title: Overweight and obesity affect treatment response in major depression.
abstract: 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.
authors.affiliation: Max Planck Institute of Psychiatry, Munich, Germany. stkloiber@mpipsykl.mpg.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Kloiber
authors.forename: Marcus
authors.initials: M
authors.lastname: Ising
authors.forename: Simone
authors.initials: S
authors.lastname: Reppermund
authors.forename: Sonja
authors.initials: S
authors.lastname: Horstmann
authors.forename: Tatjana
authors.initials: T
authors.lastname: Dose
authors.forename: Matthias
authors.initials: M
authors.lastname: Majer
authors.forename: Josef
authors.initials: J
authors.lastname: Zihl
authors.forename: Hildegard
authors.initials: H
authors.lastname: Pfister
authors.forename: Paul G
authors.initials: PG
authors.lastname: Unschuld
authors.forename: Florian
authors.initials: F
authors.lastname: Holsboer
authors.forename: Susanne
authors.initials: S
authors.lastname: Lucae
mesh_terms: 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
chemical_list: D000928:Antidepressive Agents; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone