Aug 2026· Journal of Affective Disorders· pp.
122340
· 0 citations· 43 references
Medicine
TL;DR
High BMI correlates with more severe depressive symptoms and increased inflammatory status in adolescents with MDD, especially among females, suggesting that interventions targeting immune and metabolic pathways may offer additional therapeutic benefits.
Abstract
Background
Major Depressive Disorder (MDD) and obesity are prevalent and burdensome public health issues linked by a complex, bidirectional association potentially driven by systemic inflammation. Nevertheless, this relationship remains poorly understood in adolescents with MDD.
Methods
We enrolled 339 adolescents with MDD and stratified them by body mass index (BMI) into underweight, normal weight, overweight, and obese groups. Depression and anxiety severity were evaluated using the Hamilton Depression (HAMD) and Hamilton Anxiety (HAMA) Rating Scales. Hematological inflammatory markers, including neutrophils, monocytes, lymphocyte, platelets, white blood cells, high-sensitivity C-Reactive Protein (hs-CRP), derived ratios, and systemic immune-inflammation index (SII), were assessed across groups. Linear regression and mediation analyses evaluated associations among clinical symptoms, BMI, and inflammatory markers.
Results
The association between BMI and depressive symptoms differed significantly by sex. Among females, the abnormal BMI group had significantly higher total HAMD scores than the normal-weight group, with the obese group demonstrating a higher score on the cognitive impairment factor of HAMD. Inflammatory markers increased progressively across ascending BMI categories. BMI and blood inflammatory markers were associated with depression severity in adolescents. Neutrophil count and monocyte-to-lymphocyte ratio (MLR) showed significant positive indirect effects, accounting for part of the association between obesity and depressive symptoms.
Conclusions
High BMI correlates with more severe depressive symptoms and increased inflammatory status in adolescents with MDD, especially among females. Systemic inflammation partially accounts for the association between high BMI and depression, suggesting that interventions targeting immune and metabolic pathways may offer additional therapeutic benefits.
Inflammatory dysregulation has been implicated in depression; however, the association between the systemic inflammation response index (SIRI), a composite inflammatory marker derived from peripheral neutrophil, monocyte, and lymphocyte counts, and depression in the general adult population remains unclear. This study aimed to examine the association between SIRI and depression among adults from the National Health and Nutrition Examination Survey 2005 to 2016. This cross-sectional study included 24,188 adults with available data on the Patient Health Questionnaire-9 (PHQ-9), blood cell counts, and relevant covariates. SIRI was calculated as neutrophil count × monocyte count/lymphocyte count. Depression was assessed using the PHQ-9, with a score ≥10 indicating clinically relevant depressive symptoms. Multivariable logistic regression, restricted cubic spline analysis, threshold effect analysis, and receiver operating characteristic curve analysis were performed to evaluate the association, nonlinear relationship, and incremental discriminatory value of SIRI. Among 24,188 participants, 2055 (8.50%) had clinically relevant depressive symptoms. Higher SIRI was associated with increased odds of depression after multivariable adjustment (odds ratio = 1.07, 95% confidence interval: 1.02–1.13, P = .004). Compared with the lowest quartile, participants in the highest SIRI quartile had higher odds of depression (odds ratio = 1.26, 95% confidence interval: 1.10–1.44, P < .001). Restricted cubic spline analysis demonstrated a significant nonlinear association between SIRI and depression (P for nonlinear = .007). Threshold analysis identified an inflection point at approximately 2.58, below which higher SIRI was associated with increased odds of depression, whereas the association plateaued thereafter. Adding SIRI to the basic model slightly improved discrimination (area under the curve: 0.716 vs 0.725). Higher SIRI levels were associated with higher odds of clinically relevant depressive symptoms among adults from the National Health and Nutrition Examination Survey 2005 to 2016, with a nonlinear dose-response pattern. Given the modest effect size and limited improvement in discrimination, SIRI should be interpreted as an auxiliary peripheral inflammatory marker rather than a standalone screening or diagnostic tool. Further prospective studies are required to clarify causality and clinical relevance.
Qiongqiong Zhan, Yu Wu, Jiaojiao Sun et al.· Medicine· 0 citations
Background/Objectives: Psychological distress, including symptoms of anxiety and depression, is common among individuals with inflammatory bowel disease (IBD) and may adversely affect well-being and disease management. However, routine assessment of mental health is not consistently integrated into clinical care. This study assessed the prevalence of anxiety and depression among patients newly diagnosed with IBD at diagnosis and after three months of treatment and explored associations between psychological symptoms, disease activity, and clinical characteristics. Methods: This prospective cohort study included 304 adults newly diagnosed with IBD and treated at Stavanger University Hospital between 2012 and 2019. Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale at baseline and after three months. Disease activity was evaluated using the Harvey–Bradshaw Index and Partial Mayo Score. Clinical variables included C-reactive protein, faecal calprotectin, folate, cobalamin, and body mass index. Multivariable regression analyses were conducted to identify factors associated with psychological symptoms. Results: The prevalence of anxiety decreased from 29.8% at diagnosis to 21.6% after three months, while the prevalence of combined anxiety and depression declined from 22.2% to 16.3%. The prevalence of depression alone remained stable over time. Higher disease activity, particularly as measured by the Harvey–Bradshaw Index, showed the strongest association with anxiety and depressive symptoms. However, after adjustment for potential confounders, no significant improvement in psychological symptoms was observed, suggesting that the association between time and HADS scores may be explained by changes in one or more measured covariates. Conclusions: Psychological symptoms remained common during the first months following an IBD diagnosis and were closely associated with disease activity. Medical treatment alone was insufficient to achieve meaningful improvements in mental health outcomes. These findings highlight the importance of systematic psychological assessment, early identification of emotional distress, and integrated multidisciplinary care, including nursing-led screening and supportive interventions, for individuals newly diagnosed with IBD.
Å. Sagen, G. Eide, T. Grimstad et al.· Nursing Reports· 0 citations
Sleep disorders, inflammatory dysregulation, and anxiety symptoms constitute an interconnected network associated with SI in MDD, and the importance of comprehensive, integrated interventions is highlighted.
Cailing Wei, Yudan Zhang, Yuan Gao et al.· Journal of Affective Disorde...· 0 citations
Severe depressive symptoms were associated with significantly reduced ferritin, vitamin B12, and serotonin levels, along with elevated TIBC, cortisol, CRP, and MDA levels (p < 0.05).
Alagendran Subbarayalu, L. N. Ahamed, Kowsalya R et al.· International Journal of Dru...· 0 citations
A positive correlation between the E-DII and both the risk and severity of adolescent depression is underscored, emphasizing the critical role of dietary factors in the prevention and management of adolescent depression.
Junxiang Cheng, Ning Ma, Qia Liu et al.· BMC Psychiatry· 0 citations
