Serum lipid levels in seasonal affective disorder

Examining the Influence of Early Life Stress on Serum Lipid Profiles and Cognitive Functioning in Depressed Patients

Background

Early childhood adversity is a strong predictor of the development of major depressive disorder (MDD), but not all depressed patients experience early life stress (ELS). Cardio-metabolic diseases and cognitive deficits often coincide in MDD and worsen its course and outcome. Adverse childhood experiences have been associated with elevated risk for cardiovascular disease (CVD), but little is known on the impact of ELS on cardiovascular risk factors in MDD. Here, we examined MDD patients with and without ELS to explore the effects of ELS on serum lipid and lipoprotein levels and on cognitive performances of the patients.

Methods

Participants with a mean age of 35 years (18–55 years) were recruited from the university mental health clinic and general community. Three groups, matched in age, gender and lifestyle were examined: MDD patients with ELS (n = 21), MDD patients without ELS (n = 21), and healthy controls (n = 20). The following CVD risk factors were assessed: serum lipids (total cholesterol, triglycerides, high- and low-density lipoproteins), body mass index and exercise in a typical week. MDD severity was measured by the Beck Depression Inventory. Childhood Trauma Questionnaire was used to assess early life adversities. Executive functions and attentional processes were assessed by the Wisconsin Card Sorting and Conners’ Continuous Performance tests.

Results

Major depressive disorder patients with ELS had higher serum triglyceride and lower HDL-cholesterol concentrations compared to MDD patients without ELS. Linear regression analysis revealed that the severity of ELS had a significant negative association with HDL-cholesterol levels and significant positive associations with the serum levels of TG and TC/HDL-cholesterol index. We also found significant associations between some specific trauma types and lipid profiles. Finally, we could detect significant associations between depression severity and specific domains of the cognitive tests as well as between lipid profiles and certain domains of the Wisconsin Card Sorting Test. However, we could not detect any association between the severity of ELS and cognitive performance.

Conclusion

After controlling for depressive symptom severity and lifestyle variables, ELS was found to be a strong predictor of serum lipid alterations. Several, inter-correlated pathways may mediate the undesirable effects of ELS on the course and outcome of MDD.

Prevalence of the metabolic syndrome in unipolar major depression

Previous studies on the association between affective disorders and the metabolic syndrome yielded inconclusive results. Therefore, we examined the prevalence of the metabolic syndrome in 230 men and women with unipolar major depressive disorder during inpatient treatment and compared it to 1,673 subjects from primary care from a similar region in northern Germany. We used the AHA/NHBLI criteria to determine the rate of metabolic syndrome (MetS) and each single criterion of MetS in both groups. The age-standardized prevalence of MetS was 2.4× as high in patients with major depressive disorder (MDD) compared with data from comparison subjects (41.0% vs. 17.0%). With respect to the single criteria, elevations were found in MDD patients for fasting glucose and triglycerides in both genders, and waist circumference in women. Men in the patient and the comparison groups were found to have higher rates of increased fasting glucose and triglycerides than women in the respective groups. Factors associated with the MetS in MDD patients comprise body mass index and the severity of depression. Our results demonstrate an increased prevalence of the MetS in men and women with MDD. Interventions for the frequently untreated metabolic abnormalities and careful screening for physical health conditions among people with MDD are warranted.

Increased health risk in subjects with high self-reported seasonality

BACKGROUND

Seasonal variations in mood and behaviour, termed seasonality, are commonly reported in the general population. As a part of a large cross-sectional health survey in Hordaland, Norway, we investigated the relationship between seasonality, objective health measurements and health behaviours.

METHODOLOGY/PRINCIPAL FINDINGS

A total of 11,545 subjects between 40-44 years old participated, completing the Global Seasonality Score, measuring seasonality. Waist/hip circumference, BMI and blood pressure were measured, and blood samples were analyzed for total cholesterol, HDL cholesterol, triglycerides and glucose. Subjects also completed a questionnaire on miscellaneous health behaviours (exercise, smoking, alcohol consumption). Hierarchical linear regression analyses were used to investigate associations between seasonality and objective health measurements, while binary logistic regression was used for analysing associations between seasonality and health behaviours. Analyses were adjusted for sociodemographic factors, month of questionnaire completion and sleep duration. Seasonality was positively associated with high waist-hip-ratio, BMI, triglyceride levels, and in men high total cholesterol. Seasonality was negatively associated with HDL cholesterol. In women seasonality was negatively associated with prevalence of exercise and positively associated with daily cigarette smoking.

CONCLUSIONS/SIGNIFICANCE

High seasonality was associated with objective health risk factors and in women also with health behaviours associated with an increased risk for cardiovascular disease.

Metabolic syndrome: a follow-up study of acute depressive inpatients

Previous studies pointed out the high prevalence of the metabolic syndrome among patients with bipolar disorder and major depression. A link between depression and a metabolic syndrome remains in dispute despite these studies. This study was conducted to evaluate the occurrence of the metabolic syndrome in depressive inpatients, to analyze the association between the severity of depression and the metabolic syndrome and to screen specific laboratory values in the course of depressive illness. 60 acute depressive patients were recruited for the study and underwent psychometric testing [21-item Hamilton Depression Rating Scale (HAMD), Beck Depression Inventory (BDI), Clinical Global Impression Scale (CGI) and Global Assessment of Functioning Scale (GAF)] and a metabolic syndrome screening using the modified criteria of the American National Cholesterol Education Program (NCEP) Treatment Panel III (ATP III). Moreover, CRP, cholesterol, HDL-cholesterol, fasting glucose, triglyceride and leptin levels were measured. 42 patients were reexamined in state of (partial) remission. Depression was reassessed using the 21-item HAMD, and laboratory values were analyzed a second time. 25% of the depressive patients fulfilled the criteria of metabolic syndrome (MS+). Only in the MS+ group, a positive correlation between triglyceride blood levels and severity of depression became evident as well in the state of acute depression as in the state of remission. In the group of patients without metabolic syndrome, laboratory values were not associated with severity of depression. An association between metabolic parameters and the course of depression could only be detected in the group of patients with metabolic syndrome. These findings suggest that, in these patients, a beneficial outcome of depressive illness may improve the metabolic situation.