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Association of insulin resistance with depression: cross sectional findings from the British women's heart and health study

BMJ 2003; 327 doi: (Published 11 December 2003) Cite this as: BMJ 2003;327:1383
  1. Debbie A Lawlor, senior lecturer in epidemiology and public health medicine (,
  2. George Davey Smith, professor of clinical epidemiology1,
  3. Shah Ebrahim, professor in epidemiology of ageing1
  1. 1Department of Social Medicine, University of Bristol, Bristol BS8 2PR
  1. Correspondence to: D A Lawlor
  • Accepted 30 September 2003


A large cohort study of nearly 15 000 individuals found that indicators of insulin sensitivity were associated with increased risk of suicide.1 The authors assumed that insulin resistance was the key factor responsible. Insulin resistance is a determinant of free fatty acids in the blood, which are in turn important in tryptophan metabolism and brain serotonin concentrations.2 3 Individuals who are insulin resistant may therefore have higher serotonin concentrations and as a result be less likely to be depressed.1 We know of no previous study that has assessed the association between insulin resistance and depression in humans.

Participants, methods and results

We assessed this association in a cross sectional analysis of 4286 women aged 60-79 who were randomly selected from general practitioners' lists in 23 British towns.4 We used the homoeostasis model assessment method (HOMA score), derived from fasting insulin and glucose concentrations to assess insulin resistance.4 We used three indicators of depression: current use of antidepressant medication, self report of ever having received a diagnosis of depression from a doctor, and the EQ5D mood question of the EuroQOL.5 …

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