PB0030 - The association between depressive symptom profiles and hemostasis: the biobehavioral pathway to cardiovascular diseases?

Background: Depression as a mood disorder affects 5% of adults worldwide. Individuals with depression revealed a higher risk of developing cardiovascular disease and hypercoagulability was proposed to explain this increased risk, however, the evidence was inconsistent.

Aims: To examine the association between depressive symptom profiles and hemostasis in a large population-based study.

Methods: Using baseline measurements of 5591 participants from the Netherlands Epidemiology of Obesity (NEO) study (age: 56 [SD: 6] years, 52% women, BMI: 29.9 [SD: 4.7] kg/m2), associations between depressive symptom profiles based on the Inventory of Depressive Symptomatology (IDS)-SR30 questionnaire and hemostasis parameters (i.e., factor[F] VIII/IX/XI, thrombin generation parameters, fibrinogen, platelet width distribution and thrombocyte count) were investigated using linear regression analyses, adjusting for potential confounders. To account for the heterogeneity of depression, two depressive symptom profiles, namely atypical energy-related and melancholic, were derived based on relevant items in the IDS-SR30 questionnaire. The scores of the melancholic and atypical energy-related depressive symptom profiles were divided into quartiles based on the distributions of the symptom profile scores in the NEO study population, and the first and the second quartile were combined as the reference group due to empty cells.

Results: Compared with the reference group of no atypical energy-related depressive symptom, individuals with severe atypical energy-related depressive symptom had elevated FIX activity (4.54 IU/dL, 95% CI: [0.89, 8.20]), FXI activity (3.62 IU/dL, 95% CI: [0.35, 6.89]), and thrombocyte count (16.14 10power9/L, 95% CI: [0.24, 32.03]).Compared with the reference group of no melancholic depressive symptom profile, only severe melancholic depressive symptoms were associated with elevated FXI activity (3.9 IU/dL, 95% CI: [0.71, 7.1]).

Conclusion(s): Using a large population-based study with a comprehensive adjustment of confounders, we showed an association between atypical energy-related depressive symptom and procoagulant status, which suggests a biobehavioral pathway to cardiovascular diseases through hypercoagulability.