title: Impact of major depressive disorder, distinct subtypes, and symptom severity on lifestyle in the BiDirect Study.
abstract: The aim of this study was to examine associations of major depressive disorder (MDD), its distinct subtypes, and symptom severity with the individual lifestyle factors smoking, diet quality, physical activity, and body mass index as well as with a combined lifestyle index measuring the co-occurrence of these lifestyle factors. A sample of 823 patients with MDD and 597 non-depressed controls was examined. The psychiatric assessment was based on a clinical interview including the Mini International Neuropsychiatric Interview and the Hamilton Depression Rating Scale. Each lifestyle factor was scored as either healthy or unhealthy, and the number of unhealthy lifestyle factors was added up in a combined lifestyle index. Cross-sectional analyses were performed using alternating logistic regression and ordinal logistic regression, adjusted for socio-demographic characteristics. After adjustment, MDD was significantly associated with smoking, low physical activity, and overweight. Likewise, MDD was significantly related to the overall lifestyle index. When stratifying for subtypes, all subtypes showed higher odds for an overall unhealthier lifestyle than controls, but the associations with the individual lifestyle factors were partly different. Symptom severity was associated with the lifestyle index in a dose-response manner. In conclusion, patients with MDD represent an important target group for lifestyle interventions.
authors.affiliation: Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany. Electronic address: corinna.rahe@uni-muenster.de.
authors.forename: Corinna
authors.initials: C
authors.lastname: Rahe
authors.affiliation: Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Khil
authors.affiliation: Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Wellmann
authors.affiliation: Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia.
authors.forename: Bernhard T
authors.initials: BT
authors.lastname: Baune
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Arolt
authors.affiliation: Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Berger
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000145:classification* / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000175:diagnosis / Q000523:psychology; D057185:Sedentary Behavior; D012907:Smoking / Q000523:psychology
keywords: Atypical depression; Cardiovascular risk factors; Health behavior; Lifestyle; Melancholic depression; Subtypes of depression; Unipolar depression