The Association of Metabolic Syndrome with the Initiation of Antidepressive Agents: Real-World Data Analysis of Administrative Claims and Health Examinations

Depression and metabolic syndrome (MetS) are correlated, leading to an increased healthcare burden and decreased productivity. We aimed to investigate the associations of medical conditions, including MetS and lifestyle, with depression, using a health checkup and claims database. Individuals aged 18–64 years who underwent health examinations between 2014 and 2019 were enrolled in the study. Among 81,269 participants, “ever” and “incident” antidepressant users exhibited worse metabolic profiles and underwent more prevalent cancer-related hospitalization than “never” users. In a nested case-control study with a 1:10 ratio of incident users to controls, MetS (odds ratio, 1.29 [95% confidence interval: 1.08–1.54]); “quicker” (0.69 [0.59–0.81]) and “late” eating speed (1.25 [1.07–1.46]), as compared with “normal”; poor sleep (1.41 [1.25–1.60]); “sometimes” (0.85 [0.73–0.98]) and “everyday” drink (0.78 [0.66–0.92]), as compared with “rarely drink”; and hypnotic (1.97 [1.47–2.64]), anxiolytic (3.55 [2.79–4.51]), and nonsteroidal anti-inflammatory drug (1.65 [1.18–2.32]) use were associated with incident antidepressant use. A bodyweight increase >10 kg from age 20 years (1.29 [1.14–1.46]) was also significantly associated with incident antidepressant use. In conclusion, metabolic abnormalities, hospitalization records, and lifestyle information can be useful in identifying populations at high risk of depression.