Your type of depression could shape your body’s future health

Over a seven-year period, researchers followed 5,794 adults who participated in the Netherlands Epidemiology of Obesity (NEO) Study. None of the participants had diabetes or cardiovascular disease when the study began. Each person completed a detailed questionnaire assessing depressive symptoms. Based on these responses, the researchers identified two main types of depression: one characterized by "melancholic" features (including early morning awakening and loss of appetite) and another defined by "atypical/energy-related" features (such as fatigue, increased sleep, and higher appetite).

During the study, about 8% of participants developed a cardiometabolic disorder. The specific illness that appeared, however, depended on the kind of depression they had. Individuals with "atypical/energy-related" depression were roughly 2.7 times more likely to develop Type 2 diabetes than those without depressive symptoms, but they did not face a higher risk of cardiovascular disease.

By contrast, participants with "melancholic" depression were about 1.5 times more likely to experience cardiovascular disease (including heart attack or stroke) than those without depression, but they did not have a significantly greater risk of Type 2 diabetes.

Lead researcher Dr. Yuri Milaneschi (Amsterdam UNC) explained:

"Further metabolic analysis revealed that patients with the atypical/energy-related symptoms showed disruptions in inflammatory and metabolic processes linked to cardiometabolic health. This biological signature was not seen in those with "melancholic" symptoms, suggesting biochemical differences in the way that different types of depression link to cardiovascular health.

We already knew that not all depressions are the same, but this means that we may need to consider how the type of depression someone has impacts different areas of their physical health. It very much pushes us towards the idea of precision psychiatry -- the idea that we need to look for physical associations with mental health profiles, so that we can better treat mental illness. To treat sufferers individually."

Commenting, Dr. Chiara Fabbri (of the University of Bologna) said:

"The prevention and treatment of physical diseases in people with depression are not less important than the treatment of depression. These physical conditions are common and expected to raise, for example the number of people with diabetes (66 million) in the EUR Region will see a 10% increase by 2050 according to the International Diabetes Federation. It is a health care priority to prevent cardiometabolic diseases, diagnose them early, and continue to improve monitoring and treatment. This study on the NEO cohort provides highly valuable data on how to do this better for people suffering from depressive symptoms."

Dr. Fabbri was not involved in this work; this is an independent comment.