Cardiovascular Risk Factors Differentially Predict Major Depressive Disorder Subtypes

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Investigators sought to determine whether BMI, tobacco use, hypertension would be predictors of atypical and typical MDD in adults.

A study has shown that different cardiovascular disease risk factors can serve as differential predictors of major depressive disorder (MDD) subtypes, according to a study published in Psychosomatic Medicine.

Researchers included 22,915 adult subjects in this study, none of whom showed a history of MDD at baseline. Of these subjects, 991 showed cases of typical MDD and 252 showed atypical MDD. After adjustment, baseline body mass index (BMI) (odds ratio [OR] 1.32; P <.001), previous tobacco use (OR 1.46; P <.001), and hypertension (OR 0.58; P <.001) served as differential predictors of incident atypical MDD vs no MDD. 

An absence of risk factors for cardiovascular disease served as a predictor of incident typical MDD. Additionally, baseline BMI (OR 1.26; P <.001), previous tobacco use (OR 1.53; P <.001), and hypertension (OR 0.52; P <.001) served as predictors of atypical vs typical MDD.

Participants in this study took part in 2 waves of the National Epidemiologic Survey on Alcohol and Related Conditions. Wave 1 took place between 2001 and 2002 and dealt with determining cardiovascular disease risk factors, and Wave 2 took place between 2004 and 2005 and dealt with incident MDD subtypes. These data were obtained through organized interviews.

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Researchers conclude that “[cardiovascular disease] risk factors differentially predict [major depressive disorder] subtypes, with hypertension (protective factor), former tobacco use (risk factor), and BMI (risk factor) being stronger predictors of incident atypical versus typical MDD. Such evidence could provide insights into the etiologies of MDD subtypes and inform interventions tailored to MDD subtype.”


Patel JS, Berntson J, Polanka BM, Stewart JC. Cardiovascular risk factors as differential predictors of incident atypical and typical major depressive disorder in U.S. adults [published online March 28, 2018]. Psychosom Med. doi: 10.1097/PSY.0000000000000583