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Depressive symptoms and body mass index: co-morbidity and direction of association in a British birth cohort followed over 50 years

Published online by Cambridge University Press:  19 February 2014

M.-C. Geoffroy ,
L. Li  and
C. Power
M.-C. Geoffroy
Affiliation:
Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, University College London, UK McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
L. Li
Affiliation:
Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, University College London, UK
C. Power*
Affiliation:
Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, University College London, UK
*
*Address for correspondence: Professor C. Power, MRC Centre of Epidemiology for Child Health/Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK. (Email: christine.power@ucl.ac.uk)
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Abstract

Background

An unhealthy body mass index (BMI) has been associated with depression but the direction of association is uncertain. Our aim was to estimate the co-morbidity and direction of association between BMI and depressive symptoms at several ages, from childhood to mid-adulthood.

Method

The data were from 18 558 individuals born in 1 week in March 1958, in England, Scotland and Wales, with follow-up at ages 7, 11, 16, 23, 33, 42, 45 and 50 years. Depression (scores ⩾90th percentile) was identified from child/adolescent (teacher questionnaires) and adult (self-complete questionnaires and clinical interview) measures. BMI (kg/m2) measured in child/adolescence and adulthood was classified as underweight, normal, overweight or obese.

Results

In cross-sectional analyses, obesity and underweight (not overweight) from 11 to 45 years were associated respectively with 1.3–2.1 and 1.5–2.3 times the risk of depression compared with normal weight. Using the time-lagged generalized estimating equation (GEE) approach, we tested (a) whether underweight or obesity at prior ages (7 to 45 years) predicted subsequent risk of depression (11 to 50 years), adjusting for baseline depression; and (b) whether depression at prior ages (7 to 42 years) predicted subsequent risk of underweight or obesity (11 to 45 years), adjusting for baseline BMI. In longitudinal analyses, underweight predicted subsequent depression in both sexes [odds ratio (OR) 1.25, 95% confidence interval (CI) 1.11–1.40] and depression predicted subsequent underweight in males only (OR 1.84, 95% CI 1.52–2.23). Obesity predicted subsequent depressive symptoms in females only (OR 1.34, 95% CI 1.14–1.56), but depression did not predict obesity.

Conclusions

Clinicians should consider screening routinely for depression patients with unhealthy BMI, namely underweight and obesity, and vice versa.

Keywords

Body mass indexdepressiondepressive symptomsepidemiologylife courseobesityunderweight
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 12 , September 2014 , pp. 2641 - 2652
Copyright
Copyright © Cambridge University Press 2014 

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