ATYPICAL DEPRESSION IS ASSOCIATED WITH METABOLIC SYNDROME: A SYSTEMATIC REVIEW

Introduction. Depression and metabolic syndrome (MetS) are important public health problems. This systematic review evaluated whether the atypical subtype of depression is associated with MetS, when compared to other depressive subtypes. Methods. Two independent reviewers searched in Medline, Lilacs, PsycInfo, Scopus and Web of Science databases, up to May 2021, without language restriction, including cross-sectional, case-control, and cohort studies, assessing adults. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale. The PRISMA guidelines were adopted and this review was registered in PROSPERO (CRD42018109762). Results. The databases search identified 96 articles and 6 was included in this review. The methodological quality scores ranged from 7 to 10 points. The association between atypical depression and MetS was demonstrated in all publications, as well as the lack of association with melancholic and other subtypes. The prevalence of MetS was significantly higher among individuals with atypical depression. It is worth noting that only few studies assessing this comorbidity were conducted so far. Conclusions. MetS is associated with atypical depression, but not with melancholic or other subtypes. The identification of distinct depressive clinical features seems crucial to better understand its comorbidity with MetS and elucidate its pathophysiological pathways, both necessary to better guide prevention and treatment strategies.