Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2024

Open Access 01-12-2024 | Anxiety | Research

Gender differences in prevalence and clinical correlates of anxiety in first-episode and drug-naïve patients with major depressive disorder comorbid with metabolic syndrome

Authors: Wenqi Gao, Zhifang Deng, Xiaonan Cai, Dan Zhang, Han Xiao, Xiangyang Zhang

Published in: BMC Psychiatry | Issue 1/2024

Login to get access

Abstract

Background

Although gender differences in major depressive disorder (MDD) have been widely reported, there has not been much focus on gender differences in comorbidity. In patients with MDD and comorbid metabolic syndrome (Mets), the goal of this study was to investigate potential gender differences in the prevalence and clinical correlates of concomitant anxiety.

Methods

Seven hundred and ninety-four first-episode and drug-naïve patients (FEDN) patients with MDD and comorbid Mets were recruited. For each patient, sociodemographic data, thyroid function indicators, and Mets parameters were acquired. Each participant completed the 14-item Hamilton Assessment Scale for Anxiety (HAMA) and the 17-item Hamilton Assessment Scale for Depression (HAMD).

Results

There were no gender differences in the prevalence of anxiety in patients with MDD and comorbid Mets. Female patients with MDD had a shorter duration of illness. Correlation analysis showed that HAMD score, TSH, TgAb, and TPOAb were associated with anxiety prevalence in female patients, whereas anxiety onset in male patients was only associated with TSH, TgAb, and TPOAb levels. In addition, multiple logistic regression analysis showed that TSH and TgAb predicted anxiety in male patients, whereas HAMD score and age of onset significantly predicted anxiety in female patients.

Limitations

Cross-sectional design and no control for anxiety-related factors.

Conclusions

Our study showed no gender differences in the prevalence of anxiety in patients with MDD and comorbid Mets. HAMD score was associated with anxiety in female patients, whereas TSH, TgAb, and TPOAb were associated with anxiety in male patients.
Literature
1.
Ferrari AJ, et al. The epidemiological modelling of major depressive disorder: application for the global burden of Disease Study 2010. PLoS ONE. 2013;8(7):e69637.ADSPubMedPubMedCentralCrossRef
2.
Davies P, et al. Pharmacological interventions for treatment-resistant depression in adults. Cochrane Database Syst Rev. 2019;12(12):CD010557.PubMed
3.
Chaovanalikit T, Wirairat K, Sriswadpong P. Quality of Life, Self-Esteem, and Depression among Thai Transgender women before and after male-to-female gender confirmation surgery: a prospective cohort Observational Study. Sex Med. 2022;10(4):100533.PubMedPubMedCentralCrossRef
4.
Kessler RC, et al. Sex and depression in the National Comorbidity Survey. I: lifetime prevalence, chronicity and recurrence. J Affect Disord. 1993;29(2–3):85–96.PubMedCrossRef
5.
Scott KM, et al. Association of Mental disorders with subsequent chronic physical conditions: World Mental health surveys from 17 countries. JAMA Psychiatry. 2016;73(2):150–8.PubMedPubMedCentralCrossRef
6.
Kessler RC, et al. Anxious and non-anxious major depressive disorder in the World Health Organization World Mental Health Surveys. Epidemiol Psychiatr Sci. 2015;24(3):210–26.PubMedPubMedCentralCrossRef
7.
Bernstein DP, et al. Validity of the Childhood Trauma Questionnaire in an adolescent psychiatric population. J Am Acad Child Adolesc Psychiatry. 1997;36(3):340–8.PubMedCrossRef
8.
Seo HJ, et al. Distinctive clinical characteristics and suicidal tendencies of patients with anxious depression. J Nerv Ment Dis. 2011;199(1):42–8.PubMedCrossRef
9.
Dold M, et al. Clinical characteristics and treatment outcomes of patients with major depressive disorder and comorbid anxiety disorders - results from a European multicenter study. J Psychiatr Res. 2017;91:1–13.PubMedCrossRef
10.
Arnaudo CL, Andraka-Christou B, Allgood K. Psychiatric co-morbidities in pregnant women with opioid Use disorders: Prevalence, Impact, and implications for treatment. Curr Addict Rep. 2017;4(1):1–13.PubMedPubMedCentralCrossRef
11.
Fahed G et al. Metabolic syndrome: updates on pathophysiology and management in 2021. Int J Mol Sci, 2022. 23(2).
12.
Pan A, et al. Bidirectional association between depression and metabolic syndrome: a systematic review and meta-analysis of epidemiological studies. Diabetes Care. 2012;35(5):1171–80.PubMedPubMedCentralCrossRef
13.
Vancampfort D, et al. Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis. World Psychiatry. 2015;14(3):339–47.PubMedPubMedCentralCrossRef
14.
Tang F, Wang G, Lian Y. Association between anxiety and metabolic syndrome: a systematic review and meta-analysis of epidemiological studies. Psychoneuroendocrinology. 2017;77:112–21.PubMedCrossRef
15.
Perez-Pinar M, et al. Anxiety disorders and risk of stroke: a systematic review and meta-analysis. Eur Psychiatry. 2017;41:102–8.PubMedCrossRef
16.
Marcus SM, et al. Gender differences in depression: findings from the STAR*D study. J Affect Disord. 2005;87(2–3):141–50.PubMedCrossRef
17.
Kessing LV. Gender differences in patients presenting with a single depressive episode according to ICD-10. Soc Psychiatry Psychiatr Epidemiol. 2005;40(3):197–201.PubMedCrossRef
18.
Bronisch T, Wittchen HU. Suicidal ideation and suicide attempts: comorbidity with depression, anxiety disorders, and substance abuse disorder. Eur Arch Psychiatry Clin Neurosci. 1994;244(2):93–8.PubMedCrossRef
19.
20.
Ciechanowski PS, Katon WJ, Russo JE. Depression and diabetes: impact of depressive symptoms on adherence, function, and costs. Arch Intern Med. 2000;160(21):3278–85.PubMedCrossRef
21.
Toker S, Shirom A, Melamed S. Depression and the metabolic syndrome: gender-dependent associations. Depress Anxiety. 2008;25(8):661–9.PubMedCrossRef
22.
23.
Alberti KG, Zimmet P, Shaw J. Metabolic syndrome–a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. 2006;23(5):469–80.PubMedCrossRef
24.
25.
26.
Ionescu DF, Niciu MJ, Richards EM, Zarate CA Jr. Pharmacologic treatment of dimensional anxious depression: a review. Prim Care Companion CNS Disord. 2014;16(3):PCC.13r01621.PubMedCentral
27.
Konstantakopoulos G, Masdrakis VG, Markianos M, Oulis P. On the differential diagnosis of anxious from nonanxious major depression by means of the Hamilton Scales. ScientificWorldJournal. 2013;2013:294516.PubMedPubMedCentralCrossRef
28.
29.
de Graaf R, et al. Temporal sequencing of lifetime mood disorders in relation to comorbid anxiety and substance use disorders–findings from the Netherlands Mental Health Survey and Incidence Study. Soc Psychiatry Psychiatr Epidemiol. 2003;38(1):1–11.PubMedCrossRef
30.
Shen YC, et al. Twelve-month prevalence, severity, and unmet need for treatment of mental disorders in metropolitan China. Psychol Med. 2006;36(2):257–67.MathSciNetPubMedCrossRef
31.
Zhang YS, et al. Prevalence of major depressive disorder and its socio-demographic correlates in the general adult population in Hebei Province, China. J Affect Disord. 2019;252:92–8.PubMedCrossRef
32.
Carter JD, et al. Gender differences in the presentation of depressed outpatients: a comparison of descriptive variables. J Affect Disord. 2000;61(1–2):59–67.PubMedCrossRef
33.
Lin CH, et al. A comparison of inpatients with anxious depression to those with nonanxious depression. Psychiatry Res. 2014;220(3):855–60.PubMedCrossRef
34.
Kessler RC, et al. Age differences in the prevalence and co-morbidity of DSM-IV major depressive episodes: results from the WHO World Mental Health Survey Initiative. Depress Anxiety. 2010;27(4):351–64.PubMedPubMedCentralCrossRef
35.
Fava M, et al. Clinical correlates and symptom patterns of anxious depression among patients with major depressive disorder in STAR*D. Psychol Med. 2004;34(7):1299–308.PubMedCrossRef
36.
Seemuller F, et al. Outcomes of 1014 naturalistically treated inpatients with major depressive episode. Eur Neuropsychopharmacol. 2010;20(5):346–55.PubMedCrossRef
37.
Lamers F, et al. Comorbidity patterns of anxiety and depressive disorders in a large cohort study: the Netherlands Study of Depression and anxiety (NESDA). J Clin Psychiatry. 2011;72(3):341–8.PubMedCrossRef
38.
Morales DD, et al. Metabolic syndrome in the Philippine general population: prevalence and risk for atherosclerotic cardiovascular disease and diabetes mellitus. Diab Vasc Dis Res. 2008;5(1):36–43.PubMedCrossRef
39.
Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab. 2008;93(11 Suppl 1):S9–30.PubMedCrossRef
40.
Wang H, et al. Epidemiology of general obesity, abdominal obesity and related risk factors in urban adults from 33 communities of Northeast China: the CHPSNE study. BMC Public Health. 2012;12:967.PubMedPubMedCentralCrossRef
41.
Grundy SM et al. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation, 2004. 109(3): p. 433-8.
42.
Lin CY, et al. Association among serum perfluoroalkyl chemicals, glucose homeostasis, and metabolic syndrome in adolescents and adults. Diabetes Care. 2009;32(4):702–7.PubMedCrossRef
43.
Bjerkeset O, Romundstad P, Gunnell D. Gender differences in the association of mixed anxiety and depression with suicide. Br J Psychiatry. 2008;192(6):474–5.PubMedCrossRef
44.
Brumpton B, et al. The associations of anxiety and depression symptoms with weight change and incident obesity: the HUNT study. Int J Obes (Lond). 2013;37(9):1268–74.PubMedCrossRef
45.
Colvin A, et al. The role of family history of depression and the menopausal transition in the development of major depression in midlife women: study of women’s health across the nation mental health study (SWAN MHS). Depress Anxiety. 2017;34(9):826–35.ADSPubMedPubMedCentralCrossRef
46.
Li Z, et al. Sex difference in Comorbid Depression in First-Episode and Drug-naive patients with Schizophrenia: baseline results from the Depression in Schizophrenia in China Study. Psychosom Med. 2021;83(9):1082–8.PubMedCrossRef
47.
Xu S, et al. [The characters of proliferating activity and biosynthetic function of fibroblasts from abnormal scars after complete contact in vitro]. Zhonghua Zheng Xing Wai Ke Za Zhi. 2002;18(2):86–8.PubMed
48.
Wang Q, et al. Metabolic characteristics, prevalence of anxiety and its influencing factors in first-episode and drug-naive major depressive disorder patients with impaired fasting glucose. J Affect Disord. 2023;324:341–8.PubMedCrossRef
49.
McLaughlin TP, et al. Overlap of anxiety and depression in a managed care population: prevalence and association with resource utilization. J Clin Psychiatry. 2006;67(8):1187–93.PubMedCrossRef
50.
Sweileh WM, et al. Prevalence of depression among people with type 2 diabetes mellitus: a cross sectional study in Palestine. BMC Public Health. 2014;14:163.PubMedPubMedCentralCrossRef
51.
Lustman PJ, Clouse RE. Depression in diabetic patients: the relationship between mood and glycemic control. J Diabetes Complications. 2005;19(2):113–22.PubMed
52.
53.
Oldehinkel AJ, Bouma EM. Sensitivity to the depressogenic effect of stress and HPA-axis reactivity in adolescence: a review of gender differences. Neurosci Biobehav Rev. 2011;35(8):1757–70.PubMedCrossRef
54.
Yang W, et al. Association between thyroid function and comorbid anxiety in first-episode and drug naive patients with major depressive disorder. Eur Arch Psychiatry Clin Neurosci. 2023;273(1):191–8.PubMedCrossRef
55.
Engum A, et al. Thyroid autoimmunity, depression and anxiety; are there any connections? An epidemiological study of a large population. J Psychosom Res. 2005;59(5):263–8.PubMedCrossRef
56.
Vita R, et al. A patient with stress-related onset and exacerbations of Graves disease. Nat Clin Pract Endocrinol Metab. 2009;5(1):55–61.PubMedCrossRef
57.
Fischer S, Ehlert U. Hypothalamic-pituitary-thyroid (HPT) axis functioning in anxiety disorders. A systematic review. Depress Anxiety. 2018;35(1):98–110.PubMedCrossRef
Metadata
Title
Gender differences in prevalence and clinical correlates of anxiety in first-episode and drug-naïve patients with major depressive disorder comorbid with metabolic syndrome
Authors
Wenqi Gao
Zhifang Deng
Xiaonan Cai
Dan Zhang
Han Xiao
Xiangyang Zhang
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Anxiety
Published in
BMC Psychiatry / Issue 1/2024
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-024-05574-w

Other articles of this Issue 1/2024

BMC Psychiatry 1/2024 Go to the issue

Research

Atypical brain structural connectivity and social cognition in childhood maltreatment and peer victimisation

Research

Association between handgrip strength and depressive symptoms in patients undergoing hemodialysis: a cross-sectional study from a single Chinese center

Study Protocol

Study protocol: randomized controlled trial of an individualized music intervention for people with dementia in the home care setting

Research

Associations between breakfast skipping and outcomes in neuropsychiatric disorders, cognitive performance, and frailty: a Mendelian randomization study

Research

Supporting unpaid carers around hospital leave for people detained under the Mental Health Act (1983) in England: carer and practitioner perspectives

Research

Associations between ADHD and risk of six psychiatric disorders: a Mendelian randomization study