Abstract
BackgroundDepression and obesity are two major conditions with both psychological and somatic burdens. Some data suggest strong connections between depression and obesity and more particularly associated prevalence of both disorders. However, little is known about the geographical distribution of these two diseases. This study aimed to determine if there is spatial overlap between obesity and depression using data from the entire French territory.MethodsData for 5,627 geographic codes for metropolitan France were collected from the two national hospital databases (PMSI-MCO and RIM-P) for the year 2016. We identified people who were depressed, obese or both registered in the two public medico-administrative databases, and we assessed their location. In addition, a multivariable analysis was performed in order to determine geographic interactions between obesity and depression after controlling for age, sex, environmental and socio-economic factors (social/material deprivation, urbanicity/rurality).Results1,045,682 people aged 18 years and older were identified. The mapping analysis showed several cold and hot regional clusters of coinciding obesity and depression. The multivariable analysis demonstrated significant geographic interactions, with an increasing probability of finding a high prevalence of obesity in regions with major depression (OR 1.29 95% CI 1.13–1.49, p = 0.0002) and an increased probability of finding a high prevalence of depression in regions with a high ration of obesity (OR 1.32, 95% CI 1.15–1.52, p<0.0001).ConclusionOur study confirms the significant bidirectional relationships between obesity and depression at a group level. French geographic patterns reveal a partial overlap between obesity and depression, suggesting these two diseases can be included in a common approach. Further studies should be done to increase the understanding of this complex comorbidity.
Highlights
In Western countries, depression and obesity are two highly prevalent medical conditions with major psychological and somatic burdens [1,2]
We identified people who were depressed, obese or both registered in the two public medico-administrative databases, and we assessed their location
Data from the European Study of the Epidemiology of Mental Disorders [3] demonstrated that a person living in France was more likely to develop a mood disorder than someone in Germany, Italy or Spain, illustrating the importance of this question throughout the French territory
Summary
In Western countries, depression and obesity are two highly prevalent medical conditions with major psychological and somatic burdens [1,2]. Data from the European Study of the Epidemiology of Mental Disorders [3] demonstrated that a person living in France was more likely to develop a mood disorder than someone in Germany, Italy or Spain, illustrating the importance of this question throughout the French territory Obesity is another major public health issue in France where the prevalence has reached 15%, affecting nearly 9 million people. A growing body of literature sustains that depression and obesity share some epidemiological, clinical and biological pathways [5,6,7,8,9] in a bidirectional manner, with obesity increasing the risk of depression and depression increasing the risk of obesity in prospective studies Factors such as inadequate health habits, shared biological disturbances (i.e. low-grade inflammation, HPA axis dysfunction, neuroendocrine disorders, brain disorders, gut-brain microbiota axis troubles) and common psychological determinants (e.g. early trauma, deprived environment or inadequate coping strategies) [10,11,12] are often related to the development of both depression and obesity [13]. This study aimed to determine if there is spatial overlap between obesity and depression using data from the entire French territory
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