Determination of gastrointestinal symptoms, adherence to the mediterranean diet and food choices in patients diagnosed with depression

This study was conducted to examine the effects of antidepressant use on the level of adherence to the Mediterranean diet, gastrointestinal symptoms, body image, food preferences, and physical activity levels in individuals diagnosed with depression. This descriptive and comparative study involved 110 volunteers (70 women, 40 men) aged 19–65 who had been diagnosed with depression and were receiving psychiatric medication (n=55) or who had been diagnosed with depression but were not receiving psychiatric medication (n=55). Data were collected using a face-to-face questionnaire; participants' anthropometric measurements were taken, and the International Physical Activity Questionnaire Short Form (IPAQ), Mediterranean Diet Adherence Scale (MEDAS), Body Image Scale, Gastrointestinal Symptom Rating Scale (GSDÖ), and Single-Item Food Choice Test (BST). The findings revealed that antidepressant use was significantly associated with variables such as age, number of siblings, regular medication use, weight change, number of snacks, and level of importance given to health (p <0.05). No statistical difference was found between the groups in terms of adherence to the Mediterranean diet (p>0.05). In terms of nutrients, antidepressant-using women had significantly higher vitamin E intake (p=0.019); no significant differences were found between the groups for other micronutrients (p > 0.05). Energy intake among men using antidepressants was found to be significantly higher than among those not using antidepressants (p<0.05). When evaluated in terms of gastrointestinal symptoms, constipation complaints were significantly higher in the group of men using antidepressants (p<0.05), while in women, they were higher in individuals not using antidepressants (p<0.05). In terms of body image, individuals using antidepressants had significantly higher negative body perception and total body image scores in both genders (p<0.05). In terms of food preferences, individuals who did not use antidepressants were found to have a higher tendency to prefer foods that were 'healthy, 'natural' and 'affordable' (p<0.05). The study showed that adherence to the Mediterranean diet was positively associated with foods being "healthy," "natural," "weight-control-friendly," and "environmentally friendly"; and that anthropometric measurements changed positively as physical activity levels increased. It was found to be negatively and significantly associated with total MET score, BMI, waist circumference, hip circumference, and waist-to-hip ratio (p<0.05). Body image was found to be the only significant variable negatively affecting Mediterranean diet adherence (β=-0.209, p=0.044). The effect of gastrointestinal symptoms on Mediterranean diet adherence was found to be borderline (p=0.057). In conclusion, this study demonstrates that antidepressant use in individuals with depression has significant effects not only on mental health but also on lifestyle components such as dietary habits, gastrointestinal health, body image, and physical activity. Therefore, it was concluded that a multidisciplinary approach should be adopted in the management of depression, and that integrating psychiatric interventions with nutritional and lifestyle support is important. Keywords: Depression, antidepressant agents, mediterranean diet, gastrointestinal system, eating behaviour.