title: Investigation of associations between recurrence of major depressive disorder and spinal posture alignment: A quantitative cross-sectional study.
abstract: The aim of this study was to investigate associations between poor spinal posture and the recurrence of major depressive episodes and severity of symptoms in patients with major depressive disorder (MDD). This was a cross-sectional quantitative study of MDD patients. Outpatients were recruited from consecutive admissions at a mood disorders unit of a tertiary psychiatric hospital. Of 136 MDD patients, 72 (53 women, 19 men; mean age, 42.4±9.1years) met all the criteria and completed the study. Forty-one patients were classified with a recurrent episode (RE) of MDD and 31 with a single episode (SE). Quantitative assessments of postural deviations were made using photogrammetry, including kyphosis, shoulder protraction, and head inclination. The severity of depressive episodes was assessed using the Hamilton Depression Rating Scale. The diagnosis and classification of patients were performed according to DSM-IV-TR and SCID criteria. Multivariate analysis of variance indicated that the RE group had greater anterior head inclination (35.39; SD: 1.57), greater scapular abduction (1.69; SD: 0.93), and worse thoracic kyphosis (139.38; SD: 1.19) than the SE group (p<0.001 for all). Multivariate analysis of covariance showed an interaction between the severity of depressive symptoms and the degree of thoracic kyphosis (p=0.002). Recurrence of depressive episodes is associated with measures of postural misalignment.
authors.affiliation: Mood Disorders Unit (GRUDA), Department of Psychiatry, School of Medicine, University of São Paulo, R. Dr. Ovídio Pires de Campos 785, 05403-010 São Paulo, Brazil. Electronic address: janettecanales@gmail.com.
authors.forename: Janette Z
authors.initials: JZ
authors.lastname: Canales
authors.affiliation: Laboratory of Medical Investigation (LIM 23), Department of Psychiatry, School of Medicine, University of São Paulo, R. Dr. Ovídio Pires de Campos 785, 05403-010 São Paulo, Brazil.
authors.forename: Juliana T
authors.initials: JT
authors.lastname: Fiquer
authors.affiliation: Department of Psychiatry, Federal University of Goiás, Primeira Avenida, Sem Número, Setor Universitário, 74000-000 Goiânia, Goiás, Brazil.
authors.forename: Rodolfo N
authors.initials: RN
authors.lastname: Campos
authors.affiliation: Mood Disorders Unit (GRUDA), Department of Psychiatry, School of Medicine, University of São Paulo, R. Dr. Ovídio Pires de Campos 785, 05403-010 São Paulo, Brazil.
authors.forename: Márcio Gerhardt
authors.initials: MG
authors.lastname: Soeiro-de-Souza
authors.affiliation: Mood Disorders Unit (GRUDA), Department of Psychiatry, School of Medicine, University of São Paulo, R. Dr. Ovídio Pires de Campos 785, 05403-010 São Paulo, Brazil.
authors.forename: Ricardo Alberto
authors.initials: RA
authors.lastname: Moreno
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D013121:Spinal Curvatures / Q000503:physiopathology* / Q000523:psychology; D055815:Young Adult
keywords: Major depressive disorder; Photogrammetry; Posture