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Is there a "metabolic-mood syndrome"? A review of the relationship between obesity and mood disorders.

Abstract

Obesity and mood disorders are highly prevalent and co-morbid. Epidemiological studies have highlighted the public health relevance of this association, insofar as both conditions and its co-occurrence are associated with a staggering illness-associated burden. Accumulating evidence indicates that obesity and mood disorders are intrinsically linked and share a series of clinical, neurobiological, genetic and environmental factors. The relationship of these conditions has been described as convergent and bidirectional; and some authors have attempted to describe a specific subtype of mood disorders characterized by a higher incidence of obesity and metabolic problems. However, the nature of this association remains poorly understood. There are significant inconsistencies in the studies evaluating metabolic and mood disorders; and, as a result, several questions persist about the validity and the generalizability of the findings. An important limitation in this area of research is the noteworthy phenotypic and pathophysiological heterogeneity of metabolic and mood disorders. Although clinically useful, categorical classifications in both conditions have limited heuristic value and its use hinders a more comprehensive understanding of the association between metabolic and mood disorders. A recent trend in psychiatry is to move toward a domain specific approach, wherein psychopathology constructs are agnostic to DSM-defined diagnostic categories and, instead, there is an effort to categorize domains based on pathogenic substrates, as proposed by the National Institute of Mental Health (NIMH) Research Domain Criteria Project (RDoC). Moreover, the substrates subserving psychopathology seems to be unspecific and extend into other medical illnesses that share in common brain consequences, which includes metabolic disorders. Overall, accumulating evidence indicates that there is a consistent association of multiple abnormalities in neuropsychological constructs, as well as correspondent brain abnormalities, with broad-based metabolic dysfunction, suggesting, therefore, that the existence of a "metabolic-mood syndrome" is possible. Nonetheless, empirical evidence is necessary to support and develop this concept. Future research should focus on dimensional constructs and employ integrative, multidisciplinary and multimodal approaches.

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  • Authors+Show Affiliations

    ,

    Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil. Electronic address: rodrigomansur71@uol.com.br.

    ,

    Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.

    Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada.

    Source

    MeSH

    Brain
    Environment
    Humans
    Mood Disorders
    Obesity
    Phenotype
    Risk Factors

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    25579847

    Citation

    Mansur, Rodrigo B., et al. "Is There a "metabolic-mood Syndrome"? a Review of the Relationship Between Obesity and Mood Disorders." Neuroscience and Biobehavioral Reviews, vol. 52, 2015, pp. 89-104.
    Mansur RB, Brietzke E, McIntyre RS. Is there a "metabolic-mood syndrome"? A review of the relationship between obesity and mood disorders. Neurosci Biobehav Rev. 2015;52:89-104.
    Mansur, R. B., Brietzke, E., & McIntyre, R. S. (2015). Is there a "metabolic-mood syndrome"? A review of the relationship between obesity and mood disorders. Neuroscience and Biobehavioral Reviews, 52, pp. 89-104. doi:10.1016/j.neubiorev.2014.12.017.
    Mansur RB, Brietzke E, McIntyre RS. Is There a "metabolic-mood Syndrome"? a Review of the Relationship Between Obesity and Mood Disorders. Neurosci Biobehav Rev. 2015;52:89-104. PubMed PMID: 25579847.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Is there a "metabolic-mood syndrome"? A review of the relationship between obesity and mood disorders. AU - Mansur,Rodrigo B, AU - Brietzke,Elisa, AU - McIntyre,Roger S, Y1 - 2015/01/08/ PY - 2014/04/23/received PY - 2014/12/19/revised PY - 2014/12/31/accepted PY - 2015/1/13/entrez PY - 2015/1/13/pubmed PY - 2015/12/31/medline KW - Bipolar disorder KW - Diabetes mellitus KW - Major depressive disorder KW - Metabolic syndrome KW - Metabolism KW - Mood disorders KW - Obesity KW - RDoC KW - Research domain criteria KW - Subtypes SP - 89 EP - 104 JF - Neuroscience and biobehavioral reviews JO - Neurosci Biobehav Rev VL - 52 N2 - Obesity and mood disorders are highly prevalent and co-morbid. Epidemiological studies have highlighted the public health relevance of this association, insofar as both conditions and its co-occurrence are associated with a staggering illness-associated burden. Accumulating evidence indicates that obesity and mood disorders are intrinsically linked and share a series of clinical, neurobiological, genetic and environmental factors. The relationship of these conditions has been described as convergent and bidirectional; and some authors have attempted to describe a specific subtype of mood disorders characterized by a higher incidence of obesity and metabolic problems. However, the nature of this association remains poorly understood. There are significant inconsistencies in the studies evaluating metabolic and mood disorders; and, as a result, several questions persist about the validity and the generalizability of the findings. An important limitation in this area of research is the noteworthy phenotypic and pathophysiological heterogeneity of metabolic and mood disorders. Although clinically useful, categorical classifications in both conditions have limited heuristic value and its use hinders a more comprehensive understanding of the association between metabolic and mood disorders. A recent trend in psychiatry is to move toward a domain specific approach, wherein psychopathology constructs are agnostic to DSM-defined diagnostic categories and, instead, there is an effort to categorize domains based on pathogenic substrates, as proposed by the National Institute of Mental Health (NIMH) Research Domain Criteria Project (RDoC). Moreover, the substrates subserving psychopathology seems to be unspecific and extend into other medical illnesses that share in common brain consequences, which includes metabolic disorders. Overall, accumulating evidence indicates that there is a consistent association of multiple abnormalities in neuropsychological constructs, as well as correspondent brain abnormalities, with broad-based metabolic dysfunction, suggesting, therefore, that the existence of a "metabolic-mood syndrome" is possible. Nonetheless, empirical evidence is necessary to support and develop this concept. Future research should focus on dimensional constructs and employ integrative, multidisciplinary and multimodal approaches. SN - 1873-7528 UR - https://www.unboundmedicine.com/medline/citation/25579847/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0149-7634(15)00002-0 DB - PRIME DP - Unbound Medicine ER -