Abstract
BackgroundBody image disturbance is an increasing problem in Western societies and is associated with a number of mental health outcomes including anorexia, bulimia, body dysmorphia, and depression. The aim of this study was to assess the association between body image disturbance and the incidence of depression.MethodsThis study included 10,286 participants from a dynamic prospective cohort of Spanish university graduates, who were followed-up for a median period of 4.2 years (Seguimiento Universidad de Navarra – the SUN study). The key characteristic of the study is the permanently open recruitment that started in 1999. The baseline questionnaire included information about body mass index (BMI) and the nine figure schemes that were used to assess body size perception. These variables were grouped according to recommended classifications and the difference between BMI and body size perception was considered as a proxy of body image disturbance. A subject was classified as an incident case of depression if he/she was initially free of depression and reported a physician-made diagnosis of depression and/or the use of antidepressant medication in at least one of the follow-up questionnaires. The association between body image disturbance and the incidence of depression was estimated by calculating the multivariable adjusted Odds Ratio (OR) and its 95% Confidence Interval (95% CI), using logistic regression models.ResultsThe cumulative incidence of depression during follow-up in the cohort was 4.8%. Men who underestimated their body size had a high percentage of overweight and obesity (50.1% and 12.6%, respectively), whereas women who overestimated their body size had a high percentage of underweight (87.6%). The underestimation exhibited a negative association with the incidence of depression among women (OR: 0.72, 95% CI: 0.54 – 0.95), but this effect disappeared after adjusting for possible confounding variables. The proportion of participants who correctly perceived their body size was high (53.3%) and gross misperception was seldom found, with most cases selecting only one silhouette below (42.7%) or above (2.6%) their actual BMI.ConclusionWe found no association between body image disturbance and subsequent depression in a cohort of university graduates in Spain.
Highlights
Body image disturbance is an increasing problem in Western societies and is associated with a number of mental health outcomes including anorexia, bulimia, bodydysmorphia, and depression
We found no association between body image disturbance and subsequent depression in a cohort of university graduates in Spain
Three hundred thirty eight participants initially free of depression reported a medical diagnosis of depression during this period (95 men and 243 women)
Summary
Body image disturbance is an increasing problem in Western societies and is associated with a number of mental health outcomes including anorexia, bulimia, bodydysmorphia, and depression. Aesthetic standards typical of Western cultures, based on the stereotype of a lean body for women and a muscular body for men, are considered possible determinants of body image disturbance [8, 9]. Some reports in the scientific literature have found an association between body image disturbance and a number of mental health outcomes including depression [12,13,14,15,16,17], anorexia [12,13,14], bulimia [12,13,14], and body dysmorphia [16]. There is an estimated 150 million people around the world who suffer from this disease, and it is the first and the fourth cause of morbidity among women and men, respectively [18]
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