New research shows that atypical depression increases diabetes risk, while melancholic depression heightens chances of heart disease. The findings, from a seven-year study of nearly 6,000 adults, highlight the need for tailored mental and physical health approaches. Presented at the ECNP Congress in Amsterdam, the work underscores biological differences in depression subtypes.
Scientists have identified how specific forms of depression influence cardiometabolic health differently. In a study spanning seven years, researchers tracked 5,794 adults from the Netherlands Epidemiology of Obesity (NEO) Study. At the outset, none had diabetes or cardiovascular disease. Participants completed questionnaires that revealed two primary depression types: melancholic, marked by early morning awakening and loss of appetite; and atypical or energy-related, featuring fatigue, increased sleep, and higher appetite.
About 8% of participants developed a cardiometabolic disorder during the period. Those with atypical/energy-related depression faced a 2.7 times higher risk of Type 2 diabetes compared to those without depressive symptoms, but no elevated cardiovascular disease risk. In contrast, individuals with melancholic depression were 1.5 times more likely to experience cardiovascular events like heart attack or stroke, without a significant diabetes increase.
Lead researcher Dr. Yuri Milaneschi from Amsterdam UMC noted the underlying biology: "Further metabolic analysis revealed that patients with the atypical/energy-related symptoms showed disruptions in inflammatory and metabolic processes linked to cardiometabolic health. This biological signature was not seen in those with melancholic symptoms, suggesting biochemical differences in the way that different types of depression link to cardiovascular health. We already knew that not all depressions are the same, but this means that we may need to consider how the type of depression someone has impacts different areas of their physical health. It very much pushes us towards the idea of precision psychiatry -- the idea that we need to look for physical associations with mental health profiles, so that we can better treat mental illness. To treat sufferers individually."
Independent commentator Dr. Chiara Fabbri from the University of Bologna emphasized prevention: "The prevention and treatment of physical diseases in people with depression are not less important than the treatment of depression. These physical conditions are common and expected to raise, for example the number of people with diabetes (66 million) in the EUR Region will see a 10% increase by 2050 according to the International Diabetes Federation. It is a health care priority to prevent cardiometabolic diseases, diagnose them early, and continue to improve monitoring and treatment. This study on the NEO cohort provides highly valuable data on how to do this better for people suffering from depressive symptoms."
The research advocates for precision psychiatry to address these varied risks effectively.