06 Jun Depression With Atypical Features Associated With Weight Gain, Obesity
MedicalResearch.com Interview with:
Aurélie Lasserre ,MD
Center for psychiatric epidemiology and psychopathology
Department of Psychiatry
Lausanne University Hospital (CHUV)
Site de Cery, Switzerland
MedicalResearch: What are the main findings of this study?
Dr. Lasserre: Several recent studies have shown that Major Depressive Disorder with atypical features (defined as having a depressive episode where mood reactivity is maintained and two of the following features: increase in appetite, hypersomnia (oversleeping), leaden paralysis (heavy limbs) and increased sensitivity to rejection) was associated with obesity, but the temporal sequence was not known, i.e. it was not clear whether atypical depression predisposes to obesity or the converse. Our study revealed that Major Depressive Disorder with atypical features does lead to an increase in body-mass index, obesity, waist circumference and fat mass over a period of 5 years. This result was not explained by socio-demographic characteristics, alcohol or tobacco consumption, physical activity, co-existing mental disorders or medication. Interestingly, we also observed that the weight gain in subjects with atypical features was not a temporary phenomenon but it persisted after the remission of the depressive episode and was not attributable to new episodes.
MedicalResearch: Were any of the findings unexpected?
Dr. Lasserre: Yes, the observation that the weight gain in subjects with atypical features persisted after the remission of the depressive episode was unexpected.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Lasserre: For the clinician, the atypical subtype deserves particular attention given that this subtype is a strong predictor of adiposity. Accordingly, the screening of atypical features and in particular increased appetite in depressive subjects is crucial. The prescription of appetite-stimulating medication should be avoided in these patients and dietary measures during depressive episodes with atypical features are advocated.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Lasserre: Clinical studies need to determine to which degree the timely and appropriate treatment of depressive episodes with atypical features can prevent increase of adiposity during and after such episodes and thereby reduce the long-term risk of CVD and other chronic diseases related to obesity.
Lasserre AM, Glaus J, Vandeleur CL, et al. Depression With Atypical Features and Increase in Obesity, Body Mass Index, Waist Circumference, and Fat Mass: A Prospective, Population-Based Study. JAMA Psychiatry. Published online June 04, 2014. doi:10.1001/jamapsychiatry.2014.411.