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BMC Public Health

, 9:14

First Online: 13 January 2009Received: 12 June 2008Accepted: 13 January 2009DOI: 10.1186-1471-2458-9-14

Cite this article as: de Wit, L.M., van Straten, A., van Herten, M. et al. BMC Public Health 2009 9: 14. doi:10.1186-1471-2458-9-14


BackgroundResults of studies concerning the association between obesity and depression are conflicting. Some find a positive association, some a negative association and some find no association at all. Most studies, however, examine a linear association between Body Mass Index BMI and depression. The present study investigates if a nonlinear U-shaped trend is preferable over a linear trend to describe the relationship between BMI and depression, which means that both underweight and obesity are associated with depression.

MethodsWe investigated the existence of such a U-curve in a sample of 43,534 individuals, aged between 18–90 years, who participated in a cross-sectional study Continuous Survey of Living Conditions of physical and mental health in the general population of the Netherlands. We calculated linear and nonlinear quadratic ANOVA with polynomial contrast and curve fit regression statistics to investigate whether there was a U-shaped trend in the association between BMI and depression.

ResultsWe find a very significant U-shaped association between BMI categories underweight, normal, overweight and obesity and depression p ≤ 0.001. There is a trend indicating a significant difference in the association between males and females p = 0.05. We find a very significant U-shaped quadratic association between BMI BMI and depression p ≤ 0.001, continuous BMI is not linearly associated with depression p = 0.514.

ConclusionThe results of this study give evidence for a significant U-shaped trend in the association between BMI and depression.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2458-9-14 contains supplementary material, which is available to authorized users.

Annemieke van Straten, Marieke van Herten, Brenda WJH Penninx and Pim Cuijpers contributed equally to this work.

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Author: Leonore M de Wit - Annemieke van Straten - Marieke van Herten - Brenda WJH Penninx - Pim Cuijpers



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