sociodemographic, behavioral, clinical and psychosocial characteristics were measured. Mean (SD) age was 51 (12.1) years, BMI 36.7 (6.4) kg/m, and SCL20 1.5 (0.5). Participants in the 4 comorbidity severity categories had similar sociodemographic characteristics, but differed significantly in the other characteristics. Two statistically significant canonical dimensions were identified. Participants with BMI ≥ 35 and SCL20 ≥ 1.5 differed significantly from those with BMI < 35 and SCL20 < 1.5 on dimension 1, which primarily featured high physical health (e.g., central obesity, high blood pressure and impaired sleep) and mental health comorbidities (e.g., post-traumatic stress and anxiety), poor health-related quality of life (in general and problems specifically with obesity, anxiety, depression, and usual daily activities), and an avoidance problem-solving style. Participants with BMI < 35 and SCL20 ≥ 1.5 differed significantly from those with BMI ≥ 35 and SCL20 < 1.5 on dimension 2, which primarily included fewer Hispanics, less central obesity, and more leisure-time physical activity, but greater anxiety and post-traumatic stress and poorer obesity- or mental health-related quality of life. In conclusion, patients with comorbid obesity and depression of varying severity have different profiles of behavioral, clinical and psychosocial characteristics. This insight may inform analysis of treatment heterogeneity and development of targeted intervention strategies. ClinicalTrials.gov #NCT02246413.
本研究的目的是利用2014年10月至2016年12月期间为美国加利福尼亚州湾区一项正在进行的随机对照试验（n = 409）收集的基线数据，对肥胖抑郁症参与者的特征进行描述。通过体重指数（BMI）和抑郁症状清单20（SCL20）分数的二元水平相互作用定义了四种共病严重程度类别。测量了社会人口统计学、行为、临床和心理社会特征。平均（标准差）年龄为51（12.1）岁，BMI为36.7（6.4）kg/m²，SCL20为1.5（0.5）。四个共病严重程度类别的参与者具有相似的社会人口统计学特征，但在其他特征上有显著差异。确定了两个具有统计学意义的典型维度。在维度1上，BMI≥35且SCL20≥1.5的参与者与BMI<35且SCL20<1.5的参与者有显著差异，维度1主要特征为高身体健康共病（如中心性肥胖、高血压和睡眠障碍）和心理健康共病（如创伤后应激和焦虑）、较差的健康相关生活质量（总体以及肥胖、焦虑、抑郁和日常活动方面的具体问题）以及回避型问题解决方式。在维度2上，BMI<35且SCL20≥1.5的参与者与BMI≥35且SCL20<1.5的参与者有显著差异，维度2主要包括较少的西班牙裔、较少的中心性肥胖和较多的休闲时间体育活动，但焦虑和创伤后应激更多，以及肥胖或心理健康相关生活质量更差。总之，不同严重程度的肥胖合并抑郁症患者具有不同的行为、临床和心理社会特征。这一见解可能为治疗异质性分析和针对性干预策略的制定提供信息。ClinicalTrials.gov #NCT02246413
