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Depressive symptoms during childhood and adult obesity: the Zurich Cohort Study

Abstract

Depression and obesity have become major health problems with increasing prevalence. Given the limited effectiveness of treatment for weight problems, the identification of novel, potentially modifiable risk factors may provide insights on new preventive approaches to obesity. The purpose of this study was to test the hypothesis that depressive symptoms during childhood are associated with weight gain and obesity during young adulthood. Participants were from a prospective community-based cohort study of young adults (N=591) followed between ages 19 and 40 years. The sample was stratified to increase the probability of somatic and psychological syndromes. Information was derived from six subsequent semistructured diagnostic interviews conducted by professionals over 20 years. The outcome measures were body mass index (BMI) and obesity (BMI>30). Among women, depressive symptoms before age 17 years were associated with increased weight gain (4.8 vs 2.6% BMI increase per 10 years) representing greater risk for adult obesity (hazard ratio=11.52, P<0.05). Among men, only after controlling for confounders, depressive symptoms before age 17 years were associated with increased weight gain (6.6 vs 5.2% BMI increase per 10 years) in adulthood but not with occurrence of obesity. These associations between childhood depressive symptoms and adult body weight were adjusted for baseline body weight, a family history of weight problems, levels of physical activity, consumption of alcohol and nicotine, and demographic variables. As the magnitude of the associations was high, and depression during childhood is a prevalent and treatable condition, this finding may have important clinical implications for the prevention and treatment of obesity. Whether the results of this study are limited to populations with elevated levels of psychopathology remains to be tested.

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References

  1. Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP . The spread of the obesity epidemic in the United States, 1991–1998. JAMA 1999; 282: 1519–1522.

    Article  CAS  Google Scholar 

  2. Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH . The disease burden associated with overweight and obesity. JAMA 1999; 282: 1523–1529.

    Article  CAS  Google Scholar 

  3. Gortmaker SL, Must A, Perrin JM, Sobol AM, Dietz WH . Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med 1993; 329: 1008–1012.

    Article  CAS  Google Scholar 

  4. Wolf AM, Colditz GA . Social and economic effects of body weight in the United States. Am J Clin Nutr 1996; 63: 466S–469S.

    Article  CAS  Google Scholar 

  5. Weissenburger J, Rush AJ, Giles DE, Stunkard AJ . Weight change in depression. Psychiatry Res 1986; 17: 275–283.

    Article  CAS  Google Scholar 

  6. Stunkard AJ, Fernstrom MH, Price A, Frank E, Kupfer DJ . Direction of weight change in recurrent depression. Consistency across episodes. Arch Gen Psychiatry 1990; 47: 857–860.

    Article  CAS  Google Scholar 

  7. Fagiolini A, Frank E, Houck PR, Mallinger AG, Swartz HA, Buysse DJ et al. Prevalence of obesity and weight change during treatment in patients with bipolar I disorder. J Clin Psychiatry 2002; 63: 528–533.

    Article  CAS  Google Scholar 

  8. Istvan J, Zavela K, Weidner G . Body weight and psychological distress in NHANES I. Int J Obes Relat Metab Disord 1992; 16: 999–1003.

    CAS  PubMed  Google Scholar 

  9. DiPietro L, Anda RF, Williamson DF, Stunkard AJ . Depressive symptoms and weight change in a national cohort of adults. Int J Obes Relat Metab Disord 1992; 16: 745–753.

    CAS  PubMed  Google Scholar 

  10. Pine DS, Cohen P, Brook J, Coplan JD . Psychiatric symptoms in adolescence as predictors of obesity in early adulthood: a longitudinal study. Am J Public Health 1997; 87: 1303–1310.

    Article  CAS  Google Scholar 

  11. Pine DS, Goldstein RB, Wolk S, Weissman MM . The association between childhood depression and adulthood body mass index. Pediatrics 2001; 107: 1049–1056.

    Article  CAS  Google Scholar 

  12. Goodman E, Whitaker RC . A prospective study of the role of depression in the development and persistence of adolescent obesity. Pediatrics 2002; 110: 497–504.

    Article  Google Scholar 

  13. Richardson LP, Davis R, Poulton R, McCauley E, Moffitt TE, Caspi A et al. A longitudinal evaluation of adolescent depression and adult obesity. Arch Pediatr Adolesc Med 2003; 157: 739–745.

    Article  Google Scholar 

  14. Bardone AM, Moffitt TE, Caspi A, Dickson N, Stanton WR, Silva PA . Adult physical health outcomes of adolescent girls with conduct disorder, depression, and anxiety. J Am Acad Child Adolesc Psychiatry 1998; 37: 594–601.

    Article  CAS  Google Scholar 

  15. Friedman MA, Brownell KD . Psychological correlates of obesity: moving to the next research generation. Psychol Bull 1995; 117: 3–20.

    Article  CAS  Google Scholar 

  16. Wadden TA, Stunkard AJ . Psychopathology and obesity. Ann NY Acad Sci 1987; 499: 55–65.

    Article  CAS  Google Scholar 

  17. Derogatis LR . Administration, Scoring and Procedures Manual-I for the R (revised) Version and Other Instruments of the Psychopathology Rating Scale Series. Johns Hopkins School of Medicine: Baltimore, 1977.

    Google Scholar 

  18. Eich D, Ajdacic-Gross V, Condrau M, Huber H, Gamma A, Angst J et al. The Zurich study: participation patterns and symptom checklist 90-R scores in six interviews, 1979–1999. Acta Psychiatr Scand 2003; 108: 1–4.

    Article  Google Scholar 

  19. Angst J, Dobler-Mikola A, Binder J . The Zurich Study—a prospective epidemiological study of depressive, neurotic and psychosomatic syndromes. Eur Arch Psychiatry Clin Neurosci 1984; 234: 13–20.

    Article  CAS  Google Scholar 

  20. Angst J, Dobler-Mikola A . The Zurich study. VI. A continuum from depression to anxiety disorders? Eur Arch Psychiatry Clin Neurosci 1985; 235: 179–186.

    Article  CAS  Google Scholar 

  21. Pearlin LI, Schooler C . The structure of coping. J Health Soc Behav 1978; 19: 2–21.

    Article  CAS  Google Scholar 

  22. Merikangas KR, Zhang H, Avenevoli S, Acharyya S, Neuenschwander M, Angst J . Longitudinal trajectories of depression and anxiety in a prospective community study: the Zurich Cohort Study. Arch Gen Psychiatry 2003; 60: 993–1000.

    PubMed  Google Scholar 

  23. Angst J, Gamma A, Sellaro R, Zhang H, Merikangas K . Toward validation of atypical depression in the community: results of the Zurich Cohort Study. J Affect Disord 2002; 72: 125.

    Article  Google Scholar 

  24. Vollrath M, Koch R, Angst J . Binge eating and weight concerns among young adults. Results from the Zurich Cohort Study. Br J Psychiatry 1992; 160: 498–503.

    Article  CAS  Google Scholar 

  25. Gustafson TB, Sarwer DB . Childhood sexual abuse and obesity. Obes Rev 2004; 5: 129–135.

    Article  CAS  Google Scholar 

  26. Felitti VJ . Long-term medical consequences of incest, rape, and molestation. South Med J 1991; 84: 328–331.

    Article  CAS  Google Scholar 

  27. Willett WC, Dietz WH, Colditz GA . Guidelines for healthy weight. N Engl J Med 1999; 341: 427–434.

    Article  CAS  Google Scholar 

  28. Willett WC . Nutritional Epidemiology. Oxford University Press: New York, 1998.

    Book  Google Scholar 

  29. Schutz Y, Woringer V . Obesity in Switzerland: a critical assessment of prevalence in children and adults. Int J Obes Relat Metab Disord 2002; 26 (Suppl 2): S3–S11.

    Article  Google Scholar 

  30. Kleinbaum DG, Klein M . Logistic Regression. A Self-Learning Text, 2nd edn. Springer: New York, 2002.

    Google Scholar 

  31. Hasler G, Pine DS, Gamma A, Milos G, Ajdacic V, Eich D et al. The association between psychopathology and being overweight. Psychol Med 2004; 34: 1047–1057.

    Article  CAS  Google Scholar 

  32. Faith MS, Matz PE, Jorge MA . Obesity–depression associations in the population. J Psychosom Res 2002; 53: 935–942.

    Article  Google Scholar 

  33. Kraemer HC, Stice E, Kazdin A, Offord D, Kupfer D . How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. Am J Psychiatry 2001; 158: 848–856.

    Article  CAS  Google Scholar 

  34. Kessler RC, Avenevoli S, Ries Merikangas K . Mood disorders in children and adolescents: an epidemiologic perspective. Biol Psychiatry 2001; 49: 1002–1014.

    Article  CAS  Google Scholar 

  35. Hasler G, Drevets WC, Manji HK, Charney DS . Discovering endophenotypes for major depression. Neuropsychopharmacology 2004; 29: 1765–1781.

    Article  CAS  Google Scholar 

  36. Meguid MM, Fetissov SO, Varma M, Sato T, Zhang L, Laviano A et al. Hypothalamic dopamine and serotonin in the regulation of food intake. Nutrition 2000; 16: 843–857.

    Article  CAS  Google Scholar 

  37. Musselman DL, Betan E, Larsen H, Phillips LS . Relationship of depression to diabetes types 1 and 2: epidemiology, biology, and treatment. Biol Psychiatry 2003; 54: 317–329.

    Article  Google Scholar 

  38. Kendler KS, Eaves LJ, Walters EE, Neale MC, Heath AC, Kessler RC . The identification and validation of distinct depressive syndromes in a population-based sample of female twins. Arch Gen Psychiatry 1996; 53: 391–399.

    Article  CAS  Google Scholar 

  39. Comings DE, Gade R, MacMurray JP, Muhleman D, Peters WR . Genetic variants of the human obesity (OB) gene: association with body mass index in young women, psychiatric symptoms, and interaction with the dopamine D2 receptor (DRD2) gene. Mol Psychiatry 1996; 1: 325–335.

    CAS  PubMed  Google Scholar 

  40. Levitan RD, Masellis M, Lam RW, Muglia P, Basile VS, Jain U et al. Childhood inattention and dysphoria and adult obesity associated with the dopamine D4 receptor gene in overeating women with seasonal affective disorder. Neuropsychopharmacology 2004; 29: 179–186.

    Article  CAS  Google Scholar 

  41. Fanous A, Gardner CO, Prescott CA, Cancro R, Kendler KS . Neuroticism, major depression and gender: a population-based twin study. Psychol Med 2002; 32: 719–728.

    Article  CAS  Google Scholar 

  42. Posternak MA, Zimmerman M . Symptoms of atypical depression. Psychiatry Res 2001; 104: 175–181.

    Article  CAS  Google Scholar 

  43. Gold PW, Chrousos GP . Organization of the stress system and its dysregulation in melancholic and atypical depression: high vs low CRH/NE states. Mol Psychiatry 2002; 7: 254–275.

    Article  CAS  Google Scholar 

  44. Hirshfeld-Becker DR, Biederman J, Calltharp S, Rosenbaum ED, Faraone SV, Rosenbaum JF . Behavioral inhibition and disinhibition as hypothesized precursors to psychopathology: implications for pediatric bipolar disorder. Biol Psychiatry 2003; 53: 985–999.

    Article  Google Scholar 

  45. Provencher V, Drapeau V, Tremblay A, Despres JP, Lemieux S . Eating behaviors and indexes of body composition in men and women from the Quebec family study. Obes Res 2003; 11: 783–792.

    Article  Google Scholar 

  46. Van Strien T, Schippers GM, Cox WM . On the relationship between emotional and external eating behavior. Addict Behav 1995; 20: 585–594.

    Article  CAS  Google Scholar 

  47. Lissau I, Sorensen TI . Parental neglect during childhood and increased risk of obesity in young adulthood. Lancet 1994; 343: 324–327.

    Article  CAS  Google Scholar 

  48. Cross-National Collaborative Group. The changing rate of major depression. Cross-national comparisons. JAMA 1992; 268: 3098–3105.

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Acknowledgements

This work was supported by Grant 3200-050881.97/1 of the Swiss National Science Foundation.

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Correspondence to G Hasler.

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Hasler, G., Pine, D., Kleinbaum, D. et al. Depressive symptoms during childhood and adult obesity: the Zurich Cohort Study. Mol Psychiatry 10, 842–850 (2005). https://doi.org/10.1038/sj.mp.4001671

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