Clinical Patterns of Metabolic Syndrome in First-Hospitalized Major Depressive Disorder Patients: Comparison of Antidepressant-Exposed and Drug-Naïve Groups.

Background: Major depressive disorder (MDD) and metabolic syndrome (MetS) are both major health threats nowadays, and the relationship between them is complex and close. The purpose of this paper is to compare differences in the prevalence and risk factors of MetS in first hospitalized patients with MDD with and without antidepressant exposure. Methods: A total of 636 first hospitalized MDD patients (study group) with antidepressant exposure and 345 drug-naïve patients (control group) were included in this study. Their socio-demographic data, routine biochemical indices, and psychological symptom assessment were collected. Results: There was no difference in the prevalence of MetS between the study group and the control group (F = 2.49, p = 0.115). Factors affecting MetS and its severity differed between the two groups, in the study group, the identified risk factors for MetS were onset age (B = 0.05, p <0.001, OR = 1.05, 95% CI = 1.02-1.08), TSH level (B = 0.42, p <0.001, OR = 1.53, 95% CI = 1.39-1.68). Meanwhile, in the control group, the identified risk factors for MetS were more extensive and they were, onset age (B = 0.11, p <0.001, OR = 1.12, 95% CI = 1.07-1.16), suicidal behavior (B = 1.54, p = 0.007, OR = 4.65, 95% CI = 1.51-14.33), HAMD scores (B = 0.23, p = 0.008, OR = 1.26, 95% CI = 1.06-1.49) and TSH levels (B = 0.33, p <0.001, OR = 1.39, 95% CI = 1.17-1.65). The number of risk factors identified was lower in the study group. Conclusion: Antidepressant use was associated with greater MetS severity but did not affect overall prevalence. Antidepressants appear to modify MetS risk factors, highlighting the need to differentiate these effects from those in drug-naïve patients when developing MetS interventions for the MDD population.