Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands.
Department of Clinical Psychology, Behavioural Science Institute, Radboud University Nijmegen, Montessorilaan 3, 6525 HR Nijmegen, The Netherlands; Amsterdam Public Health Research Institute, VU University, de Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.
J Psychiatr Res. 2018 Feb;97:38-46. doi: 10.1016/j.jpsychires.2017.11.003. Epub 2017 Nov 7.
Depressed persons have been found to present disturbances in eating styles, but it is unclear whether eating styles are different in subgroups of depressed patients. We studied the association between depressive disorder, severity, course and specific depressive symptom profiles and unhealthy eating styles. Cross-sectional and course data from 1060 remitted depressed patients, 309 currently depressed patients and 381 healthy controls from the Netherlands Study of Depression and Anxiety were used. Depressive disorders (DSM-IV based psychiatric interview) and self-reported depressive symptoms (Inventory of Depressive Symptomatology) were related to emotional, external and restrained eating (Dutch Eating Behavior Questionnaire) using analyses of covariance and linear regression. Remitted and current depressive disorders were significantly associated with higher emotional eating (Cohen's d = 0.40 and 0.60 respectively, p < 0.001) and higher external eating (Cohen's d = 0.20, p = 0.001 and Cohen's d = 0.32, p < 0.001 respectively). Little differences in eating styles between depression course groups were observed. Associations followed a dose-response association, with more emotional and external eating when depression was more severe (both p-values <0.001). Longer symptom duration was also associated to more emotional and external eating (p < 0.001 and p = 0.001 respectively). When examining individual depressive symptoms, neuro-vegetative depressive symptoms contributed relatively more to emotional and external eating, while mood and anxious symptoms contributed relatively less to emotional and external eating. No depression associations were found with restrained eating. Intervention programs for depression should examine whether treating disordered eating specifically in those with neuro-vegetative, atypical depressive symptoms may help prevent or minimize adverse health consequences.
研究发现抑郁患者的进食方式存在紊乱，但尚不清楚抑郁患者亚组的进食方式是否存在差异。我们研究了抑郁障碍、严重程度、病程和特定抑郁症状谱与不健康进食方式之间的关联。使用荷兰抑郁和焦虑研究中的横断面和病程数据，纳入了 1060 名缓解期抑郁患者、309 名现患抑郁患者和 381 名健康对照者。采用协方差分析和线性回归，将基于 DSM-IV 的精神科访谈诊断的抑郁障碍和自我报告的抑郁症状（抑郁症状清单）与情绪性、外显性和约束性进食（荷兰进食行为问卷）相关联。缓解期和现患抑郁障碍与更高的情绪性进食（Cohen's d 值分别为 0.40 和 0.60，p 值均<0.001）和更高的外显性进食（Cohen's d 值分别为 0.20，p=0.001 和 Cohen's d 值为 0.32，p<0.001）显著相关。在抑郁病程组之间观察到的进食方式差异较小。关联呈剂量-反应关系，抑郁越严重，情绪性和外显性进食越多（均 p 值<0.001）。症状持续时间较长也与情绪性和外显性进食增加相关（p 值均<0.001 和 p=0.001）。当检查个体抑郁症状时，神经植物性抑郁症状对情绪性和外显性进食的贡献相对更大，而情绪和焦虑症状对情绪性和外显性进食的贡献相对较小。未发现抑郁与约束性进食有关。抑郁干预计划应检查针对具有神经植物性、非典型抑郁症状的患者专门治疗饮食障碍是否有助于预防或最小化不良健康后果。
