A low intake of folate and vitamin B12 increases the risk of melancholic depressive symptoms, according to a study among nearly 3,000 middle-aged and elderly Finnish subjects. On the other hand, non-melancholic depressive symptoms are associated with an increased risk for the metabolic syndrome. Based on these new observations, melancholic and non-melancholic depression may be separate depressive subtypes with different etiologies in terms of proinflammation and diet. The study was the first to look at these depressive sub-types separately.
"The findings have practical implications in the care of patients with depressive symptoms. For example, it may be wise to avoid medication causing weight gain among patients with non-melancholic depression, whereas melancholic depressive symptoms may call for a closer look at the quality of the patient's diet," says Mr Jussi Sepp-l-, MD, Chief of the Department of Psychiatry of the Hospital District of Southern Savo.
Melancholic depression involves typical depressive symptoms, such as a depressed mood. Non-melancholic depression is characterized by other types of symptoms, such as low self-esteem and feelings of worry and anxiety.
Among subjects with the highest folate intake, the risk for melancholic depressive symptoms was almost 50 per cent lower than among those with the lowest intake. In addition, among those with the highest vitamin B12 levels, the risk for melancholic depressive symptoms was almost three times lower than among those with the lowest levels. Both findings are new. A similar association with non-melancholic depressive symptoms was not observed.
Another novel observation is that the risk for the metabolic syndrome was twofold among those with non-melancholic depressive symptoms, as compared to those with melancholic symptoms or those with no depressive symptoms.