[Factors mediating the depression in the adult obese outpatients].

INTRODUCTION: The prevalence of obesity is rising to epidemic proportions at the alarming rate in both developed and underdeveloped countries around the world. Current prevalence data from individual national studies suggest that the obesity prevalence in the European countries ranges from 10% to 20% for men, and 10% to 25% for women. Health consequences of obesity imply both a number of fatal and non-fatal health problems (out of which the most common are cardiovascular problems, non-insulin dependent diabetes mellitus, cancers), and also a wide spectrum of psychological consequences from diminished self-esteem to clinical depression. Causal relationship between obesity and many chronic diseases is evidence-based. At the same time, there are marked differences in research data regarding causal obesity-depression relationship. Several studies have found no direct association between obesity and depression, while in others the prevalence of depression in obese patients was up to 50%. Gender, obesity grade, socioeconomic status and asking for professional help are named as moderators and mediators of this relationship. Among recommended screening methods, BDI-II is the most frequently used in the adult outpatient departments.
OBJECTIVE: The aim of the study was to determine possible risk factors of depression in adult obese patients treated for obesity. Gender, obesity and education level as well as marital status were analyzed as possible moderators of depression-obesity relationship.
METHOD: The research included 267 patients, 38.0 +/- 14.6 years of age, who referred to the Outpatient Nutrition Department for dietetic consultation or nutritional medical therapy. Nutritional status was assessed by BMI (kg/m2), calculated from measured values of body weight and height according to WHO recommendations. An estimate of the existence and/or depression level was investigated by Beck Depression Inventory--self-administered questionnaire recommended for use in Serbian population.
RESULTS: The results revealed higher average BDI score values in obese patients (F(267,1) = 6.014, p = 0.015) in comparison to their non-obese counterparts. In addition, the percentage of depressive obese patients was significantly higher (55.1%, chi2(267.1) = 22.64, p < 0.001). There was significant correlation of BMI and BDI scores (r = 0.246, p < 0.001). The number of women with depression was significantly higher in comparison to men (chi2(267.1) = 4.261, p = 0.039). Women also had higher average BDI score (p = 0.003). MANOVA showed that BDI score was influenced by gender (F(267.1) = 8.936, p = 0.030) and nutritional status (F(267.1) = 6.115, p = 0.014), but combined effect of the above-mentioned moderators was not significant.
CONCLUSION: Depression is ten times more frequent in obese patients undergoing the obesity treatment vs. general population and, therefore, screening for depression is needed. Special attention should be paid to women and more obese patients due to higher incidence of depression in these groups.