title: Cardiometabolic risk factors in patients referred to depression nurse case managers.
abstract: BACKGROUND
  Disturbances in lipid and glucose metabolism are associated with depressive symptoms, and may increase suicidal behavior.
  
  
  OBJECTIVE
  To investigate the prevalence of cardiometabolic risk factors, severity of depressive symptoms, and suicidal thoughts and previous attempts in patients referred to depression nurse case managers.
  
  
  METHODS
  Blood cholesterol, triglyceride and glucose levels, depressive symptoms and suicidality were studied in 706 depressed participants and 426 controls. In addition, we compared the Beck Depression Inventory (BDI) with a diagnostic interview.
  
  
  RESULTS
  448 (63%) of the patients scoring ≥ 10 on BDI had major depression or dysthymic disorder, 258 had an anxiety or alcohol use disorder, 137 (19%) had two or more diagnoses in the Mini-International Neuropsychiatric Interview. Suicidal thoughts (49%) and previous suicide attempts (16%) were more common in patients with depressive disorders. Patients diagnosed with depression had highest BDI scores and higher blood glucose levels measured at baseline and at 2 h in the oral glucose tolerance test (OGTT). Both patient groups also had higher triglyceride levels compared with the controls. In addition, metabolic syndrome and type 2 diabetes were most common among the depressed participants. In the whole study population, levels of low-density lipoprotein-cholesterol as well as baseline and 2-h blood glucose in OGTT were higher among patients with suicidal behavior.
  
  
  CONCLUSIONS
  Cardiometabolic risk factors and metabolic syndrome are common in patients with depression, and in patients with anxiety and alcohol use disorders. The results imply that disturbance in glucose metabolism may be associated with suicidal thoughts and previous attempts.
authors.affiliation: Hannu Koponen, Professor of Old Age Psychiatry, Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki, and Department of Psychiatry, Helsinki University Central Hospital , Helsinki , Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Koponen
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.forename: Esa
authors.initials: E
authors.lastname: Leppänen
authors.forename: Pekka
authors.initials: P
authors.lastname: Mäntyselkä
authors.forename: Mauno
authors.initials: M
authors.lastname: Vanhala
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D009718:Nurse Administrators; D012017:Referral and Consultation; D012307:Risk Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology
keywords: Beck Depression Inventory; Cardiometabolic risk factors; Depression; Metabolic syndrome; Suicidal behavior