Metabolic disturbances in depression : epidemiological studies on the role of diagnostic approach and treatment setting

Luppino, F.S. (2015)

Doctoral Thesis

Depression and cardiovascular disease (CVD) are among the most prevalent health problems worldwide, with a significant burden of disease. Both conditions are associated and thought to be mediated by the metabolic syndrome (MetSyn), a cluster of cardiovascular risk factors (waist circumference, blood sugar, cholesterol, triglycerides, blood pressure) and related parameters (BMI, waist-hip-ratio and LDL-cholesterol). Better insights in this association are important in order to better prevent and treat both conditions. This thesis focuses on the association between depression and metabolic disturbances. The results show that there is a significant and longitudinal and bidirectional association between depression and obesity, which is most pronounced among those with a clinical diagnosis depression. When subjects are approached not based on the presence or absence of the diagnosis, but based on the most prevalent symptoms, results show that only __Somatic Arousal__ symptoms (palpitations, dizziness, tension, shortness of breath) are associated with most MetSyn components. Comparing depressed inpatients to depressed outpatients, inpatients show more adverse metabolic disturbances in the lipid-spectrum, while blood pressure is more favorable. Further, inpatients show higher cortisol levels, which are considered to be a measure of the HPA-axis, an important stress-system in the onset and natural course of depression.

• Outpatients
• Inpatients
• Cortisol
• Sympton dimensions
• Metabolic syndrome
• Obesity
• Major depression

• All authors: Luppino, F.S.
• Supervisor: Penninx, B.W.J.H.; Zitman, F.G.
• Co-supervisor: Bouvy, P.F.; Giltay, E.J.
• Qualification: Doctor (dr.)
• Awarding Institution: Department of Psychiatry, Faculty of Medicine (LUMC), Leiden University
• Date: 2015-09-03