Kiểu hình trầm cảm và mối liên hệ với khẩu phần 24 giờ ở bệnh nhân rối loạn trầm cảm chủ yếu điều trị bằng thuốc chống trầm cảm

Abstract

This prospective cohort study of 250 outpatients with major depressive disorder over 6 months aimed to characterize symptom phenotypes and their associations with dietary intake. Depressive symptoms were assessed using the QIDS-SR16, and dietary intake was measured 24-hour recall at four-time points (T0, T1, T3, T6). Exploratory factor analysis revealed a stable two-factor structure (typical and atypical) over time; however, the atypical phenotype (increased appetite/weight and hypersomnia) became more prominent after 6 months despite overall improvement in depression severity. Generalized structural equation modeling showed that total QIDS-SR16 scores were inversely associated with energy, protein, carbohydrates, potassium, and vitamin A intake. At the item level, specific and sometimes opposing associations emerged: insomnia, hypersomnia, and psychomotor activity were positively associated with carbohydrates, potassium, and vitamin A; hypersomnia was also positively associated with iron; and fatigue was positively associated with calcium and phosphorus. These findings highlight the importance of monitoring symptom structure and implementing personalized nutritional interventions, particularly for symptoms related to sleep, psychomotor activity, and appetite, in comprehensive treatment strategies.