Group Of Depressed Patients Research Articles

Autobiographical Memory Specificity in Patients with Tinnitus Versus Patients with Depression and Normal Controls

Several studies show that patients with depression and post-traumatic stress disorder respond with fewer specific autobiographical memories in a cued memory task (i.e. the autobiographical memory test; AMT) compared to healthy controls. One previous study found this phenomenon among tinnitus patients as well (Andersson, Ingerholt, & Jansson, 2003). The aim of this study was to replicate the previous study with an additional control group of depressed patients and memory errors as measured with the AMT as an additional outcome. We included 20 normal hearing tinnitus patients, 20 healthy controls and 20 persons diagnosed with clinical depression. The AMT was administered together with self-report measures of depression, anxiety and tinnitus distress. Both the tinnitus and depression groups differed from the healthy control group in that they reported fewer specific autobiographical memories. There were, however, differences between the tinnitus and depression groups in terms of the errors made on the AMT. The depression group had more overgeneral memories than the normal control group, whereas the tinnitus group did not differ from the control group on this memory error. The tinnitus group had more semantic associations and non-memories than the other two groups, suggesting that executive functioning may play a role for the tinnitus group when completing the AMT. Clinical and theoretical implications of the findings are discussed.

Characteristics of Depressed Patients Treated in Rural Areas of Chile

Objective: To describe a group of depressed patients that participated in a clinical intervention to improve depression treatment in rural areas. Materials and Methods: It is a clinical intervention for depressed patients from 15 rural hospitals. The principal outcome is depressive symptomatology measured with the Beck Depression Inventory (BDI), and the secondary outcome is quality of life. The intervention consists of a collaborative program between primary care teams and specialized teams, with support from an electronic platform and a call center. Results: 254 subjects—13.8% men and 86.2% women—were recruited, with an age range between 18 and 65 years. The majority had a stable partner and attended high school. Homemakers made up 47.4% of the sample, and 38.7% were employed. The average BDI score was 29.8 (s. d. = 9.2). There was a history of previous depressive episodes in 42.9% of the cases, 37.4% presented severe suicide risk, and 59.1% had a comorbid anxiety disorder. Conclusion: It is a clinical sample of patients with severe depressive symptoms who are treated by primary care physicians in rural zones. The sample had comorbid anxiety and poor quality of life associated with their mental illness.

Health-related quality of life in recurrent major depressive disorder—A 10-year follow-up study

Årdal G, Lund A, Hammar Å. Health-related quality of life in recurrent major depressive disorder—A 10-year follow-up study. Nord J Psychiatry 2012;Early online:1–5. Background: Major depressive disorder strongly affects health-related quality of life (HRQOL). Few studies have followed patients suffering recurrent major depressive disorder (rMDD) and paid attention to HRQOL in remitted state. Aim: The aim of the present study was to assess HRQOL in a 10-year longitudinal perspective in patients suffering rMDD, and comparable healthy control subjects. Results: The results show significant lowered HRQOL in depressed patients on all measured domains in the acute phase of illness. Conclusions: Although HRQOL in the depressed patient group significantly improved on most measures between the two assessments, the patient group still reported a significant lowered HRQOL compared with matched controls at the 10-year follow-up assessment. More research should focus on HRQOL after a depressive episode.

Sustained unemployment in psychiatric outpatients with bipolar depression compared to major depressive disorder with comorbid borderline personality disorder

The morbidity associated with bipolar disorder is, in part, responsible for repeated calls for improved detection and recognition. No such clinical commentary exists for improved detection of borderline personality disorder in depressed patients. Clinical experience suggests that borderline personality disorder is as disabling as bipolar disorder; however, no studies have directly compared the two disorders. For this reason we undertook the current analysis from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project comparing unemployment and disability rates in patients with bipolar disorder and borderline personality disorder. Patients were interviewed with semi-structured interviews. We compared three non-overlapping groups of depressed patients: (i) 181 patients with DSM-IV major depressive disorder and borderline personality disorder, (ii) 1068 patients with major depressive disorder without borderline personality disorder, and (iii) 84 patients with bipolar depression without borderline personality disorder. Compared to depressed patients without borderline personality disorder, depressed patients with borderline personality disorder were significantly more likely to have been persistently unemployed. A similar difference was found between patients with bipolar depression and major depressive disorder without borderline personality disorder. No differences were found between patients with bipolar depression and depression with borderline personality disorder. Both bipolar disorder and borderline personality disorder were associated with impaired occupational functioning and thus carry a significant public health burden. Efforts to improve detection of borderline personality disorder in depressed patients might be as important as the recognition of bipolar disorder.

Exposure to Antidepressant Medications and Suicide Attempts in Adult Depressed Inpatients

The effects of antidepressant medication on suicide risk remain unclear. This study explores any association between antidepressant medication and suicide attempts leading to hospitalization in adult depressed patients.The medical records of 103 patients admitted after a suicide attempt were examined and compared with those of a matched control group of depressed patients (n = 103) admitted without suicide attempts as well as a patient group with and without suicide attempts on separate hospitalizations (n = 25). No significant difference in antidepressant medication exposure before hospitalization was found between groups. Selective serotonin reuptake inhibitor exposure was higher in patients with suicide attempts, albeit nonsignificant, but was identical in patients admitted on two occasions with and without suicide attempts. The most common method for suicide attempt was drug overdose (52.4%). Patients in the group with suicide attempts had significantly more past suicide attempts. Study results do not confirm any relationship between antidepressants and suicide attempts. Close monitoring of depressed patients is advised especially in early treatment.

Sexual Arousal Difficulties in Women Treated with Antidepressants: A Comparison between Escitalopram and Fluoxetine

To compare the risk of sexual arousal difficulties between two groups of depressed female patients in remission who were treated with either escitalopram or fluoxetine. Associated factors were also examined. This was a cross-sectional study involving 112 female patients attending the psychiatric clinic, University Kebangsaan Malaysia Medical Centre (UKMMC) with depressive disorders as assessed by using the Structured Clinical Interview for DSM-IV (SCID), who had been in remission for the previous 2 months as defined by a score of < or = 10 from an assessment using the Montgomery-Asberg Depression Rating Scale (MADRS) and were treated with either fluoxetine or escitalopram. Sexual arousal difficulties were assessed using the arousal subscale of Malay Version of the Female Sexual Function Index (MVFSFI). The rate of sexual arousal difficulties was 41.1% for all subjects. Sexual arousal difficulties occurred in 50.0% of subjects treated with fluoxetine and 32.1% with escitalopram. However, this difference was not statistically significant (p = 0.055). Multivariate logistic regression analysis showed that higher dose of antidepressant (adjusted OR = 4.08, 95 CI = 1.70-9.81) was significantly associated with female sexual arousal difficulties. The risk of sexual arousal difficulties was higher in female patients who were treated with higher doses of either fluoxetine or escitalopram.

Increased IgA and IgM responses against gut commensals in chronic depression: Further evidence for increased bacterial translocation or leaky gut

Recently, we discovered that depression is accompanied by increased IgM and IgA responses directed against gram negative gut commensals. The aim of this study was to replicate these findings in a larger study group of depressed patients and to examine the associations between the IgA and IgM responses to gut commensals and staging of depression as well as the fatigue and somatic (F&S) symptoms of depression. We measured serum concentrations of IgM and IgA against the LPS of gram-negative enterobacteria, i.e. Hafnia alvei, Pseudomonas aeruginosa, Morganella morganii, Pseudomonas putida, Citrobacter koseri, and Klebsiella pneumoniae in 112 depressed patients and 28 normal controls. The severity of F&S symptoms was measured using the Fibromyalgia and Chronic Fatigue Syndrome Rating Scale. The prevalences and median values of serum IgM and IgA against LPS of these commensals were significantly higher in depressed patients than in controls. The IgM levels directed against the LPS of these commensal bacteria were significantly higher in patients with chronic depression than in those without. The immune responses directed against LPS were not associated with melancholia or recurrent depression. There was a significant correlation between the IgA response directed against LPS and gastro-intestinal symptoms. The results indicate that increased bacterial translocation with immune responses to the LPS of commensal bacteria may play a role in the pathophysiology of depression, particularly chronic depression. Bacterial translocation may a) occur secondary to systemic inflammation in depression and intensify and perpetuate the primary inflammatory response once the commensals are translocated; or b) be a primary trigger factor associated with the onset of depression in some vulnerable individuals. The findings suggest that "translocated" gut commensal bacteria activate immune cells to elicit IgA and IgM responses and that this phenomenon may play a role in the pathophysiology of (chronic) depression by causing progressive amplifications of immune pathways.

Plasma Metabonomics as a Novel Diagnostic Approach for Major Depressive Disorder

Major depressive disorder (MDD) is a socially detrimental psychiatric disorder, contributing to increased healthcare expenditures and suicide rates. However, no empirical laboratory-based tests are available to support the diagnosis of MDD. In this study, a NMR-based plasma metabonomic method for the diagnosis of MDD was tested. Proton nuclear magnetic resonance ((1)H NMR) spectra of plasma sampled from first-episode drug-naı̈ve depressed patients (n = 58) and healthy controls (n = 42) were recorded and analyzed by orthogonal partial least-squares discriminant analysis (OPLS-DA). The OPLS-DA score plots of the spectra demonstrated that the depressed patient group was significantly distinguishable from the healthy control group. Moreover, the method accurately diagnosed blinded samples (n = 26) in an independent replication cohort with a sensitivity and specificity of 92.8% and 83.3%, respectively. Taken together, NMR-based plasma metabonomics may offer an accurate empirical laboratory-based method applicable to the diagnosis of MDD.

P-1032 - Inflammation as a hypothetic mechanisms underlying depression in patients with chronic obstructive pulmonary disease

Introduction Depression is a highly prevalent comorbidity in patients suffering from chronic obstructive pulmonary disease (COPD). Both, depression and COPD are believed to be associated with inflammation. The aim of our study was to verify hypothesis that altered inflammatory response causes depression in patients with chronic obstructive pulmonary disease. Material and methods Blood was collected from 45 patients of whom 18 had COPD, 18 were depressed and 9 had COPD with comorbid depression. Total of 27 age and sex matched healthy controls were also included in the study. IL-2, IL-8 and IL-17A concentrations were assayed by ELISA technique in sera of all subjects. Results We observed significantly decreased concentration of IL-17A in a group of depressed patients (D) when compared with controls, 4.46 ± 0.573 pg/mL vs. 8.87 ± 1.182 pg/mL, respectively, P = 0.0005. Increased concentration of IL-2 in depressed patients (D) as compared with controls, 3.00 ± 0.223 pg/mL vs. 2.30 ± 0.176 pg/mL, respectively, P = 0.013 was also revealed. There was also increased concentration of IL-8 in COPD subjects if compared with controls and depression group, 4.55 ± 0.176 pg/mL vs. 3.71 ± .132 and 3.95 ± 0.118 pg/mL, respectively, P = 0.008. Conclusions The results from our study suggest that there is significant difference between depression and COPDs with respect to IL-8 concentration also a lower concentration of IL-17A was noticeable in depressed patients (P = 0.06). We need more data on depressed COPD patients to argue the role of inflammation on depression in COPD patients.

P-488 - Socio-demographic and clinical risk factors on the non-recovery of the major depressive disorder: a 52-week follow-up study

Unfortunately, many patients who remit fully or partially from an episode of major depression continue to have difficulty in achieving the recovery. Our study assesses the effect of some probable risk factors on the non-recovery in a group of major depressive patients. Sixty patients, 18 to 65 years of age, with current major depressive disorder defined using DSM-IV-TR criteria were participated in the study. They began a 24-week course of open-label acute plus continuation phase treatment mainly with SSRIs, especially escitalopram. Maintenance treatment was not planned for not affecting the natural course. All participants were evaluated by CGI-S, BDI, HAMD-17, PSQI, and ISI at weeks 0, 4, 12, 24, and 52. Logistic regression analysis was done to predict the effect of some probable risk factors that obtained from 1st evaluation (at week 0) on the non-recovery (at week 52) and current age, number of previous episodes, age of first depressive episode, and episode type (first-episode versus double or chronic or recurrent) were found to be statistically significant. Early recognition of the socio-demographic and clinical risk factors impairing the recovery process of the major depressive disorder may be important for developing an individualised treatment plan.

Depression uncouples brain hate circuit

It is increasingly recognized that we need a better understanding of how mental disorders such as depression alter the brain's functional connections to improve both early diagnosis and therapy. A new holistic approach has been used to investigate functional connectivity changes in the brains of patients suffering from major depression using resting-state functional magnetic resonance imaging (fMRI) data. A canonical template of connectivity in 90 different brain regions was constructed from healthy control subjects and this identified a six-community structure with each network corresponding to a different functional system. This template was compared with functional networks derived from fMRI scans of both first-episode and longer-term, drug resistant, patients suffering from severe depression. The greatest change in both groups of depressed patients was uncoupling of the so-called ‘hate circuit' involving the superior frontal gyrus, insula and putamen. Other major changes occurred in circuits related to risk and action responses, reward and emotion, attention and memory processing. A voxel-based morphometry analysis was also carried out but this revealed no evidence in the depressed patients for altered gray or white matter densities in the regions showing altered functional connectivity. This is the first evidence for the involvement of the ‘hate circuit' in depression and suggests a potential reappraisal of the key neural circuitry involved. We have hypothesized that this may reflect reduced cognitive control over negative feelings toward both self and others.

Ethnic and migrational impact on the clinical manifestation of depression

Depressive disorders are still underdiagnosed. Ethnic and cultural factors may influence the way depression is presented and therefore contribute to problems in assessing these disorders in different ethnic populations appropriately. In this investigation, the impact of both ethnicity and migration on the manifestation of depression was studied. Three groups of depressed female patients (n = 136) were included in this investigation on the variation in depressive symptomatology by ethnic groups. Group 1 consisted of Austrian patients living in Austria, group 2 were Turkish patients who had migrated to Austria and group 3 were Turkish patients living in Turkey. Participants were rated using the Montgomery-Åsberg Depression Rating Scale (MADRS), the Beck Depression Inventory (BDI), the Bradford Somatic Inventory (BSI) and an additional list of physical symptoms. Both Turkish groups had significantly higher BSI scores and more somatic symptom severity. Migrated Turkish patients scored significantly higher in the items headache, backache and dry mouth than Turkish patients in Turkey. In addition, there were between-group differences in non-physical symptoms. Depressive symptomatology varies between ethnic groups. These differences are mainly due to ethnicity as such but migration may play an additional role. It is essential for physicians to be aware of atypical presentation forms of depression in minority groups.

Patients with Major Depression Show Intact Memory Performance—Given Optimal Conditions

In the present study, verbal and visual memory functioning in a group of recurrent major depressive disorder patients were investigated. The study included 48 participants: 24 patients and 24 control subjects. Verbal and visual memory were investigated using the California Verbal Learning Test and the Rey Complex Figure Test. The results show that the depressed patients performed significantly worse compared with the controls on the very first trial in the verbal memory test. On all other conditions, the patients showed intact verbal memory, while visual memory was impaired. It is important to highlight the intact verbal memory performance in the acute phase of illness to detect cognitive strengths in this patient group.

Antidepressant-associated mania or hypomania: A comparison with personality and bipolarity features of bipolar I disorder

Hypomania/mania during antidepressant treatment is often neglected by clinicians. There are no specific diagnostic criteria for hypomania and mania associated by antidepressant treatment in the bipolar spectrum. The aim of this study is to compare various characteristics of bipolar I disorder and antidepressant-associated mania. In this study, 76 bipolar patients who met DSM-IV criteria for bipolar disorder-type I in remission from mania or depression (Group 1; n = 44) and patients with major depression in remission, who had mania associated by antidepressant treatment (Group 2; n = 32), were admitted. All patients were assessed using the SCID I, Bipolarity Index (BI) and a patient data form. First-degree relatives of all patients were evaluated using the Mood Disorder Questionnaire (MDQ). Sociodemographic features of both groups were similar. The rate of major depression in the relatives of Group 2 was significantly higher than in Group 1. The severity of manic symptoms in Group 2 was significantly lower than in Group 1. Those in Group 2 who were diagnosed with their first episode had atypical depressive features. First-degree relatives of patients in Group 1 had higher positive scores on the MDQ. A statistically significant difference was found between the two groups on all dimensions of the BI except family history. This is a cross-sectional study with a relatively small number of subjects. There is no control group of major depressive patients who did not develop mania during antidepressive treatment. Our results suggest that antidepressant-associated hypomania/mania could be a different subgroup in the bipolar spectrum.

Thrombocyte serotonin and serum cholesterol concentration in suicidal and non-suicidal depressed patients

Numerous studies have confirmed the connection of reduced serum cholesterol and thrombocyte serotonin concentration with suicidal behavior in psychiatric patients. The purpose of such studies was to determine the link among cholesterol and serotonin concentration, comparing depressed patients with and without attempted suicide with phenotypically healthy control group. The examinees' groups consisted of 55 depressed patients with suicide attempt and 77 depressed patients with no suicide attempt. In accordance to ICD-10, the above patients were separated in two subgroups; F32.2 and F33.2. Phenotypically healthy control group was presented by the group of healthy blood donors. The fasting serum cholesterol concentration was established using standard enzymatic method, while the thrombocyte serotonin concentration was determined by the enzymatic immune-chemical method (ELISA). The ANOVA test (N=228, F(ratio)=8.26, p<0.001) found significant difference of cholesterol concentration between groups, with lowest concentration in depressed patients with attempted suicide (SNK post hoc test, p<0.05). Upon gender stratification, the significance remained for the female patients (ANOVA, N=125, F(ratio)=6.06, p=0.003). The serum cholesterol was shown to be statistically lower in the group of depressed patients with attempted suicide, diagnoses F32.2 (p=0.031) and F33.2 (p=0.011), compared to the group of depressed patients without attempted suicides. The thrombocyte serotonin was found to be significantly different in all examined groups, with the lowest thrombocyte serotonin in the group of depressed patients with no suicide attempt (SNK post hoc test, p<0.05, N=187, F(ratio)=37.69, p<0.001). The same significance was found for the group of female (ANOVA, N=103, F(ratio)=11.81, p<0.001) and the group of male patients (ANOVA, N=84, F(ratio)=30.40, p<0.001). The thrombocyte serotonin was significantly lower in the group of depressed patients with no suicide attempt (F32.2), compared to the same diagnosis in the group of depressed patients with suicide attempt (MW-test, p=0.018). In the group of depressed patients with attempted suicide, statistically significant lower serum cholesterol values have been confirmed. In the group of depressed patients with no suicide attempt, statistically significant lower values of thrombocyte serotonin have been confirmed, presumably as the response to the psychopharmacological therapy.

Telomere length of patients with major depression is shortened but independent from therapy and severity of the disease

Shortened telomere length has been observed in a variety of diseases. Our objective was to analyze mean telomere length of patients with major depressive disorder. A key question was whether telomere length varies in different groups of depressive patients. We obtained blood samples from patients with major depressive disorder (n = 54) and healthy subjects (n = 20). We isolated genomic DNA and measured mean telomere length using telomere restriction fragments and Southern blotting. We grouped patients according to the therapy they received including total antidepressant dose. Mean telomere length of the entire patient group (7.20 ± 0.61 kb) was significantly shorter than in the control group (7.55 ± 0.54 kb). We observed no significant difference in telomere length among the different patient groups, but each of these patient groups had significantly shorter telomeres than the healthy subjects. Further analysis revealed no significant association between telomere length and illness duration and between telomere length and the severity of depression, as determined by the Hamilton score. These results provide further evidence that major depressive disorder is associated with shortened telomeres. However, differences in the applied therapy, the duration of illness, or the severity of depression do not seem to have any influence on telomere length.

A yes or no answer

Medical students are chosen, at least largely, for academic and scholarly potential, and most physicians enjoy reading and keeping up in the literature of their field. However, since medicine is a practical art, physicians read with the goal of updating their knowledge to maximize their treatment of their patients. The literature on biological pathophysiology of depression has expanded exponentially over the last 30 years, and physicians who completed their training in the 1970s, 1980s and 1990s have been faced with a huge amount of literature promising insights into depression, one of their most common areas of professional activity 1. Sophisticated molecular genetics, revolutionary imaging technology, erudite neuroendocrine analyses and numerous other approaches have strained the ability of many clinicians to feel that they are up-to-date in their field. In the last few years, a creeping feeling of doubt has entered the hearts and minds of numerous clinicians around the world as to whether the mountain of new data is really of any value to the clinical practitioner of psychiatry. The title of G. Hasler‘s paper, therefore, is guaranteed to attract a huge audience, as is appropriate for World Psychiatry. However, in my opinion, this paper does not bite the bullet and avoids giving an answer to its own question. The abstract states that antidepressant treatments should be tailored for individual patients and disease states, but nowhere in the paper does the author say how to do this. The conclusion relates to a table where the various neurobiological hypotheses are presented and an argument made against a unified hypothesis of depression. Fair enough. The paper goes on to state that “this encourages research on predictors of response” and that “the identification of reliable predictors will allow for the development of personalized medicine”. Promises, promises, promises. I had hoped this article was going to tell me whether we have any solid evidence of interest to clinicians now. Personally, I think the answer is no and that we must bravely face this fact. I share Hasler’s belief that depression is heterogeneous and his hope that future research will allow for better treatments. However, clinicians will be more honest with themselves, their patients and our society if we answer this paper’s question with a clear “no”. There is no genetic test, blood test, spinal fluid test or imaging test today that can aid in the diagnosis of depression. There are many findings reported in groups of depressed patients of changes in spinal fluid or blood metabolites or proteins or in brain functional imaging. However, few if any are consistently replicable. Many could be secondary to the powerful lifestyle changes induced by depression, such as weight loss, inactivity, and poor sleep 2. Even more important for a clinician to understand is that a mean difference reported as a finding in a research paper, even when highly statistically significant, often conceals a large overlap between patient and control populations that makes diagnostic use of the finding impossible. I have sometimes been told by those who agree with the previous statement that my views should be hidden from the public, so as not to endanger the prestige of psychiatry or our rightful share of research funding. Such an opinion, of course, has more to do with ethics and values than with science. However, the psychoanalytic tradition that the truth makes one free has always seemed to me even more relevant in biological psychiatry. Our trainees, patients and public are increasingly confused by contradictory claims to have found the biological basis of depression in genetics, imaging, neuroendocrinology, or neurotrophic factors. We must create a new style of discourse where research results, exciting as they are, are translated into a proper understanding of the long slow road we are likely to travel in order to understand depression pathophysiology 3.

Chronic and treatment-resistant depression: A study using arterial spin labeling perfusion MRI at 3 Tesla

The aim of the present study was to compare patients displaying chronic and treatment-resistant depression with healthy controls, using the resting-state perfusion with arterial spin labeling (ASL) perfusion magnetic resonance imaging (MRI) technique at 3 T. The study focused on the subgenual anterior cingulate cortex (sACC), which is a key component in the pathophysiology of depression. Six patients with chronic and treatment-resistant depression and six healthy control subjects were included. ASL is an innovative imaging technique which sidesteps the limitations of other functional neuroimaging techniques (functional MRI, positron emission tomography). A statistical analysis of perfusion maps was performed using SPM2 software. Statistically significant hyperperfusion regions were found in the depressed patient group compared with the healthy control group in the following: the bilateral sACC, left prefrontal dorsomedian cortex, left ACC and left subcortical areas (putamen, pallidum and amygdala). This study confirmed the involvement of the sACC in depression, particularly chronic and treatment-resistant depression, using ASL at 3 T, a safe perfusion technique that seems to be appropriate for investigating functional abnormalities in psychiatric disorders.

Depression vs. Dementia: A comparative analysis of neuropsychological functions

Previous studies concerned with neuropsychological aspect of depression, detected comparatively specific profile of cognitive deficiencies, including the disorders of attention, memory and executive functions. Although the classical depression is recognized as psuedodementia, or reversible dementia, these two entities frequently overlap in the elder population. Many patients who are at first depressive, become demented later, and the initial stages of dementia are not rarely accompanied with mood changes. The aim of this study is the establishing of differences between neuropsychological profiles of depression and dementia. The sample included three groups: the first group represented the patients with endogenous depression, the second - the patients with dementia, and the third one - healthy individuals. The participants have been tested by a neuropsychological battery. Two patient groups were tested during the stage of remission/adequate mood. Abilities most susceptible to depression are: attention, executive functions and memory. Cognitive flexibility and general cognitive ability are preserved in depressive patients. Depressive patients express cognitive disorders of moderate degree during the remission stage. Impairment pattern in the group of depressive patients does not indicate intellectual degradation of the dementia type. Neuropsychological deficiencies of the patients with endogenous depression suggest frontal limbic dysfunction. Excesses in cognitive functioning of demented patients are more serious and massive in comparison with cognitive difficulties in depressive patients.

Characteristics of depression in obese people living in an insecure environment

Obesity and depression are significant characteristics of people living in a state of chronic stress. Our aim was to determine the characteristics of depression in obese people living in an insecure unstable environment. The case-control study was organized in two rural environments in Kosovo and Metochia, Serbia. The main criterion for selection of participants was that respondents were more than 18 years old and had a body mass index of 25 kg/m 2 or more. Other anthropometric parameters determined were body weight, height, body fat mass, hip and waist circumference and the waist/hip ratio. The sex, demographic characteristics, profession, marital status, social status, existence of comorbidity, and cigarette smoking habits were recorded, and the arterial blood pressure measured for all participants. In the form of an interview, all respondents answered 17 questions, based on the Hamilton scale for depression. The group of depressed patients was dominated by women (P = 0.009). A significant difference (P = 0.007) was found in relation to profession. Depression was significantly more frequent in those without a regular income (P < 0.001). Depressed patients were significantly older (P = 0.017), more obese (P = 0.04), shorter (P = 0.0001), had a larger hip circumference (P = 0.039) and WHR index (P = 0.049) compared to patients in whom depression was not established. Depression is a significant characteristic in people living in an insecure environment, more common in women, without a permanent financial income.