title: Depression and major weight gain: a 6-year prospective follow-up of outpatients.
abstract: BACKGROUND
  Depression and weight change are linked, but there is a paucity of studies on their association during clinical treatment. The present study investigated how risk factors for a weight gain of at least 10% (major weight gain) and mental health modify their mutual association during a 6-year prospective follow-up of depressed outpatients.
  
  
  METHODS
  The study sample consisted of 121 depressed treatment-seeking outpatients with a mean age of 44.9 years. A 6-year follow-up started in January 1996. At baseline and on follow-up after 2 and 6 years, psychiatric diagnoses were obtained using the Structured Clinical Interview for DSM-III-R (SCID-I), while cluster C personality disorders (PD) were assessed on 6-month follow-up (SCID-II). Depression was also assessed with the Hamilton Rating Scale for Depression (HAM-D) and general psychopathology with the Symptom Checklist-90 (SCL-90) at baseline and at the end of the 6-year follow-up. Weight changes were based on measurements at baseline and at the end of the follow-up. Logistic regression was used to study the factors associated with major weight gain (≥ 10%).
  
  
  RESULTS
  Altogether, 16% of the study sample experienced major weight gain during the 6-year follow-up. Adverse childhood/adolescent experiences as a self-perceived cause of depression (OR 3.72, 95% CI 1.06-13.1, p=0.040), higher scores in the HAM-D (OR 1.11, 95% CI 1.02-1.22, p=0.019) and the SCL-90 subscale of anxiety (OR 2.22, 95% CI 1.11-4.42, p=0.023) at baseline, and cluster C PD at 6 months (OR 3.16, 95% CI 1.11-8.97, p=0.031) were separately associated with major weight gain after adjusting for age, gender, and baseline body mass index (BMI).
  
  
  CONCLUSIONS
  The severity of depressive and anxiety symptoms and linking adverse childhood with depression at the beginning of treatment, as well as cluster C PD at 6 months, were predictors of major weight gain.
authors.affiliation: Department of Psychiatry, Kuopio University Hospital, PO Box 1777, FIN-70210 Kuopio, Finland. tuula.heiskanen@kuh.fi
authors.forename: Tuula H
authors.initials: TH
authors.lastname: Heiskanen
authors.forename: Heli T
authors.initials: HT
authors.lastname: Koivumaa-Honkanen
authors.forename: Leo K
authors.initials: LK
authors.lastname: Niskanen
authors.forename: Soili M
authors.initials: SM
authors.lastname: Lehto
authors.forename: Kirsi M
authors.initials: KM
authors.lastname: Honkalampi
authors.forename: Jukka J
authors.initials: JJ
authors.lastname: Hintikka
authors.forename: Heimo T
authors.initials: HT
authors.lastname: Viinamäki
mesh_terms: D000328:Adult; D001007:Anxiety / Q000503:physiopathology* / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D015992:Body Mass Index; D003863:Depression / Q000503:physiopathology* / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology; D010551:Personality; D011446:Prospective Studies; D015430:Weight Gain / Q000502:physiology*