Doms № 5 -2022

Anxiety-depressive disorders in obese patients

Velichko V.I.

https://orcid.org/0000-0002-1936-3421

Odesa National Medical University, Odessa, Ukraine  City Health Center, Ukraine

Lahoda D. O.

https://orcid.org/0000-0002-5647-4593

Odesa National Medical University, Odessa, Ukraine  City Health Center, Ukraine

Danylchuk G. O.

https://orcid.org/0000-0003-0783-6225

Odesa National Medical University, Odessa, Ukraine  City Health Center, Ukraine

 Panenko A. V.

Odesa National Medical University, Odessa, Ukraine  City Health Center, Ukraine

Venher Y. I.

https://orcid.org/0000-0002-1314-485

Odesa National Medical University, Odessa, Ukraine  City Health Center, Ukraine

Kolotvina L. I.

Odesa National Medical University, Odessa, Ukraine  City Health Center, Ukraine

Nedashkivska V. H.

Odesa National Medical University, Odessa, Ukraine  City Health Center, Ukraine

 

DOI: https://doi.org/10.57105-2415-7252-2022-5-03

Key words: overweight, obesity, anxiety, depression, comorbid pathology.

Abstract

The likelihood of developing major depressive disorder (MDD) and anxiety (T) increases with the number of comorbid metabolic disorders, such as dyslipidemia, insulin resistance, hypertension (AH), and obesity. Research indicates that long-term inflammation caused by reduced physical activity, sedentary behavior, and poor eating habits is necessary for this connection to occur, which in turn can lead to metabolic disorders. The aim of our study was to identify possible anxiety-depressive disorders in obese patients and to investigate the prevalence of such disorders in patients of the Odesa region. According to the research design, 67 obese patients who were treated at the Department of Family Medicine and Polyclinic Therapy of Odesa National Medical University were examined. Patients included in our study were asked to undergo an examination according to a generally accepted algorithm, an anthropometric examination to calculate BMI and determine the content of visceral fat. In addition, patients were asked to complete a series of questionnaires, namely: the physical activity level questionnaire, the HADS Hospital Anxiety and Depression Scale, the Beck Depression Scale, the Generalized Anxiety Disorder Questionnaire (GAD-7), the PHQ-9 questionnaire, and the M.I.N.I. (International Neuropsychiatric Questionnaire). As a result of taking anamnesis, it was established that the vast majority had comorbid diseases in the form of: hypertension – 36 patients (56.72%), type 2 diabetes – 29 patients (43.28%), prediabetes – 15 (22.39%), dyslipidemia was diagnosed in 39 patients (58.21%). Questionnaire M.I.N.I. was used by us to determine the subtype of depressive disorder in our patients. Thus, we found that the most common subtypes were: ADHD (26.87%), depressive disorder with melancholia (16.42%) and dysthymia (17.91%). In our opinion, it is appropriate to use psychological questionnaires in the practice of doctors of various specialties who interact with patients living with obesity. When patients with TDD are identified using diagnostic screening, namely questionnaires, they should be referred for further consultation with a psychotherapist.

 

References

  1. Zhao G., Ford E. S., Dhingra S., Li C., Strine T. W., Mokdad A. H. Depression and anxiety among US adults: associations with body mass index. Int J Obes. 2009. Vol. 33, N 2. P. 257–266. DOI: 10.1038/ijo.2008.268.
  2. Milaneschi Y., Simmons W. K., van Rossum E. F. C., Penninx B. W. Depression and obesity: evidence of shared biological mechanisms. Mol Psychiatry. Vol. 24, N 1. P. 18–33. DOI: 10.1038/s41380-018-0017-5.
  3. Jokela M., Hamer M., Singh-Manoux A., Batty G. D., Kivimäki M. Association of metabolically healthy obesity with depressive symptoms: pooled analysis of eight studies. Mol Psychiatry. 2014. Vol. 19, N
    P. 910–914. DOI: 10.1038/mp.2013.162.
  4. Tang F., Wang G., Lian Y. et al. Association between anxiety and metabolic syndrome: a systematic review and meta-analysis of epidemiological studies. 2017. Vol. 77.
    P. 112–121. DOI: 10.1016/j.psyneuen.2016.11.025
  5. Rapuano K. M., Laurent J. S., Hagler Jr D. J. et al. Nucleus accumbens cytoarchitecture predicts weight gain in children. Proc Natl Acad Sci U S A. 2020. Vol. 117, N 43. P. 26977–26984. DOI: 10.1073/pnas.2007918117.
  6. Opel N., Thalamuthu A., Milaneschi Y. et al. Brain structural abnormalities in obesity: relation to age, genetic risk, and common psychiatric disorders: evidence through univariate and multivariate mega-analysis including 6420 participants from the ENIGMA MDD working group. Mol Psychiatry. 2021. Vol. 26, N 9. P. 4839–4852. DOI: 10.1038/s41380-020-0774-9.
  7. Farruggia M. C., Small D. M. Effects of adiposity and metabolic dysfunction on cognition: a review. Physiol Behav. Vol. 208.
    P. 112578. DOI: 10.1016/j.physbeh.2019.112578.
  8. Kendig M. D., S.-J. Leigh, Morris M. J. Unravelling the impacts of western-style diets on brain, gut microbiota and cognition. Neurosci Biobehav Rev. Vol. 128. P. 233–243. URL: http://hdl.handle.net/10453/154999.
  9. Milaneschi Y., Lamers F., Peyrot W. J. et al. Genetic association of major depression with atypical features and obesity-related immunometabolic dysregulations. JAMA Psychiatry. 2017. Vol. 74, N 12. P. 1214–1225. DOI: 10.1001/jamapsychiatry.2017.3016.
  10. Rudolf S., Greggersen W., Kahl K. G., Hüppe M., Schweiger U. Elevated IL-6 levels in patients with atypical depression but not in patients with typical depression. Psychiatry Res. 2014. Vol. 217, N 1/2. P. 34–38. DOI: 10.1016/j.psychres.2014.02.016.
  11. Yoon H. K., Kim Y.-K., Lee H.-J., Kwon Do-Y., Kim L. Role of cytokines in atypical depression. Nord J Psychiatry. 2012. Vol. 66, N 3. P. 183–188. DOI: 10.3109/08039488.2011.611894.
  12. Woelfer M., Kasties V., Kahlfuss S., Walter M. The role of depressive subtypes within the neuroinflammation hypothesis of major depressive disorder. Neuroscience. 2019. Vol. 403. P. 93–110. DOI: 10.1016/j.neuroscience.2018.03.034.
  13. Thase M. E. Recognition and diagnosis of atypical depression. J Clin Psychiatry. Vol. 68, Suppl 8. P. 11–16.
  14. Henkel V., Mergl R., Allgaier A.-K., Kohnen R., Möller H.-J., Hegerl U. Treatment of depression with atypical features: a meta-analytic approach. Psychiatry Res. Vol. 141, N 1. P. 89–101. DOI: 10.1016/j.psychres.2005.07.012.
  15. Luppino F. S., de Wit L. M., Bouvy P. F. et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010. Vol. 67, N 3. P. 220–229. DOI: 10.1001/archgenpsychiatry.2010.2.
  16. Zhao G., Ford E. S., Li C., Tsai J., Dhingra S., Balluz L. S. Waist circumference, abdominal obesity, and depression among overweight and obese U.S. adults: National Health and Nutrition Examination Survey 2005-2006. BMC Psychiatry. 2011. Vol. 11. P. 130. DOI: 10.1186/1471-244X-11-130.
  17. Xu Q., Anderson D., Lurie-Beck J. The relationship between abdominal obesity and depression in the general population: a systematic review and meta-analysis. Obes Res Clin Pract. 2011. Vol. 5, N 4. P. e267-360. DOI: 10.1016/j.orcp.2011.04.007.
  18. Ross R., Neeland I. J., Yamashita S. et al. Waist circumference as a vital sign in clinical practice: a consensus statement from the IAS and ICCR Working Group on Visceral Obesity. Nat Rev Endocrinol. Vol. 16, N 3. P. 177–189. DOI: 10.1038/s41574-019-0310-7.
  19. Mannan M., Mamun A. A., Clavarino A. Prospective associations between depression and obesity for adolescent males and females- a systematic review and meta-analysis of longitudinal studies. PLoS One. 2016. Vol. 11. e0157240. DOI:10.1371/journal.pone.0157240.
  20. Gariepy G., Wang J. L., Lesage A. D., Schmitz N. The longitudinal association from obesity to depression: results from the 12-year National Population Health Survey. Obesity (Silver Spring). 2010. Vol. 18, N 5.
    1033–1038. DOI: 10.1038/oby.2009.333.
  21. Ozhirinnya ta rozladi harchovoyi povedinki: diagnostika, profilaktika i terapiya: posibnik / [O. Ye. Abaturov, L. M. Yur’yeva, V. I. Velychko ta in.] ; za red. O. Ye. Abaturova ta L. M. Yur’yevoyi. – Lviv : Vidavec Marchenko T. V., 2021. – 268 s. ISBN 978-617-7937-10-3
  22. Velychko V., Mankovskij B., Tatarchuk T., Lahoda D., Todurov I. ta Lishishina O. (2021). Suchasnij poglyad na likuvannya ozhirinnya u doroslih: oglyad literaturi. Reproduktivna endokrinologiya, 2021 № 61 R. 45-50.