title: Depression, stress, and weight loss in individuals with metabolic syndrome in SHINE, a DPP translation study.
abstract: OBJECTIVE
  To examine the relationships between elevated depression symptoms (EDS) or stress and weight loss in SHINE, a telephonic, primary-care based, translation of the Diabetes Prevention Program.
  
  
  METHODS
  N = 257 adults with metabolic syndrome were randomized to individual (IC) or group (CC) phone participation. Weight, depression, anti-depressant use (ADMs), and stress (baseline, 6 months, 1 and 2 years) were assessed. Univariate analyses used linear and logistic regression, t tests for continuous variables and exact tests for categorical variables. Stratified analyses assessed modifiers of effects of depression/stress on weight loss.
  
  
  RESULTS
  Approximately 35% reported EDS, with no change over time. Approximately 28% of all participants used ADMs. Participants with EDS had lower mean % weight loss and a smaller % who achieved ≥5% weight loss. Participants with EDS were less likely to be "completers" (40.1% vs. 61.5%, P = 0.002), coached (48.0% vs. 60.7%, P = 0.049), or log diet/activity (19.4% vs. 42.7%, P < 0.001), behaviors related to weight loss. Results were similar for high stress. ADM use had no independent effect on weight loss.
  
  
  CONCLUSIONS
  Individuals with metabolic syndrome and EDS and/or high stress were less likely to lose significant weight. Pre-intervention depression and stress screening to intervene may improve weight loss.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, New York, USA; Department of Medicine, SUNY Upstate Medical University, New York, USA.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Trief
authors.forename: Donald
authors.initials: D
authors.lastname: Cibula
authors.forename: Linda M
authors.initials: LM
authors.lastname: Delahanty
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Weinstock
mesh_terms: D000328:Adult; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000628:therapy*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000453:epidemiology* / Q000517:prevention & control; D016896:Treatment Outcome; D015431:Weight Loss; D061217:Weight Reduction Programs