Journal of The Korean Society of Maternal and Child Health (한국모자보건학회지)

The Korean Society of Maternal and Child Health (한국모자보건학회)
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Depression, Stress and How They are Related with Health Behaviors and Metabolic Syndrome among Women Over 40 Years

40세 이상 여성에서 우울, 스트레스와 건강행동 및 대사증후군의 관련성

  • Jeon, Jin Hyeg (Daegu Catholic University Hospital, Department of Family Medicine) ;
  • Kim, Sung Hi (Daegu Catholic University Hospital, Department of Family Medicine)
  • 전진혁 (대구가톨릭대학교병원 가정의학과) ;
  • 김성희 (대구가톨릭대학교병원 가정의학과)
  • Published : 2012.07.31
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Abstract

Objectives: In this study, the relationship between psychologic factors (depression and stress) and health behaviors, metabolic syndrome were evaluated. Methods: The study population was 1,559 women, aged over 40 years, April to December in 2009. We used modified National Cholesterol Education Program Adult Treatment Panel-III (modified NCEP ATP-lll) criteria for metabolic syndrome, Center for Epidemiologic Studies-Depression scale (CES-D) for depression and Psychosocial Wellbeing Index-Short Form (PWI-SF) for stress. Analysis of covariance (ANCOVA) were used to compare the mean scores of depression, stress by the number of metabolic syndrome components present. Logistic regression analyses were used to explore the variables associated with depression, stress, health behaviors and metabolic syndrome. Results: The prevalence of depression, stress and metabolic syndrome were 18.8%, 15.8%, 22.1%. Metabolic syndrome and negative health behaviors were more frequently observed in depressed and stressed groups. CES-D and PWI-SF scores increased with the number of components metabolic syndrome present. After covariates (age, education) adjusted, the odds ratios of bad health behaviors with depression and stress were 1.67 (95% CI=1.21~2.28) and 2.77 (95% CI=1.15~2.55). After covariates (age, education, BMI, smoking, drinking, exercise) adjusted, the odds ratios of metabolic syndrome with depression and stress were 1.48 (95% CI=1.07~2.06) and 1.75 (95 % CI=1.23~2.48). Conclusion: Depression and stress were independently associated with health behaviors and metabolic syndrome.

Keywords

References

  1. Bae SW, Shin WS. The Factor Structure of the CESD Scale (The Center for Epidemiologic Studies-Depression Scale): An Application of Confirmatory Factor Analysis. Health and Social Science 2005;18(1):165-190
  2. Cho JJ, Byun JS. Occupational Stress on Risk Factors for Cardiovascular Diseases and Metabolic Syndrome. Korean Society of Occupational and Environmental Medicine 2006;18(3):209-220
  3. Kim JE, Choi YS, Kim SM, Kim JA, Kim SY et al. Correlation Between Metabolic Syndrome and Depression according to BDI (Beck's Depression Inventory). Korean Journal of Health Promotion 2007;7(1):52-59
  4. Lee CY, Lee JY. Reliability and Validity of PWI (Psychosocial Wellbeing Index). Peventive Medicine 1996;29(2):255-264
  5. Sung KW, Lee JH. The Effects of Regular Walking Exercise on Metabolic Syndrome, Cardiovascular Risk Factors, and Depressive Symptoms in the Elderly with Diabetic. Korean Academy of Communuty Health Nursing 2010;21(4):409-418
  6. Yoon DH, Park JH, Cho SC, Park MJ, Kim SS et al. Depressive Symptomatology and Metabolic Syndrome in Korean Women. Korean Society for the Study of Obesity 2005;14(4):213-222
  7. Adriaanse MC, Dekker JM, Nijpels G, Heine RJ, Snoek FJ, Pouwer F. Associations between depressive symptoms and insulin resistance: the Hoorn Study. Diabetologia 2006;49(12):2874-2877 https://doi.org/10.1007/s00125-006-0500-4
  8. Ahola AJ, Thorn LM, Saraheimo M, Forsblom C, Groop PH. Depression is associated with the metabolic syndrome among patients with type 1 diabetes. Ann Med 2010;42(7):495-501 https://doi.org/10.3109/07853890.2010.503660
  9. Anisman H. Cascading effects of stressors and inflammatory immune system activation: implications for major depressive disorder. J Psychiatry Neurosci 2009;34(1):4-20
  10. Bauer ME. Chronic stress and immunosenescence: a review. Neuroimmunomodulation 2008;15(4-6):241-250 https://doi.org/10.1159/000156467
  11. Bianchi C, Penno G, Daniele G, Benzi L, Del Prato S, Miccoli R. Optimizing management of metabolic syndrome to reduce risk: focus on life-style. Internal And Emergency Medicine 2008;3(2):87-98 https://doi.org/10.1007/s11739-008-0122-6
  12. Cohen BE, Panguluri P, Na B, Whooley MA. Psychological risk factors and the metabolic syndrome in patients with coronary heart disease: findings from the Heart and Soul Study. Psychiatry Res 2010;175(1-2):133-137 https://doi.org/10.1016/j.psychres.2009.02.004
  13. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346(6):393-340 https://doi.org/10.1056/NEJMoa012512
  14. Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344(18):1343-1350 https://doi.org/10.1056/NEJM200105033441801
  15. Goldbacher EM, Edie M, Matthews, Karen A. Are Psychological Characteristics Related to Risk of the Metabolic Syndrome? A Review of the Literature Annals of Behavioral Medicine 2007;34:240-252 https://doi.org/10.1007/BF02874549
  16. Hartley TA, Knox SS, Fekedulegn D, Barbosa-Leiker C, Violanti JM, Andrew ME et al. Association between depressive symptoms and metabolic syndrome in police officers: results from two crosssectional studies. J Environ Public Health 2012:8612-8619
  17. Herman M, van Praag HM. Can stress cause depression? World J Biol Psychiatry 2005;6(2):5-22
  18. Heuser I. Depression, endocrinologically a syndrome of premature aging? Maturitas 2002;1:19-23
  19. Holsboer F. Stress, hypercortisolism and corticosteroid receptors in depression: implications for therapy. J Affect Disord 2001;62(1-2):77-91 https://doi.org/10.1016/S0165-0327(00)00352-9
  20. Lakka TA, Laaksonen DE. Physical activity in prevention and treatment of the metabolic syndrome. Applied Physiology, Nutrition & Metabolism 2007;32:76-88
  21. Laudisio A, Marzetti E, Pagano F, Pozzi G, Bernabei R et al. Depressive symptoms and metabolic syndrome: selective association in older women. J Geriatr Psychiatry Neurol 2009;22(4):215-222 https://doi.org/10.1177/0891988709335793
  22. Muhtz C, Zyriax BC, Klähn T, Windler E, Otte C. Depressive symptoms and metabolic risk: effects of cortisol and gender. Psychoneuroendocrinology 2009;34(7):1004-1111 https://doi.org/10.1016/j.psyneuen.2009.01.016
  23. Murphy JM, Horton NJ, Burke Jr JD, Monson RR, Laird NM, Lesage A, et al. Obesity and weight gain in relation to depression: findings from the Stirling County Study. International Journal of Obesity 2009;33(3):335-341 https://doi.org/10.1038/ijo.2008.273
  24. Orchard TJ, Temprosa M, Goldberg R, Haffner S, Ratner R, Marcovina S, et al. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann Intern Med 2005;142(8):611-619 https://doi.org/10.7326/0003-4819-142-8-200504190-00009
  25. Owen M, Wolkowitz OM, Epel ES, Reus VI, Mellon SH. Depression gets old fast: do stress and depression accelerate cell aging? Depress Anxiety 2010;27(4):327-338 https://doi.org/10.1002/da.20686
  26. Pouwer F, Kupper N, Adriaanse MC. Does emotional stress cause type 2 diabetes mellitus? A review from the European Depression in Diabetes. Discov Med 2010;9(45):112-118
  27. Rasmusson AM, Schnurr PP, Zukowska Z, Scioli E, Forman DE, Adaptation to extreme stress: posttraumatic stress disorder, neuropeptide Y and metabolic syndrome. Exp Biol Med 2010;235(10):1150-1162 https://doi.org/10.1258/ebm.2010.009334
  28. Reaven GM. Role of insuline resitance in human disease. Diabetes 1988;37(12):1595-1607 https://doi.org/10.2337/diabetes.37.12.1595
  29. Roland Rosmond. Role of stress in the pathogenesis of the metabolic syndrome. Psychoneuroendocrinology 2005;30:1-10 https://doi.org/10.1016/j.psyneuen.2004.05.007
  30. Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation 1999;99(16):2192-2217 https://doi.org/10.1161/01.CIR.99.16.2192
  31. Scott M. Grundy, James I. Cleeman, C. Noel Bairey Merz, H. Bryan Brewer, Luther T. Clark, Donald B. Hunninghake, et al. ATP III Update 2004: Implications of Recent Clinical Trials for the ATP III Guidelines. Circulation 2004;110:227-239 https://doi.org/10.1161/01.CIR.0000133317.49796.0E
  32. Sung-Woo Bae, Won-Shik Shin. The Factor Structure of the CES-D Scale(The Center for Epidemiologic Studies-Depression Scale): An Application of Confirmatory Factor Analysis. Health and social science 2005;18:165-190
  33. Troxel WM, Matthews KA, Gallo LC, Kuller LH. Marital quality and occurance of the metabolic syndrome in women. Arch Intern Med 2005;165:1022-1027 https://doi.org/10.1001/archinte.165.9.1022
  34. Toker S, Shirom A, Melamed S. Depression and the metabolic syndrome: gender-dependent associations. Depress Anxiety 2008;25(8):661-669 https://doi.org/10.1002/da.20379
  35. Vaccarino V, McClure C, Johnson BD, Sheps DS, Bittner V, Rutledge T et al. Psychosom Med 2008;70(1):40-48
  36. Vanhala M, Jokelainen J, Keinänen-K S, Kumpusalo E, Koponen H. Depressive symptoms predispose females to metabolic syndrome: a 7-year followup study. Acta Psychiatr Scand 2009;119(2):137-142 https://doi.org/10.1111/j.1600-0447.2008.01283.x
  37. Vogelzangs N, Beekman AT, Boelhouwer IG, Bandinelli S, Milaneschi Y, Ferrucci L et al. Metabolic depression: a chronic depressive subtype? Findings from the In CHIANTI study of older persons. J Clin Psychiatry 2011;72(5):598-604 https://doi.org/10.4088/JCP.10m06559
  38. Wolkowitz OM, Epel ES, Reus VI, Mellon SH. Depression gets old fast: do stress and depression accelerate cell aging? Depress Anxiety 2010;27(4):327-328 https://doi.org/10.1002/da.20686