U-shaped relationship between depression and body mass index in the Korean adults

J-H Lee; S K Park; J-H Ryoo; C-M Oh; J-M Choi; R S McIntyre; R B Mansur; H Kim; S Hales; J Y Jung

doi:10.1016/j.eurpsy.2017.05.025

U-shaped relationship between depression and body mass index in the Korean adults

Eur Psychiatry. 2017 Sep:45:72-80. doi: 10.1016/j.eurpsy.2017.05.025. Epub 2017 Jun 3.

Authors

J-H Lee¹, S K Park², J-H Ryoo³, C-M Oh³, J-M Choi³, R S McIntyre⁴, R B Mansur⁵, H Kim⁶, S Hales⁷, J Y Jung⁸

Affiliations

¹ Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea; Department of Psychiatry, University of Toronto, Ontario, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.
² Cohort Team, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of medicine, Seoul, Korea.
³ Departments of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.
⁴ Department of Psychiatry, University of Toronto, Ontario, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada; Department of Pharmacology, University of Toronto, Ontario, Canada.
⁵ Department of Psychiatry, University of Toronto, Ontario, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.
⁶ Department of Psychiatry, University of Toronto, Ontario, Canada.
⁷ Department of Psychiatry, University of Toronto, Ontario, Canada; Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
⁸ Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of medicine, Seoul, Korea. Electronic address: jjy0501@naver.com.

PMID: 28738292
DOI: 10.1016/j.eurpsy.2017.05.025

Abstract

Background: Although a number of studies have examined the relationship between depression and obesity, it is still insufficient to establish the specific pattern of relationship between depression and body mass index (BMI) categories. Thus, this study was aimed to investigate the relationship between depression and BMI categories.

Methods: A cross-sectional study was conducted for a cohort of 159,390 Korean based on Kangbuk Samsung Health Study (KSHS). Study participants were classified into 5 groups by Asian-specific cut-off of BMI (18.5, 23, 25 and 30kg/m²). The presence of depression was determined by Center for Epidemiologic Studies-Depression scales (CES-D)≥16 and≥25. The adjusted odd ratios (ORs) for depression were evaluated by multiple logistic regression analysis, in which independent variable was 5 categories of BMI and dependent variable was depression. Subgroup analysis was conducted by gender and age.

Results: When normal group was set as a reference, the adjusted ORs for depression formed U-shaped pattern of relationship with BMI categories [underweight: 1.31 (1.14-1.50), overweight: 0.94 (0.85-1.04), obese group: 1.01 (0.91-1.12), severe obese group: 1.28 (1.05-1.54)]. This pattern of relationship was more prominent in female and young age group than male and elderly subgroup. BMI level with the lowest likelihood of depression was 18.5kg/m² to 25kg/m² in women and 23kg/m² to 25kg/m² in men.

Conclusions: There was a U-shaped relationship between depression and BMI categories. This finding suggests that both underweight and severe obesity are associated with the increased risk for depression.

Keywords: Body mass index; Depression; Obesity; Underweight.

MeSH terms

Adult
Aged
Body Mass Index*
Cohort Studies
Comorbidity
Cross-Sectional Studies
Depression / epidemiology*
Female
Humans
Male
Middle Aged
Obesity / epidemiology*
Overweight / epidemiology
Reference Values
Republic of Korea
Thinness / epidemiology
Young Adult