Prevalence of metabolic syndrome in subjects with melancholic and non-melancholic depressive symptoms. A Finnish population-based study

Background: We aimed to evaluate the prevalence of the metabolic syndrome (MetS) and its components in subjects with predominantly melancholic or non-melancholic depressive symptoms (DS) in a population-based study evaluating the efficacy of the Finnish diabetes prevention program (FIN-D2D). Methods: Altogether, 4500 randomly-selected Finnish men and women aged 45-74 years were initially enrolled from the National Population Register: 2820 (63%) attended a health examination. Diagnosis of MetS was based on the criteria of the National Cholesterol Education Program (NCEP-ATPIII), and DS on the 21-item Beck Depression Inventory (BDI-21, >= 10 points). A summary score of the melancholic items in the BDI was used to divide the subjects with DS (N=432) into melancholic and a non-melancholic sub-groups. Results: The prevalence of MetS was higher among subjects with non-melancholic DS compared to those with melancholic DS (69% versus 55%, p 0.004). The prevalence of MetS among subjects without DS was 51%. The sex- and age-adjusted odd ratio (OR) for MetS was 2.10 (95%CI 1.62 to 2.73, p<0.001) when comparing the non-melancholic and non-depressed groups, 1.15 (95%CI 0.81 to 1.61, p=0.44) for the melancholic and non-depressed groups, and 1.84 (95%CI 1.20 to 2.80, p=0.005) for the non-melancholic and melancholic groups. Limitations: DS were based on a self-rating scale, and due to the cross-sectional design of our study, we cannot make inferences of causality. Conclusions: Compared to subjects without DS and those with melancholic DS, persons with non-melancholic DS may more frequently suffer from MetS. (C) 2011 Elsevier B.V. All rights reserved.