Short-term and long-term effects of major depressive disorder subtypes on obesity markers and impact of sex on these associations.

BACKGROUND: Only a few studies with conflicting results have examined the effects of sex on the prospective association between depression and subsequent obesity. OBJECTIVE: (1) To simultaneously assess the associations of the subtypes (atypical, melancholic, unspecified) of major depressive disorder (MDD) measured at baseline and subtypes of major depressive episodes (MDE) that emerged during a 5.5-year follow-up with changes in obesity markers (body mass index, waist circumference, fat mass) during this follow-up, and (2) to test the effect of sex on these associations. METHODS: Data from CoLaus|PsyCoLaus, a population-based cohort study including 2702 participants (50.1% women, mean age 49.6 years). Criteria for mental disorders were elicited using semi-structured interviews. RESULTS: History of atypical MDD at baseline was associated with a steeper increase in BMI and waist circumference, whereas atypical MDE during follow-up was associated with a steeper increase in the three studied obesity markers. Melancholic MDD at baseline was associated with a steeper increase in BMI. Several significant interactions with sex were found indicating higher increase in fat mass in men than in women following melancholic MDD reported at baseline, higher decrease in BMI and fat mass in women than in men related to melancholic MDE emerging during follow-up and higher increase in waist circumference in men than in women following unspecified MDD reported at baseline. LIMITATIONS: Urban sample which may not be representative for the whole population. CONCLUSIONS: Our results further advocate for the specific need of a thorough monitoring of obesity markers in patients with atypical MDD and suggest less favorable obesity marker changes mainly related to melancholic MDE in men.

[Asylum seekers : collaboration between nurses and medical students during the COVID-19 epidemic]. / Patients issus de l'asile : collaboration infirmiers-étudiants en médecine durant l'épidémie de Covid-19.

The exceptional health challenges generated by the COVID-19 pandemic have sparked a wave of mobilization among medical students. We were four students to provide support to the Migrant Care Units of the Vulnerability and Social Medicine Department of Unisanté. This two-month experience, very different from the academic framework we were used to during our studies, allowed us to discover a clinic grappling with social and cross-cultural issues, and taught us the mutual benefits of an interprofessional collaboration with experienced nurses. Through a few clinical vignettes, we would like to share the challenges of the care we have seen, as well as the significant lessons we have learned from them.

Les défis sanitaires exceptionnels générés par la pandémie de Covid-19 ont donné lieu à une vague de mobilisation parmi les étudiant·e·s en médecine. Nous avons été quatre étudiant·e·s à apporter notre soutien aux Unités de soins aux migrants du Département Vulnérabilités et médecine sociale d'Unisanté. Cette expérience de deux mois, bien différente du cadre académique dont nous avons eu l'habitude au cours de nos études, nous a permis de découvrir une clinique en prise avec des problématiques sociales et transculturelles, et nous a appris les bénéfices mutuels d'une collaboration interprofessionnelle avec des infirmier·ère·s expérimenté·e·s. Au travers de quelques vignettes cliniques, nous souhaitons ainsi partager les enjeux des prises en soins auxquelles nous avons assisté, ainsi que les enseignements marquants que nous en avons retirés.