title: Fat distribution and major depressive disorder in late adolescence.
abstract: OBJECTIVE
  Substantial evidence exists to indicate bidirectional relationships between obesity and depressive disorders and the importance of fat distribution to this relationship. This analysis used a well-characterized sample of individuals in late adolescence to determine the association between depressive illness and fat distribution.
  
  
  METHODS
  Medically healthy 15- to 20-year-olds, one-half of whom had recently begun treatment with a selective serotonin reuptake inhibitor, underwent a comprehensive psychiatric evaluation that resulted in diagnostic classification and weekly psychiatric disorder ratings over the prior 4 months using the Longitudinal Interval Follow-Up Evaluation. A whole-body scan, using dual-energy x-ray absorptiometry, allowed estimations of total body less head (TBLH), total mass, fat mass, and visceral adipose tissue (VAT) mass. Assessments occurred between September 2010 and April 2014. Multivariable linear regression analyses, adjusted for relevant covariates, examined the association between DSM-IV-TR-diagnosed major depressive disorder (MDD) and VAT, the primary outcome of interest. These procedures also determined whether significant associations were confined to overweight/obese participants.
  
  
  RESULTS
  The analysis included data from 200 participants (71% female; mean age = 19.0 ± 1.6 years), of whom 128 had current MDD. The presence of MDD was associated with increased fat mass among overweight/obese participants (Cohen d = 0.79, P < .02), but not normal weight participants. This was true of both visceral and nonvisceral fat mass measures. Accounting for the presence of generalized anxiety disorder (GAD) did not alter the findings.
  
  
  CONCLUSIONS
  In adolescents, relationships between central adiposity and MDD may be confined to those who are overweight/obese. Despite the high comorbidity of GAD and depressive disorders, only the latter appeared to be significantly associated with central adiposity.
authors.affiliation: University of Iowa, Carver College of Medicine, Department of Psychiatry Research, 500 Newton Rd, Ste 2-205 MEB, Iowa City, IA 52242-1900 william-coryell@uiowa.edu.
authors.forename: William H
authors.initials: WH
authors.lastname: Coryell
authors.forename: Brandon D
authors.initials: BD
authors.lastname: Butcher
authors.forename: Trudy L
authors.initials: TL
authors.lastname: Burns
authors.forename: Lilian N
authors.initials: LN
authors.lastname: Dindo
authors.forename: Janet A
authors.initials: JA
authors.lastname: Schlechte
authors.forename: Chadi A
authors.initials: CA
authors.lastname: Calarge
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D050218:Body Fat Distribution; D015992:Body Mass Index; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000378:metabolism; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000378:metabolism; D050177:Overweight / Q000453:epidemiology* / Q000378:metabolism; D055815:Young Adult