Introduction

Cognitive behavioural therapy (CBT) is an established first-line treatment for depression; however, it remains unclear which factors predict a positive outcome with this approach. Prior work suggests that co-morbid obesity predicts a poorer response to antidepressant medication. The current study examined whether there is an association between weight parameters and improvement of depressive symptoms with CBT.

Methods

This was a secondary analysis of data from the “Clinical and Biological Markers of Response to Cognitive Behavioural Therapy for Depression – 6” (CANBIND-6; https://clinicaltrials.gov/ct2/show/NCT02883257) study. Adult participants (n = 41) with a diagnosis of Major Depressive Disorder (MDD) or Persistent Depressive Disorder (PDD) were recruited from an outpatient tertiary psychiatric centre in Canada. Participants completed 20 individual sessions of CBT over 16 weeks. The primary measure for treatment outcome was the Montgomery–Åsberg Depression Rating Scale (MADRS) total score at week 16.

Results

Thirty-seven participants completed assessments pre and post CBT. Baseline weight parameters were not correlated with treatment response to CBT in the entire group. There was a significant sex*waist circumference (WC) (B:-1.34; p = 0.004) and sex*body mass index (BMI) interaction (B:-2.03; p:0.009). In female participants, baseline waist circumference, but not BMI, significantly predicted week 16 MADRS after controlling for age and baseline MADRS (B:0.422 p:0.049).

Limitations

The major limitation of our preliminary finding is the small sample size.

Conclusion

Our preliminary findings suggest that higher waist circumference may be associated with a better treatment response to CBT for depression in females. This result could be of clinical relevance and warrants further investigation in larger and independent samples.

中文翻译：

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与女性抑郁症认知行为治疗反应相关的代谢变量：加拿大抑郁症生物标志物整合网络 (CAN-BIND) 研究

介绍

认知行为疗法 (CBT) 是一种成熟的抑郁症一线治疗方法；然而，目前尚不清楚哪些因素可以预测这种方法的积极结果。先前的工作表明，合并症肥胖预示着对抗抑郁药物的反应较差。目前的研究检查了体重参数与 CBT 抑郁症状改善之间是否存在关联。

方法

这是对“抑郁症认知行为疗法反应的临床和生物标志物 – 6”（CANBIND-6；https://clinicaltrials.gov/ct2/show/NCT02883257）研究数据的二次分析。从加拿大的门诊三级精神病中心招募了诊断为重度抑郁症 (MDD) 或持续性抑郁症 (PDD) 的成年参与者 (n = 41)。参与者在 16 周内完成了 20 个单独的 CBT 课程。治疗结果的主要衡量标准是第 16 周的蒙哥马利-奥斯伯格抑郁量表 (MADRS) 总分。

结果

37 名参与者完成了 CBT 前后的评估。在整个组中，基线体重参数与对 CBT 的治疗反应无​​关。性别*腰围 (WC) (B:-1.34; p = 0.004) 和性别*体重指数 (BMI) 交互作用显着 (B:-2.03; p:0.009)。在女性参与者中，在控制年龄和基线 MADRS 后，基线腰围而非 BMI 显着预测了第 16 周的 MADRS（B：0.422 p：0.049）。

限制

我们初步发现的主要限制是样本量小。

结论

我们的初步研究结果表明，较高的腰围可能与对女性抑郁症的 CBT 更好的治疗反应有关。该结果可能具有临床相关性，值得在更大的独立样本中进行进一步研究。