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Genetic Association of Major Depression With Atypical Features and Obesity-Related Immunometabolic Dysregulations
Open accessAbstract
Importance: The association between major depressive disorder (MDD) and obesity may stem from shared immunometabolic mechanisms particularly evident in MDD with atypical features, characterized by increased appetite and/or weight (A/W) during an active episode. Objective: To determine whether subgroups of patients with MDD stratified according to the A/W criterion had a different degree of genetic overlap with obesity-related traits (body mass index [BMI] and levels of C-reactive protein [CRP] and leptin). Design, Setting, and Patients: This multicenter study assembled genome-wide genotypic and phenotypic measures from 14 data sets of the Psychiatric Genomics Consortium. Data sets were drawn from case-control, cohort, and population-based studies, including 26 628 participants with established psychiatric diagnoses and genome-wide genotype data. Data on BMI were available for 15 237 participants. Data were retrieved and analyzed from September 28, 2015, through May 20, 2017. Main Outcomes and Measures: Lifetime DSM-IV MDD was diagnosed using structured diagnostic instruments. Patients with MDD were stratified into subgroups according to change in the DSM-IV A/W symptoms as decreased or increased. Results: Data included 11 837 participants with MDD and 14 791 control individuals, for a total of 26 628 participants (59.1% female and 40.9% male). Among participants with MDD, 5347 (45.2%) were classified in the decreased A/W and 1871 (15.8%) in the increased A/W subgroups. Common genetic variants explained approximately 10% of the heritability in the 2 subgroups. The increased A/W subgroup showed a strong and positive genetic correlation (SE) with BMI (0.53 [0.15]; P = 6.3 × 10-4), whereas the decreased A/W subgroup showed an inverse correlation (-0.28 [0.14]; P = .06). Furthermore, the decreased A/W subgroup had a higher polygenic risk for increased BMI (odds ratio [OR], 1.18; 95% CI, 1.12-1.25; P = 1.6 × 10-10) and levels of CRP (OR, 1.08; 95% CI, 1.02-1.13; P = 7.3 × 10-3) and leptin (OR, 1.09; 95% CI, 1.06-1.12; P = 1.7 × 10-3). Conclusions and Relevance: The phenotypic associations between atypical depressive symptoms and obesity-related traits may arise from shared pathophysiologic mechanisms in patients with MDD. Development of treatments effectively targeting immunometabolic dysregulations may benefit patients with depression and obesity, both syndromes with important disability.
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“Obese individuals, particularly those presenting attributes of metabolic syndrome (abdominal obesity, hyperglycemia, hypertension, elevated triglycerides), tend to develop the atypical subtype [9] (Box 1).”
From The menace of obesity to depression and anxiety prevalence (2022) · cites this paper as [9]
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“Models applied to the total sample were adjusted for age, sex (0 = male, 1 = female), smoking status (0 = non-smoking, 1 = smoking), BMI, hormonal contraceptive use (0 = no intake, 1 = intake) and menopause (0 = no, 1 = yes).”
InfluentialGenetic and Phenotypic Associations With Sustained Antidepressant Use in Major Depressive Disorder
Walker, A., Mitchell, B. L., Lin, T., Crouse, J. J., Albiñana, C., Yap, C. X., Lynall, M.-E., Lind, P. A., Cipriani, A., Byrne, E. M., et al. (2026) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2025.4372 · Cited by 2
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Obesity and depression: A molecular and epidemiological view of two comorbid disorders
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“In fact, these factors are equally involved during the development of these pathologies, with an additive genetic effect accounting for 40 % of these conditions’ heritability (45,46).”
BackgroundAssociation between serum 25 (OH) D levels and depression symptoms in adults with prediabetes
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“Inoltre, Milaneschi e colleghi riportano una forte correla-zione tra le caratteristiche atipiche della depressione, come ipersonnia e iperfagia, e le disfunzioni immunometaboliche e suggeriscono la presenza di una specifica condizione di “depressione immunometabolica” [38].”
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Leptin and leptin receptor gene polymorphisms and depression treatment response
Tavast, I.-M., Solismaa, A., Lyytikäinen, L., Mononen, N., Moilanen, E., Hämäläinen, M., Lehtimäki, T. J., & Kampman, O. (2024) · Acta Neuropsychiatrica · doi:10.1017/neu.2024.43 · Cited by 3
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“There is growing evidence to suggest a bidirectional link between depression and metabolic complications such as dyslipidemia [6], arising from obesity [4,32], including MASLD [3], with a proposed role of perturbed lipid metabolism [15,33–35].”
Impact of obesity on immune function and depressive disorder: integrative review
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Stratifying depression by neuroticism: revisiting a diagnostic tradition using GWAS dataPreprint
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Obesity in Children and Adolescents and its Impact on Mental Health
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Vuksan-Ćusa, B., Jakšić, N., Matovinović, M., Baretić, M., Vuksan-Ćusa, Z., Mustač, F., Tudor, K. I., Šagud, M., & Marčinko, D. (2020) · PubMed · Cited by 1
Les premiers succès de la piste immuno-métabolique en psychiatrie de précision
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S.02.01 Immune-metabolic depression: evidence for a subtype of depression
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Decoding Treatment Choice: Genetic and Phenotypic Analyses of Long-term Antidepressant AcceptabilityPreprint
Walker, A., Mitchell, B. L., Lin, T., Crouse, J. J., Albiñana, C., Yap, C. X., Lynall, M.-E., Lind, P. A., Cipriani, A., Byrne, E. M., et al. (2025) · medRxiv · doi:10.1101/2025.08.19.25333784 · Cited by 1
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Interações entre depressão, qualidade de sono e hábitos de vida:
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Eriksson, M. D., Eriksson, J. G., Korhonen, P. E., Salonen, M. K., Mikkola, T. M., Kajantie, E., Wasenius, N., von Bonsdorff, M. B., Kautiainen, H., & Laine, M. K. (2021) · Research Square · doi:10.21203/rs.3.rs-911998/v1
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Functional connectivity of the reward circuit predicts changes in appetite in depressionPreprint
Kroemer, N. B., Opel, N., Teckentrup, V., Li, M., Grotegerd, D., Meinert, S. L., Lemke, H., Kircher, T. T. J., Nenadić, I., Krug, A., et al. (2022) · doi:10.31234/osf.io/4ua8x
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Marshall, S., Adams, M. J., Evans, K. L., Strawbridge, R. J., Campbell, A., Hayward, C., McIntosh, A. M., & Thomson, P. A. (2022) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2022.08.30.504498
“Thus, it is becoming increasingly common for both genetic(7-9) and epidemiological studies(10-12) to utilise these symptoms over the full DSM-V criteria when examining atypical depression.”
BackgroundResultInfluential
Metadata
- Authors
- Milaneschi, Y., Lamers, F., Peyrot, W. J., Baune, B. T., Breen, G., Dehghan, A., Forstner, A. J., Grabe, H. J., Homuth, G., Kan, C., Lewis, C., Mullins, N., Nauck, M., Pistis, G., Preisig, M., Rivera, M., Rietschel, M., Streit, F., Strohmaier, J., Teumer, A., Van der Auwera, S., Wray, N. R., Boomsma, D. I., Penninx, B. W. J. H., & for the CHARGE Inflammation Working Group and the Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium
- Affiliations
- Amsterdam Neuroscience (NL)
- The University of Adelaide (AU)
- King's College London (GB)
- Imperial College London (GB)
- University of Bonn (DE)
- Universitätsmedizin Greifswald (DE)
- Centre Hospitalier Universitaire Vaudois (CH)
- Universidad de Granada (ES)
- Heidelberg University (DE)
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- The University of Queensland (AU)
- Vrije Universiteit Amsterdam (NL)
- Corresponding author
- Milaneschi, Yuri
- ORCID
- Milaneschi, Yuri
- Lamers, Femke
- Peyrot, Wouter J.
- Baune, Bernhard T.
- Breen, Gerome
- Dehghan, Abbas
- Grabe, Hans J.
- Homuth, Georg
- Kan, Carol
- Lewis, Cathryn
- Mullins, Niamh
- Pistis, Giorgio
- Preisig, Martin
- Rivera, Margarita
- Rietschel, Marcella
- Streit, Fabian
- Strohmaier, Jana
- Teumer, Alexander
- Wray, Naomi R.
- Boomsma, Dorret I.
- Penninx, Brenda W. J. H.
- Venue
- JAMA Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2017-12-01
- Volume
- 74
- Issue
- 12
- Pages
- 1214
- ISSN
- 2168-622X (ISSN-L)
- PMC
- PMC6396812
- OpenAlex
- W2766503838
- Cited by
- 233
- References
- 56
- Citations by year
- 2026: 15 · 2025: 30 · 2024: 15 · 2023: 29 · 2022: 33 · 2021: 41 · 2020: 31 · 2019: 29 · 2018: 9 · 2017: 1
- FWCI
- 12.71
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Psychiatry (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- ResearchOnline - JCU (James Cook University) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- RISalud Institutional Health Repository of Andalucía (submittedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- IRIS (submittedVersion)
- Iris (University of Trento) (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
- SERVAL (Université de Lausanne) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- National Science Foundation (33CS30-139468, 33CS30-148401, 33CSCO-122661)
- Foundation for the National Institutes of Health (1RC2 MH089995)
- Amgen
- Pfizer
- GlaxoSmithKline (3200B0–105993, 33CSCO-122661, 3200B0-118308, 33CS30-148401, 33CS30-139468)
- Brigham and Women's Hospital
- Massachusetts General Hospital
- University of Southern California
- Kaiser Permanente
- Massachusetts Institute of Technology
- Emory University
- F. Hoffmann-La Roche
- Washington University in St. Louis
- Aarhus Universitet
- Aarhus Universitetshospital
- Johns Hopkins University
- University of Texas Southwestern Medical Center
- Universität Basel
- Virginia Commonwealth University
- South London and Maudsley NHS Foundation Trust
- Wellcome Trust (104036/Z/14/Z)
- QIMR Berghofer Medical Research Institute
- Broad Institute
- Universitätsmedizin Göttingen
- National Institute for Health and Care Research (CL-2017-17-003)
- King's College London
- University College London
- University of Oxford
- Newcastle University
- European Commission (QLG2-CT-2002-01254, LSHB-CT-2003–503428, 503428, 230374, 01ZZ0103, 01ZZ0403, 01254, 03ZIK012, 01ZZ9603, 334065, LSHB-CT-2003)
- University of Glasgow
- Cardiff University
- Trinity College Dublin
- Deutsche Forschungsgemeinschaft (Gr1912/5‐1, 01ZZ0403, 01ZZ9603, 03ZIK012, 01ZZ0103)
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (148401, 122661, 33CSCO, 118308, 105993, 230374, 3200B0, 33CS30, 139468)
- Universiteit Leiden (10‐000‐1002)
- Rijksuniversiteit Groningen (10‐000‐1002)
- Stiftelsen för Strategisk Forskning
- James Cook University
- Queensland University of Technology
- University of Queensland
- ZonMw (Middelgroot‐911‐09‐032, 56-464-14192, 184.021.007, 911‐09‐032, 1RC2 MH089995, 10‐000‐1002)
- Vrije Universiteit Amsterdam (2008.024)
- Bundesministerium für Bildung und Forschung (01ZZ9603, 01ZZ0103, and 01ZZ0403, 01ZX1314G, 01GS08147, 03ZIK012, 01ZZ0403, and 01ZZ0403, 01ZX1314D, 01GS08144, 01ZZ0103, 01ZX1314A, 01ZZ9603)
- Albert-Ludwigs-Universität Freiburg
- Gentofte Hospital
- Dalhousie University
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (184021007, 10-000-1002, 56‐464‐14192, Spinozapremie 56-464-14192)
- GGZ inGeest
- Rivierduinen
- GGZ Friesland
- GGZ Drenthe
- Nederlands Instituut voor Onderzoek van de Gezondheidszorg (10-000-1002)
- Lundbeckfonden
- University of Toronto
- Università degli Studi di Trento
- Karolinska Institutet
- Novo Nordisk
- Vetenskapsrådet (M-2005-1112)
- Westfälische Wilhelms-Universität Münster
- Leids Universitair Medisch Centrum
- Universitair Medisch Centrum Groningen
- Rigshospitalet
- Region Hovedstaden
- Háskóli Íslands
- Dokuz Eylül Üniversitesi
- Universidad de Granada
- Tartu Ülikool
- Rheinische Friedrich-Wilhelms-Universität Bonn
- Chinese Society of Clinical Oncology
- Siemens Healthineers (01ZZ0103, 01ZZ0403, 01ZZ9603)
- H. Lundbeck A/S
- Centre for Cognitive Ageing and Cognitive Epidemiology
- Universität Greifswald
- Ministry of Cultural Affairs
- National Institutes of Health (184.021.007, 389875, EU/QLRT-2001-01254, 1s10od018164-01, 1r01mh081802-01, MH66206, N01MH90003, AA13321, MH059542, AA13320, MH059541, DA12854)
- School of Medicine, Emory University
- University of North Carolina at Chapel Hill
- University of California, San Diego
- McDonnell Center for Systems Neuroscience
- Stanley Center for Psychiatric Research, Broad Institute
- Department of Psychiatry, University of Toronto
- Medical Research Council (G0701420, MR/K026992/1)
- Australian Research Council (FT0991360, FT0991022, 389875, QLG2-CT-2002-01254)
- Queensland Brain Institute
- Institute of Molecular and Cell Biology
- Statens Serum Institut
- Medizinische Fakultät der Albert-Ludwigs-Universität Freiburg
- National Institute on Alcohol Abuse and Alcoholism (R01AA014041, R01AA007535)
- National Institute of Mental Health (MH66206, MH068457, N01‐MH‐90003, U01MH109528, MH-081802, RC2MH089995, MH089951, MH109532, U24MH068457, MH085520, R01MH060912, U01MH109532, R01MH059552, RC2MH089951, R01MH061686, MH089995, R01MH080403)
- National Institute on Drug Abuse (K08DA019951)
- National Cancer Institute
- National Institute of Diabetes and Digestive and Kidney Diseases (U01DK066134)
- Janssen Research and Development
- Institute of Genetics
- Division of Cancer Epidemiology and Genetics, National Cancer Institute
- NHLBI Division of Intramural Research
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- major depressive disorder, atypical depression, obesity, genetic correlation, body mass index, C-reactive protein, leptin, polygenic risk, genetic overlap, Psychiatric Genomics Consortium, heritability
- MeSH terms
- Adult, C-Reactive Protein, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, International Cooperation, Male, Obesity, Psychiatric Status Rating Scales, Weight Gain, Body Mass Index, Genetic Predisposition to Disease, Diagnostic and Statistical Manual of Mental Disorders, Genome-Wide Association Study, Craving
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