PMID- 25037643 OWN - NLM STAT- MEDLINE DCOM- 20160616 LR - 20211021 IS - 2044-6055 (Print) IS - 2044-6055 (Electronic) IS - 2044-6055 (Linking) VI - 4 IP - 7 DP - 2014 Jul 18 TI - Pop, heavy metal and the blues: secondary analysis of persistent organic pollutants (POP), heavy metals and depressive symptoms in the NHANES National Epidemiological Survey. PG - e005142 LID - 10.1136/bmjopen-2014-005142 [doi] LID - e005142 AB - OBJECTIVES: Persistent environmental pollutants, including heavy metals and persistent organic pollutants (POPs), have a ubiquitous presence. Many of these pollutants affect neurobiological processes, either accidentally or by design. The aim of this study was to explore the associations between assayed measures of POPs and heavy metals and depressive symptoms. We hypothesised that higher levels of pollutants and metals would be associated with depressive symptoms. SETTING: National Health and Nutrition Examination Survey (NHANES). PARTICIPANTS: A total of 15 140 eligible people were included across the three examined waves of NHANES. PRIMARY AND SECONDARY OUTCOME MEASURES: Depressive symptoms were assessed using the nine-item version of the Patient Health Questionnaire (PHQ-9), using a cut-off point of 9/10 as likely depression cases. Organic pollutants and heavy metals, including cadmium, lead and mercury, as well as polyfluorinated compounds (PFCs), pesticides, phenols and phthalates, were measured in blood or urine. RESULTS: Higher cadmium was positively associated with depression (adjusted Prevalence Ratios (PR)=1.48, 95% CI 1.16 to 1.90). Higher levels of mercury were negatively associated with depression (adjusted PR=0.62, 95% CI 0.50 to 0.78), and mercury was associated with increased fish consumption (n=5500, r=0.366, p<0.001). In addition, several PFCs (perfluorooctanoic acid, perfluorohexane sulfonic acid, perfluorodecanoic acid and perfluorononanoic acid) were negatively associated with the prevalence of depression. CONCLUSIONS: Cadmium was associated with an increased likelihood of depression. Contrary to hypotheses, many of persistent environmental pollutants were not associated or negatively associated with depression. While the inverse association between mercury and depressive symptoms may be explained by a protective role for fish consumption, the negative associations with other pollutants remains unclear. This exploratory study suggests the need for further investigation of the role of various agents and classes of agents in the pathophysiology of depression. CI - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. FAU - Berk, Michael AU - Berk M AD - IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia Barwon Health and the Geelong Clinic, Swanston Centre, Geelong, Victoria, Australia Florey Institute for Neuroscience and Mental Health, Parkville, Australia Department of Psychiatry, University of Melbourne, Parkville, Australia. FAU - Williams, Lana J AU - Williams LJ AD - IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia Department of Psychiatry, University of Melbourne, Parkville, Australia. FAU - Andreazza, Ana C AU - Andreazza AC AD - Departments of Psychiatry and Pharmacology, University of Toronto, Ontario, Canada Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. FAU - Pasco, Julie A AU - Pasco JA AD - IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia Department of Medicine, NorthWest Academic Centre, The University of Melbourne, St Albans, Victoria, Australia. FAU - Dodd, Seetal AU - Dodd S AD - IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia Barwon Health and the Geelong Clinic, Swanston Centre, Geelong, Victoria, Australia Department of Psychiatry, University of Melbourne, Parkville, Australia. FAU - Jacka, Felice N AU - Jacka FN AD - IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia Department of Psychiatry, University of Melbourne, Parkville, Australia. FAU - Moylan, Steven AU - Moylan S AD - IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia Barwon Health and the Geelong Clinic, Swanston Centre, Geelong, Victoria, Australia. FAU - Reiner, Eric J AU - Reiner EJ AD - Laboratory Services Branch, Ontario Ministry of the Environment, Toronto, Ontario, Canada. FAU - Magalhaes, Pedro V S AU - Magalhaes PV AD - National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil. LA - eng PT - Journal Article DEP - 20140718 PL - England TA - BMJ Open JT - BMJ open JID - 101552874 RN - 0 (Environmental Pollutants) RN - 0 (Metals, Heavy) RN - 0 (Organic Chemicals) SB - IM MH - Adult MH - Depression/*chemically induced MH - Environmental Pollutants/*adverse effects/analysis MH - Epidemiological Monitoring MH - Female MH - Health Surveys MH - Humans MH - Male MH - Metals, Heavy/*adverse effects/analysis MH - Middle Aged MH - Organic Chemicals/*adverse effects/analysis PMC - PMC4120423 OTO - NOTNLM OT - MENTAL HEALTH EDAT- 2014/07/20 06:00 MHDA- 2014/07/20 06:01 PMCR- 2014/07/18 CRDT- 2014/07/20 06:00 PHST- 2014/07/20 06:00 [entrez] PHST- 2014/07/20 06:00 [pubmed] PHST- 2014/07/20 06:01 [medline] PHST- 2014/07/18 00:00 [pmc-release] AID - bmjopen-2014-005142 [pii] AID - 10.1136/bmjopen-2014-005142 [doi] PST - epublish SO - BMJ Open. 2014 Jul 18;4(7):e005142. doi: 10.1136/bmjopen-2014-005142.