One-Year Changes in Symptoms of Depression and Weight in Overweight/Obese Individuals With Type 2 Diabetes in the Look AHEAD Study

被引:82
作者
Faulconbridge, Lucy F. [1 ]
Wadden, Thomas A. [1 ]
Rubin, Richard R. [2 ,3 ]
Wing, Rena R. [4 ]
Walkup, Michael P. [5 ]
Fabricatore, Anthony N. [1 ]
Coday, Mace [6 ]
Van Dorsten, Brent [7 ]
Mount, David L. [8 ]
Ewing, Linda J. [9 ]
机构
[1] Univ Penn, Dept Psychiat, Perelman Sch Med, Philadelphia, PA 19104 USA
[2] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA
[3] Johns Hopkins Univ, Sch Med, Dept Psychiat, Baltimore, MD 21205 USA
[4] Brown Univ, Dept Psychiat & Human Behav, Warren Alpert Med Sch, Providence, RI 02912 USA
[5] Wake Forest Univ, Bowman Gray Sch Med, Dept Biostat Sci, Winston Salem, NC USA
[6] Univ Tennessee, Ctr Hlth Sci, Dept Prevent Med, Memphis, TN 38163 USA
[7] Univ Colorado, Sch Med, Dept Phys Med & Rehabil, Aurora, CO USA
[8] Wake Forest Univ, Bowman Gray Sch Med, Dept Internal Med, Winston Salem, NC 27103 USA
[9] Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA
基金
美国国家卫生研究院;
关键词
ANTIDEPRESSANT MEDICINE USE; LIFE-STYLE MODIFICATION; BINGE-EATING DISORDER; QUALITY-OF-LIFE; OBESE INDIVIDUALS; MAJOR DEPRESSION; PROGRAM; ASSOCIATION; PREVALENCE; PREDICTORS;
D O I
10.1038/oby.2011.315
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Depressed individuals are frequently excluded from weight loss trials because of fears that weight reduction may precipitate mood disorders, as well as concerns that depressed participants will not lose weight satisfactorily. The present study examined participants in the Look AHEAD study to determine whether moderate weight loss would be associated with incident symptoms of depression and suicidal ideation, and whether symptoms of depression at baseline would limit weight loss at 1 year. Overweight/obese adults with type 2 diabetes (n = 5,145) were randomly assigned to an Intensive Lifestyle Intervention (ILI) or a usual care group, Diabetes Support and Education (DSE). Of these, 5,129 participants completed the Beck Depression Inventory (BDI) and had their weight measured at baseline and 1 year. Potentially significant symptoms of depression were defined by a BDI score = 10. Participants in ILI lost 8.6 +/- 6.9% of initial weight at 1 year, compared to 0.7 +/- 4.8% for DSE (P < 0.001, effect size = 1.33), and had a reduction of 1.4 +/- 4.7 points on the BDI, compared to 0.4 +/- 4.5 for DSE (P < 0.001, effect size = 0.23). At 1 year, the incidence of potentially significant symptoms of depression was significantly lower in the ILI than DSE group (6.3% vs. 9.6%) (relative risk (RR) = 0.66, 95% confidence interval (CI) = 0.5, 0.8; P < 0.001). In the ILI group, participants with and without symptoms of depression lost 7.8 +/- 6.7% and 8.7 +/- 6.9%, respectively, a difference not considered clinically meaningful. Intentional weight loss was not associated with the precipitation of symptoms of depression, but instead appeared to protect against this occurrence. Mild (or greater) symptoms of depression at baseline did not prevent overweight/obese individuals with type 2 diabetes from achieving significant weight loss.
引用
收藏
页码:783 / 793
页数:11
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