Association of treatment response with obesity and other metabolic risk factors in adults with depressive disorders: Results from a National Depression Cohort study in Korea (the CRESCEND study)

Young Sup Woo, Roger S. McIntyre, Jung Bum Kim, Min-Soo Lee, Jae Min Kim, Hyeon Woo Yim, Tae Youn Jun

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    10 Citations (Scopus)

    Abstract

    Background Available studies indicate that obesity may exert a moderational effect on antidepressant treatment response. The aim of this study was to investigate the relationship between treatment response and metabolic abnormalities amongst patients with depressive disorders in a large naturalistic clinical setting. Methods A nationwide prospective study was conducted in 18 hospitals in South Korea; 541 depressive patients meeting DSM-IV criteria were recruited. After baseline evaluation, subjects received naturalistic clinician-determined antidepressant interventions. Assessment was performed at baseline and weeks 1, 2, 4, 8, 12, 24 and 52. Treatment response was defined as a ≥50% reduction from baseline on at least one evaluation point. Results In univariate comparison, the patients who showed insufficient response to antidepressant therapy were more likely to be male, unmarried, unemployed, and obese. After adjusting for baseline variables, male sex (OR=1.82) and obesity (OR=1.55) remained as were significant variables. Stratification of the subjects into one of three groups, i.e. male, pre-menopausal female and post-menopausal female, revealed that males with concurrent metabolic problems, (i.e. the presence of one or more of hypertension, hyperglycemia, or hypercholesterolemia) had significantly higher risk for insufficient response (OR=2.32) and, after adjusting for baseline variables, obesity predicted insufficient response in post-menopausal female (OR=2.41). Conclusions The presence of metabolic abnormalities in patients with depressive disorders was associated with decreased treatment response to antidepressants. These results underscore the neurobiological relationship between obesity and the central nervous system, and provide empiric evidence supporting stratification of treatment response in depression.

    Original languageEnglish
    Pages (from-to)190-198
    Number of pages9
    JournalJournal of Affective Disorders
    Volume203
    DOIs
    Publication statusPublished - 2016 Oct 1

    Keywords

    • Antidepressant
    • Depression
    • Gender difference
    • Menopause
    • Metabolic abnormalities
    • Treatment outcome

    ASJC Scopus subject areas

    • Clinical Psychology
    • Psychiatry and Mental health

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