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J Affect Disord. 2019 Jun 4;256:221-227. doi: 10.1016/j.jad.2019.06.002. [Epub ahead of print]

Effort-based decision-making is affected by overweight/obesity in major depressive disorder.

Author information

1
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, M5T 2S8, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, M5T 2S8, Canada. Electronic address: rodrigo.mansur@uhn.ca.
2
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, M5T 2S8, Canada.
3
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, M5T 2S8, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, M5T 2S8, Canada.
4
Department of Psychiatry, University of Toronto, Toronto, ON, M5T 2S8, Canada; Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, Canada.
5
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Ontario, Canada.
6
Center for Neuroscience in Women's Health, Stanford University, Palo Alto, USA.
7
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, M5T 2S8, Canada; Department of Psychiatry, Queen's University, Kingston, ON, K7L 7X3, Canada; Research Group in Molecular and Behavioral Neurosciences of Mood Disorders, Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, 04038-000, Brazil.
8
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, M5T 2S8, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, M5T 2S8, Canada; Research Group in Molecular and Behavioral Neurosciences of Mood Disorders, Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, 04038-000, Brazil; Brain and Cognition Discovery Foundation, Mississauga, ON L5C 4E, Canada.

Abstract

BACKGROUND:

Anhedonia and abnormalities in reward behavior are core features of major depressive disorder (MDD). Convergent evidence indicates that overweight/obesity (OW), a highly prevalent condition in MDD, is independently associated with reward disturbances. We therefore aimed to investigate the moderating effect of OW on the willingness to expend efforts for reward in individuals with MDD and healthy controls (HC).

METHODS:

Forty-one adults (HC n = 20, MDD n = 21) completed the Effort Expenditure for Rewards Task (EEfRT), clinical and cognitive measures. Anthropometric parameters were assessed in all participants, and an additional evaluation of laboratorial parameters were conducted solely on those with MDD. Individuals with MDD were all on vortioxetine monotherapy (10-20 mg/day).

RESULTS:

Interactions between reward magnitude, group and OW were observed (χ2 = 9.192, p = 0.010); the OW-MDD group chose the hard task significantly less than normal weight (NW)-HC (p = 0.033) and OW-HC (p = 0.034), whereas there were no differences between NW-MDD and HCs. Within individuals with MDD, the proportion of hard task choices was more strongly correlated with body mass index (BMI) (r = -0.456, p = 0.043) and insulin resistance (HOMA2-IR) (r = -0.467, p = 0.038), than with depressive symptoms (r = 0.290, p = 0.214).

CONCLUSIONS:

OW significantly moderated the association between MDD and willingness to make efforts for rewards. These findings offer novel evidence on the potential role of metabolic factors on the basis of anhedonia, and for the heuristic models proposing a pathophysiological connection between mood and metabolic disorders.

KEYWORDS:

Anhedonia; Insulin; Major depressive disorder; Obesity; Reward

PMID:
31181378
DOI:
10.1016/j.jad.2019.06.002

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