Association of Body Mass Index with Depression, Anxiety and Suicide-An Instrumental Variable Analysis of the HUNT Study.

<h4>Objective</h4>While high body mass index is associated with an increased risk of depression and anxiety, cumulative evidence indicates that it is a protective factor for suicide. The associations from conventional observational studies of body mass index with mental health outcomes a...

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Main Authors: Johan Håkon Bjørngaard, David Carslake, Tom Ivar Lund Nilsen, Astrid C E Linthorst, George Davey Smith, David Gunnell, Pål Richard Romundstad
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0131708
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author Johan Håkon Bjørngaard
David Carslake
Tom Ivar Lund Nilsen
Astrid C E Linthorst
George Davey Smith
David Gunnell
Pål Richard Romundstad
author_facet Johan Håkon Bjørngaard
David Carslake
Tom Ivar Lund Nilsen
Astrid C E Linthorst
George Davey Smith
David Gunnell
Pål Richard Romundstad
author_sort Johan Håkon Bjørngaard
collection DOAJ
description <h4>Objective</h4>While high body mass index is associated with an increased risk of depression and anxiety, cumulative evidence indicates that it is a protective factor for suicide. The associations from conventional observational studies of body mass index with mental health outcomes are likely to be influenced by reverse causality or confounding by ill-health. In the present study, we investigated the associations between offspring body mass index and parental anxiety, depression and suicide in order to avoid problems with reverse causality and confounding by ill-health.<h4>Methods</h4>We used data from 32,457 mother-offspring and 27,753 father-offspring pairs from the Norwegian HUNT-study. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale and suicide death from national registers. Associations between offspring and own body mass index and symptoms of anxiety and depression and suicide mortality were estimated using logistic and Cox regression. Causal effect estimates were estimated with a two sample instrument variable approach using offspring body mass index as an instrument for parental body mass index.<h4>Results</h4>Both own and offspring body mass index were positively associated with depression, while the results did not indicate any substantial association between body mass index and anxiety. Although precision was low, suicide mortality was inversely associated with own body mass index and the results from the analysis using offspring body mass index supported these results. Adjusted odds ratios per standard deviation body mass index from the instrumental variable analysis were 1.22 (95% CI: 1.05, 1.43) for depression, 1.10 (95% CI: 0.95, 1.27) for anxiety, and the instrumental variable estimated hazard ratios for suicide was 0.69 (95% CI: 0.30, 1.63).<h4>Conclusion</h4>The present study's results indicate that suicide mortality is inversely associated with body mass index. We also found support for a positive association between body mass index and depression, but not for anxiety.
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spelling doaj-art-4b6dbc7bc8cb4e97a69719e6ecc163b12025-08-20T03:46:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01107e013170810.1371/journal.pone.0131708Association of Body Mass Index with Depression, Anxiety and Suicide-An Instrumental Variable Analysis of the HUNT Study.Johan Håkon BjørngaardDavid CarslakeTom Ivar Lund NilsenAstrid C E LinthorstGeorge Davey SmithDavid GunnellPål Richard Romundstad<h4>Objective</h4>While high body mass index is associated with an increased risk of depression and anxiety, cumulative evidence indicates that it is a protective factor for suicide. The associations from conventional observational studies of body mass index with mental health outcomes are likely to be influenced by reverse causality or confounding by ill-health. In the present study, we investigated the associations between offspring body mass index and parental anxiety, depression and suicide in order to avoid problems with reverse causality and confounding by ill-health.<h4>Methods</h4>We used data from 32,457 mother-offspring and 27,753 father-offspring pairs from the Norwegian HUNT-study. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale and suicide death from national registers. Associations between offspring and own body mass index and symptoms of anxiety and depression and suicide mortality were estimated using logistic and Cox regression. Causal effect estimates were estimated with a two sample instrument variable approach using offspring body mass index as an instrument for parental body mass index.<h4>Results</h4>Both own and offspring body mass index were positively associated with depression, while the results did not indicate any substantial association between body mass index and anxiety. Although precision was low, suicide mortality was inversely associated with own body mass index and the results from the analysis using offspring body mass index supported these results. Adjusted odds ratios per standard deviation body mass index from the instrumental variable analysis were 1.22 (95% CI: 1.05, 1.43) for depression, 1.10 (95% CI: 0.95, 1.27) for anxiety, and the instrumental variable estimated hazard ratios for suicide was 0.69 (95% CI: 0.30, 1.63).<h4>Conclusion</h4>The present study's results indicate that suicide mortality is inversely associated with body mass index. We also found support for a positive association between body mass index and depression, but not for anxiety.https://doi.org/10.1371/journal.pone.0131708
spellingShingle Johan Håkon Bjørngaard
David Carslake
Tom Ivar Lund Nilsen
Astrid C E Linthorst
George Davey Smith
David Gunnell
Pål Richard Romundstad
Association of Body Mass Index with Depression, Anxiety and Suicide-An Instrumental Variable Analysis of the HUNT Study.
PLoS ONE
title Association of Body Mass Index with Depression, Anxiety and Suicide-An Instrumental Variable Analysis of the HUNT Study.
title_full Association of Body Mass Index with Depression, Anxiety and Suicide-An Instrumental Variable Analysis of the HUNT Study.
title_fullStr Association of Body Mass Index with Depression, Anxiety and Suicide-An Instrumental Variable Analysis of the HUNT Study.
title_full_unstemmed Association of Body Mass Index with Depression, Anxiety and Suicide-An Instrumental Variable Analysis of the HUNT Study.
title_short Association of Body Mass Index with Depression, Anxiety and Suicide-An Instrumental Variable Analysis of the HUNT Study.
title_sort association of body mass index with depression anxiety and suicide an instrumental variable analysis of the hunt study
url https://doi.org/10.1371/journal.pone.0131708
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