Research report Lifetime psychiatric disorders and body composition: A population-based study Lana J. Williams a, ⁎, Julie A. Pasco a , Margaret J. Henry a , Felice N. Jacka a , Seetal Dodd a , Geoffrey C. Nicholson a , Mark A. Kotowicz a , Michael Berk a,b,c a Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, PO Box 281, Geelong 3220, Australia b Orygen Research Centre, Parkville, Australia c Mental Health Research Institute, Parkville, Australia article info abstract Article history: Received 10 December 2008 Received in revised form 1 February 2009 Accepted 2 February 2009 Available online 26 February 2009 Background: This study aimed to investigate the relationship between depressive and anxiety disorders and indices of adiposity, including body fat mass and percent body fat, as measured by dual energy X-ray absorptiometry. Methods: In this observational study of 979 randomly-selected women aged 20–93 years, psychiatric history was ascertained using a structured clinical interview (SCID-I/NP). Total body fat was assessed using dual-energy X-ray absorptiometry and weight, height and waist circumference were measured. Medication use and lifestyle factors were self-reported. Results: Those with a lifetime history of depression had increased fat mass (+7.4%) and percent body fat (+ 4.3%), as well as greater mean weight (+ 3.3%), waist circumference (+2.9%) and BMI (+3.5%) after adjustment for age, anxiety, alcohol consumption, physical activity and past smoking. Furthermore, those meeting criteria for a lifetime history of depression had a 1.7-fold increased odds of being overweight or obese (BMI ≥ 25), a 2.0-fold increased odds of being obese (BMI ≥ 30) and a 1.8-fold increased odds of having a waist circumference ≥80 cm. These patterns persisted after further adjustment for psychotropic medication use, smoking status and energy intake. No differences in any measures of adiposity were observed among those with anxiety disorders compared to controls. Limitations: There is potential for unrecognised confounding, interpretations are limited to women and a temporal relationship could not be inferred. Conclusions: Depression was associated with greater adiposity. The difference in body fat mass was numerically greater than differences in indirect measures of adiposity, suggesting that the latter may underestimate the extent of adiposity in this population. © 2009 Elsevier B.V. All rights reserved. Keywords: Depressive disorders Anxiety disorders Body composition Adiposity Psychiatric epidemiology Imaging techniques 1. Introduction Although the adverse impact of obesity on a host of chronic physical ailments and all causes mortality have been well characterised (Kopelman, 2000), less is known about the relationship between body composition and psychiatric disorders. Given the public health implications of obesity, the association with psychiatric illness is of significant importance. Cross-sectional studies have reported increased body mass index (BMI) and waist circumference among women with depression (Kloiber et al., 2007; Carpenter et al., 2000). However, others have found no association (Hach et al., 2006), or a gender- specific relationship, with either no association or lower BMI seen only in men with major depression disorder (MDD) (Mcintyre et al., 2006; Carpenter et al., 2000; Raikkonen et al., 1994). Previous studies have suggested that 40% to 70% of individuals with depressive disorders or symptoms are overweight or obese Journal of Affective Disorders 118 (2009) 173–179 ⁎ Corresponding author. Tel.: +61 3 5260 3085; fax: +613 5246 5165. E-mail address: lanaw@barwonhealth.org.au (L.J. Williams). 0165-0327/$ – see front matter © 2009 Elsevier B.V. All rights reserved. doi:10.1016/j.jad.2009.02.001 Contents lists available at ScienceDirect Journal of Affective Disorders journal homepage: www.elsevier.com/locate/jad