1. ¹Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
2. ²Department of Psychiatry, Neurogenetics Section, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
3. ³Department of Psychiatry, University of British Columbia, Toronto, ON, Canada
4. ⁴Eating Disorders Program, Department of Psychiatry, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
5. ⁵Department of Psychology, York University, Toronto, ON, Canada

Correspondence: Dr RD Levitan, Department of Psychiatry, Centre for Addiction and Mental Health, 250 College Street, Room 1126, Toronto, ON, Canada M5T 1R8. Tel: +1 416 535 8501 ext. 4020, Fax: +1 416 979 6821, E-mail: Robert_levitan@camh.net

Received 12 October 2005; Revised 26 April 2006; Accepted 11 May 2006; Published online 7 June 2006.

Abstract

We have recently described an association between the hypofunctional 7-repeat allele (7R) of the dopamine-4 receptor gene (DRD4), weight gain, and obesity in women with seasonal affective disorder (SAD). In the current study, we examined whether season-of-birth might interact with the 7R allele to influence body weight regulation in SAD. In 182 female probands with SAD, we performed an analysis of covariance predicting maximum lifetime body mass index (BMI) with both the exon-3 variable number of tandem repeat polymorphism of DRD4 and season-of-birth as independent variables, and age as the covariate. The overall model was highly significant (F=4.42, df=8, 173, p<0.0001) with season-of-birth predicting maximal lifetime BMI both on its own and in its interaction with the 7R allele. The latter finding was attributable to 7-repeat carriers born in the spring (N=17), who had a mean maximal lifetime BMI of 33.7 kg/m² (SD 8.6), compared to 26.7 kg/m² (SD 5.4) for all other probands combined (N=165) (F=20.01, df=1, 179, p<0.0001). The lifetime rate of obesity (maximal BMI >30 kg/m²) was also significantly higher in the 7R/spring birth group (9/17=52.9% vs 32/165=19.4%; ²=9.94, df=1, p=0.002; odds ratio=4.68, 95% CI=1.67–13.07). These data may reflect a novel gene–environment interaction, during early brain development, which establishes an increased risk for obesity in women with SAD. Although the mechanism for season-of-birth effects in psychiatric disorders is unknown, a characteristic pattern of melatonin exposure during the second and third trimesters may be of particular relevance in this study population. We speculate that these data may reflect the vestigial expression of a seasonal thrifty phenotype that contributed to the positive selection of the 7R allele over the past 40 000 years.