3 New Studies About Depression and Lifestyle

October 18, 2018

Three new studies highlight the link between depression and opioid overdoses; “early birds” are less prone to depression; and consuming fish may reduce the risk of depression.

Patients with major depressive disorder are often affected by lifestyle choices. Three new studies highlight the link between depression and opioid overdoses; “early birds” are less prone to depression; and consuming fish may reduce the risk of depression.

In the wake of the opioid epidemic, depression and fatal opioid overdoses in the United States have been linked together. An analysis of data from the Centers for Disease Control and Prevention on opioid-related deaths from 2011 to 2015 was coupled with data on depression that was collected by a telephone survey of more than 400,000 people across the country. About 19% of respondents reported a depression diagnosis. For every additional 1% of the population that has a depression diagnosis there was between a 25% and 35% increase in the number of opioid overdose deaths. This relationship continued even after unintentional overdoses were sectioned out.

Clinical Implications: “We know from prior literature that people who are depressed are more likely to be prescribed opioids, but also that people who are prescribed opioids are more likely to become depressed. We need to recognize that this is probably a bidirectional relationship,” said lead author Laura Schwab Reese, an assistant professor of health and kinesiology at Purdue University. She suggested that doctors should screen for depression and discuss the risk with patients before prescribing opioids.

Foley M, et al. Associations of state-level rates of depression and fatal opioid overdose in the United States, 2011-2015. Soc Psychiatry Epidemiol. 2018 Sep 1. doi: 10.1007/s00127-018-1594-y.

Clinical Implications: “Our results show a modest link between chronotype and depression risk. This could be related to the overlap in genetic pathways associated with chronotype and mood,” said lead author CÃ©line Vetter, director of the Circadian and Sleep Epidemiology Laboratory at Colorado University Boulder. “This tells us that there might be an effect of chronotype on depression risk that is not driven by environmental and lifestyle factors.”

Vetter C, et al. Prospective study of chronotype and incident depression among middle- and older-aged women in the Nurses' Health Study II. J Psychiatr Res 2018 Aug;103:156-160. doi: 10.1016/j.jpsychires.2018.05.022.

Chronotype may influence the risk of depression in middle-to older-aged women. A cross-sectional study examined the association between chronotype and incident depression in 32,470 female participants of the Nurses’ Health Study II cohort. In 2009, all participants were free of depression, and they were followed for 4 years. They self-described their sleep patterns as early types (37%), intermediate types (53%), and evening types (10%). After accounting for depression risk factors, the results show early risers had a 12% to 27% lower risk of being depressed than intermediate types. Late types had a 6% higher risk than intermediate types.

Fresh seafood in the local diet may help protect against depression. A cross-sectional study examined the association of seafood consumption, polyunsaturated fatty acids and depressive symptoms among 206 people in two Torres Strait communities in Australia. One island was more isolated with no fast-food outlets; on the other island, fast-food restaurants were readily available. A higher blood level ratio of omega-6 to omega-3 long-chain omega polyunsaturated fatty acids was associated with moderate/severe depression scores on both sites. People on the more isolated island with no fast food outlets reported significantly higher seafood consumption. The level of the fatty acid associated with depression and found in many take-away foods was higher in people living on the island with ready access to fast food. The level of the fatty acid associated with protection against depression and found in seafood was higher on the other island.

Clinical Implications: “Depression is complex, it’s also linked to social and environmental factors so there will be no silver bullet cure, but our data suggests that a diet that is rich in omega-3 long-chain omega polyunsaturated fatty acids as provided by seafood and low in omega-6 polyunsaturated fatty acids as found in many take-away foods may be beneficial,” said lead author Maximus Berger of the James Cook University.

Berger M, Taylor S, Harriss L, et al. Cross-sectional association of seafood consumption, polyunsaturated fatty acids and depressive symptoms in two Torres Strait communities. Nutr Neurosci. 2018;3:1-10.