Major Depressive Disorder, Inflammation, and Nutrition: A Tricky Pattern?

Major depressive disorder (MDD) is a psychiatric disease associated with inflammation. The Western diet (WD) is a high-fat, high-sugar diet also associated with inflammation. We aimed to show whether the diet of MDD patients was a WD and could act as a risk factor in this context. We conducted a transversal study of MDD patients and controls (CTRLs) without comorbidities. We performed blood analyses including C-reactive protein (CRP), a diet anamnesis, and an advanced glycation end-product assessment. We found that 34.37% of MDD patients had a CRP level above 3 to 10 mg/L, which remained higher than CTRLs after adjustments (sex, BMI, age, smoking status). The MDD patients had an excess of sugar and saturated and trans fatty acids; a deficiency in n-3 polyunsaturated fatty acid, monounsaturated acid, dietary fibers, and antioxidants; a high glycemic load; and aggravating nutritional factors when compared to the CTRLs. We found correlations between nutritional factors and CRP in univariate/multivariate analysis models. Thus, MDD patients showed an elevated CRP level and a WD pattern that could contribute to sustaining an inflammatory state. Further studies are required to confirm this, but the results highlighted the importance of nutrition in the context of MDD.

The Relationship between Typus Melancholicus and Unipolar Depression: A Literature Review.

BACKGROUND: The Typus Melancholicus (TM) is the premorbid personality of endogenous depression defined by Tellenbach and Kraus and characterized by orderliness, conscientiousness, norm orientation and intolerance of ambiguity. Tellenbach's hypothesis was to find around 50% of TM in the sample of patients with an Unipolar Depression (UD). The present paper aims to make a literature review on the relationship between the Typus Melancholicus (TM) and Unipolar Depression (UD). METHODS: Nineteen references were selected through searches on PubMed, Google Scholar and Sciences-Direct with the following MeSH terms in the title: Typus Melancholicus AND Depressive or Depression or Dépression or Depressione. Nine of them were selected for our review. RESULTS: Eight of the nine reviewed articles confirm Tellenbach's hypothesis. The literature review also shows that, in a population of UD, TM is always constant regardless of age or sex, has no relationship to clinical characteristics and could contribute to the chronicity of depression. The TM with depression have increased levels of "lack of vital drive" and "feelings of guilt" and low scores in irritability and dysphoria compared to Non-Typus Melancholicus (NTM). Due to its characteristics, TM could also be involved in some pathologies such as burnout or postpartum depression. TM does not seem to be linked to a particular Personality Disorder or maladaptive personality, but the two may coexist in certain circumstances. It has been suggested that specific psychotherapeutic methods can be used to treat TM with UD. CONCLUSIONS: The TM could be very useful in our clinical practice. Better practical knowledge of TM could lead to more efficient psychiatric care as well as heightened capacity to predict new episodes.