مقاله انگلیسی رایگان در مورد سندرم متابولیک، افسردگی و انهدونی در میان بزرگسالان – الزویر 2018

The aim of this study was to assess the association between anhedonia and metabolic syndrome in a well-characterized community sample of individuals with a current depressive episode. This is a cross-sectional study with young adults aged 24 to 30 years old. Depressive episode and the presence of anhedonia was assessed using the Mini International Neuropsychiatric Interview – Plus version (MINI Plus). The MetS was assessed using the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III). The sample included 931 subjects, being 22 had depression without anhedonia, whereas 55 had depression with anhedonia. MetS was more prevalent among subjects with depression and anhedonia (43.6%) when compared to individuals without anhedonia and population control group. Moreover, subjects with depression and anhedonia have a significant increase of levels of glucose, triglycerides, total-cholesterol and LDLcholesterol, as well as significant decreased in the HDL-cholesterol level. The present study showed that individuals with depression and anhedonia present higher prevalence of MetS. Our study suggests that the use of the concept of anhedonia may contribute to a better understanding of the complex relationship between depression and metabolic syndrome.

Introduction

Anhedonia is defined by DSM-V as the diminished ability to obtain pleasure from otherwise positive stimuli and as a keystone symptom of various neuropsychiatric disorders, such as major depressive disorder (MDD) (American Psychiatric Association, 2013). It is one of the main symptoms of depression and recent studies indicate that approximately 40% of individuals diagnosed with depression experience significant anhedonia (Pelizza and Ferrari, 2009; Romer Thomsen et al., 2015; Spijker et al., 2001). Emerging evidence consistently documents that depression is an important risk factor for Metabolic Syndrome (MetS) (Pan et al., 2012; Vancampfort et al., 2014). A recent meta-analysis found that individuals with depression showed 1.5 times higher of developing MetS compared with general population controls (Vancampfort et al., 2014). It’s considered the influence of anhedonia on unhealthy lifestyles such as poor dietary habits, lack of physical exercise, smoking and excessive alcohol consumption. Psychotropic drugs are also established risk factors that contribute to the MetS (Ho et al., 2014). Lifestyle may be impaired in the presence of anhedonia due to the lack of motivation to develop and/or maintain a healthy lifestyle including physical activity and eating habits (Ghanei Gheshlagh et al., 2016; Lehto et al., 2008; Pan et al., 2012). MetS is a clustering of cardiovascular and metabolic risk factors that include impaired glucose metabolism, dyslipidemia, abdominal obesity and hypertension (Eckel et al., 2005). Approximately one-third of the adult population fulfills the diagnostic criteria for MetS, increased to 42% in individuals with depression (Eckel et al., 2005; Pan et al., 2012). This high co-occurrence between depression and MetS suggests a possible pathophysiological overlap (Pan et al., 2012). High cortisol secretion due to hyperactivity the hypothalamic-pituitary-adrenal (HPA) axis, insulin resistance and unhealthy lifestyle habits are some factors that may mediate the association between depression and MetS (Martinac et al., 2014). In this sense, epidemiologic studies evaluating the association between depressive disorders/symptoms and MeS suggest that a bidirectional relationship exists between these conditions. Depression occurs at a higher rate in individuals with components of MeS (and vice versa). While there are numerous accounts on the association between depression and MetS fewer studies looked specifically at the relationship between metabolic changes and anhedonia (Ghanei Gheshlagh et al., 2016; Lehto et al., 2008; Pan et al., 2012). Thus, our hypothesis is that individuals with depression suffering from anhedonia, would present a higher prevalence of metabolic syndrome than those not suffering from anhedonia. The aim of this study was to assess the association between anhedonia and metabolic syndrome in a well-characterized community sample of individuals with a current depressive episode.