Overweight and obesity affect treatment response in major depression.
BACKGROUND
Epidemiologic and clinical studies suggest comorbidity between major depressive disorder (MDD) and obesity. To elucidate the impact of weight on the course of depression beyond comorbidity, we investigated psychopathology, attention, neuroendocrinology, weight change, and treatment response in MDD patients, depending on their weight.


METHODS
Four hundred eight inpatients with MDD participated in the Munich Antidepressant Response Signature Study, designed to discover biomarkers and genotypes that are predictive for clinical outcome. Psychopathology and anthropometric parameters were monitored weekly in 230 patients. In subsamples, combined dexamethasone-corticotropin-releasing hormone and attention tests were conducted at admission and discharge. One thousand twenty-nine diagnosed matched controls served for morphometric comparisons.


RESULTS
Patients with MDD had a significantly higher body mass index (BMI) compared with healthy controls. Patients with high BMI (> or =25) showed a significantly slower clinical response, less improvement in neuroendocrinology and attention, and less weight gain than did patients with normal BMI (18.5 < or = BMI < 25) during antidepressant treatment.


CONCLUSIONS
Our findings suggest that overweight and obesity characterize a subgroup of MDD patients with unfavorable treatment outcome.
Kloiber
Stefan
S
Max Planck Institute of Psychiatry, Munich, Germany. stkloiber@mpipsykl.mpg.de
Ising
Marcus
M
Reppermund
Simone
S
Horstmann
Sonja
S
Dose
Tatjana
T
Majer
Matthias
M
Zihl
Josef
J
Pfister
Hildegard
H
Unschuld
Paul G
PG
Holsboer
Florian
F
Lucae
Susanne
S
D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001288:Attention / Q000187:drug effects / Q000502:physiology; D015992:Body Mass Index; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications*; D050177:Overweight / Q000187:drug effects / Q000502:physiology*; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D012016:Reference Values; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000928:Antidepressive Agents; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone