Lifetime psychiatric disorders and body composition: A population-based study

Background: This study aimed to investigate the relationship between depressive and anxiety disorders and indices of adiposity, including body fat mass and percent body fat, as measured by dual energy X-ray absorptiometry. Methods: In this observational study of 979 randomly-selected women aged 20-93 years, psychiatric history was ascertained using a structured clinical interview (SCID-I/NP). Total body fat was assessed using dual-energy X-ray absorptiometry and weight, height and waist circumference were measured. Medication use and lifestyle factors were self-reported. Results: Those with a lifetime history of depression had increased fat mass (+ 7.4%) and percent body fat (+ 4.3%), as well as greater mean weight (+ 3.3%), waist circumference (+ 2.9%) and BMI (+ 3.5%) after adjustment for age, anxiety, alcohol consumption, physical activity and past smoking. Furthermore, those meeting criteria for a lifetime history of depression had a 1.7-fold increased odds of being overweight or obese (BMI 25), a 2.0-fold increased odds of being obese (BMI >= 30) and a 1.8-fold increased odds of having a waist circumference >= 80 cm. These patterns persisted after further adjustment for psychotropic medication use, smoking status and energy intake. No differences in any measures of adiposity were observed among those with anxiety disorders compared to controls. Limitations: There is potential for unrecognised confounding, interpretations are limited to women and a temporal relationship could not be inferred. Conclusions: Depression was associated with greater adiposity. The difference in body fat mass was numerically greater than differences in indirect measures of adiposity, suggesting that the latter may underestimate the extent of adiposity in this population. (C) 2009 Elsevier B.V. All rights reserved.