Foi realizada busca nas bases de dados Medline, Lilacs e PsycInfo por dois revisores independentes, até agosto de 2018, sem restrição de idioma, incluindo estudos de delineamento transversal, caso-controle e de coorte, avaliando adultos (18-65 anos), de ambos os sexos. A qualidade dos estudos foi aferida por meio do instrumento Newcastle-Ottawa Scale. Esta revisão sistemática foi conduzida de acordo com as normas do Prisma e foi registrada no Prospero (CRD42018105248).

RESULTADOS:

A busca resultou em 1.770 artigos, dos quais cinco foram incluídos nesta revisão, todos de desenho transversal. Os escores de qualidade dos estudos variaram de 8 a 9 pontos, num total de 10. A associação entre depressão, medidas antropométricas e autoimagem corporal foi encontrada em todos os estudos incluídos, independentemente dos diferentes métodos estatísticos empregados. No geral, as mulheres percebiam o seu corpo maior do que realmente era ou estavam insatisfeitas por desejarem ter um corpo mais magro, enquanto que, entre os homens, a percepção de estar abaixo do peso ou a insatisfação com a imagem corporal foram observadas, principalmente, por desejarem ter um corpo maior. Tanto a percepção distorcida ou a insatisfação com a imagem corporal se mostraram associadas à depressão e ao índice de massa corporal conjuntamente.

CONCLUSÃO:

Depressão, indicadores antropométricos e autoimagem corporal se mostraram associadas. Destaca-se a necessidade da condução de outros estudos, especialmente de desenho longitudinal, para maior elucidação desta relação.

PALAVRAS-CHAVE:
Imagem corporal; Depressão; Índice de massa corporal; Obesidade; Revisão

Author/Year	Country	Study design	Population	Self-body image and dimension evaluated	Depression	Anthropometric indicator	NOS score
Gavin et al.²³23. Gavin AR, Simon GE, Ludman EJ. The association between obesity, depression, and educational attainment in women: the mediating role of body image dissatisfaction. J Psychosom Res. 2010;69(9):573-81. (2010)	USA	Cross-sectional	4,543 women enrolled in the Group Health Cooperative, 40 years old or older	Score of 0 (always) to 5 (never) to the statement “I feel satisfied with my body shape” Satisfaction with body image	PHQ-9	BMI (self-reported weight and height)	8
Gaskin et al.²⁴24. Gaskin JL, Pulver AJ, Branch K, Kabore A, James T, Zhang J. Perception or reality of body weight: which matters to the depressive symptoms. J Affect Disord. 2013;150(2):350-5. (2013)	USA	Cross-sectional	13,548 participants from Nhanes, 18 years old or older	“Do you consider yourself to be underweight, overweight or with an appropriate weight?” Self-perception of body image	PHQ-9	BMI (weight and height measured)	8
Richard et al.¹²12. Richard A, Rohrmann S, Lohse T, Eichholzer M. Is body weight dissatisfaction a predictor of depression independent of body mass index, sex, and age? Results of a cross-sectional study. BMC Public Health. 2016;16(1):863. (2016)	Switzerland	Cross-sectional	15,975 participants from SHS, 18 years old or older	“Are you satisfied with your body?” Satisfied (absolutely satisfied or very satisfied) and dissatisfied (rather dissatisfied or absolutely dissatisfied) Satisfaction with body image	PHQ-9	BMI (self-reported weight and height)	8
Kim et al.²⁵25. Kim Y, Austin SB, Subramanian SV, Kawachi I. Body weight perception, disordered weight control behaviors, and depressive symptoms among Korean adults: the Korea National Health and Nutrition Examination Survey 2014. PLoS One. 2018;13(6):e0198841. (2018)	Korea	Cross-sectional	Participants of Knhanes VI-2 from 19 to 65 years old	“How would you describe your body image?” (Very thin/slightly thin, normal, slightly/very obese) Comparison of body self-image with BMI measured: Accurate perception (perceived weight = measured); Overestimation (perceived weight > measured) and underestimation (perceived weight < measured). Self-perception of body image	PHQ-9K (Korean version)	BMI (measured weight and height)	8
Paans et al.¹⁴14. Paans NPG, Bot M, Brouwer IA, Visser M, Penninx BWJH. Contributions of depression and body mass index to body image. J Psychiatr Res. 2018;103:18-25. (2018)	Netherlands	Cross-sectional	1,452 participants of the Wave 9 of Nesda, 18 to 65 years old	Stunkard Adult Figure Rating Scale, specific for sex, containing 9 figures (very thin=1 and very heavy=9) – Circle the figure that shows your body today (Self-perception of body image) – Circle the figure that shows the body that you would like to have (idealized body image) Categories: 1) Individuals who would like to have a larger silhouette; 2) Individuals who were satisfied with their body; 3) Individuals who would like to have a smaller silhouette Satisfaction with body image	Cidi for diagnosis of depression IDS-SR for assessing the severity of depression	BMI (measured weight and height)	9

Authors	Objectives	Measure of Association	Main Results
Gavin et al.²³23. Gavin AR, Simon GE, Ludman EJ. The association between obesity, depression, and educational attainment in women: the mediating role of body image dissatisfaction. J Psychosom Res. 2010;69(9):573-81. (2010)	– To evaluate the association between obesity and depression in a population sample of middle-aged women – To evaluate if the dissatisfaction with body image has a mediator role in this association and whether this varies with the level of formal eduication	Odds Ratio (OR)	Obesity and Depression – Adjusted by dissatisfaction with body image and stratified by level of formal education <16 years of formal education: OR= 1.81; CI 95% 1.15; 2.86* >=16 years of formal education: OR= 1.25; CI 95% 0.85; 1.85 – Adjusted by dissatisfaction with body image and other sociodemographic co-variables and smoking, stratified by level of formal education <16 years of formal education: OR= 1.75; CI 95% 1.11; 2.77* >=16 years of formal education: OR= 1.15; CI 95% 0.77; 1.72
Gaskin et al.²⁴24. Gaskin JL, Pulver AJ, Branch K, Kabore A, James T, Zhang J. Perception or reality of body weight: which matters to the depressive symptoms. J Affect Disord. 2013;150(2):350-5. (2013)	– To evaluate the strength of the association of depression with weight and the self-perception of body image – To evaluate whether the relationship between excess body weight and depression was mediated or confounded by the perception of body image	Odds Ratio (OR)	Women – Depression and BMI adjusted for self-perception of body image Obesity (vs eutrophy): OR= 1.72; CI 95% 1.01; 2.92* Overweight (vs eutrophy): OR= 1.62; CI 95% 1.01; 2.60* Low weight (vs eutrophy): OR= 0.92; CI 95% 0.19; 4.42 – Depression and self-perception of body image with adjustment for BMI Overweight (vs eutrophy): OR= 1.73; CI 95% 1.14; 2.61* Low weight (vs eutrophy): OR= 2.75; CI 95% 1.47; 5.14* Men – Depression and BMI adjusted for self-perception of body image Obesity (vs eutrophy): OR= 1.24; CI 95% 0.62; 2.49 Overweight (vs eutrophy): OR= 0.77; CI 95% 0.39; 1.50 Low weight (vs eutrophy): OR= 0.46; CI 95% 0.13; 1.63 – Depression and self-perception of body image with adjustment for BMI Overweight (vs eutrophy): OR= 1.47; CI 95% 0.81; 2.67 Low weight (vs eutrophy): OR= 2.80; CI 95% 1.42; 5.54*
Richard et al.¹²12. Richard A, Rohrmann S, Lohse T, Eichholzer M. Is body weight dissatisfaction a predictor of depression independent of body mass index, sex, and age? Results of a cross-sectional study. BMC Public Health. 2016;16(1):863. (2016)	– To evaluate the association between dissatisfaction with body image and depression among men and women of different age subgroups	Odds Ratio (OR)	Dissatisfaction with body image and depression – Adjusted by BMI and other sociodemographic and clinical variables, stratified by sex Total sample: OR= 2.04; CI 95% 1.66; 2.50* Men: OR= 1.85; CI 95% 1.34; 2.56* Women: OR= 2.25; CI 95% 1.71; 2.96* – Adjusted by BMI and other sociodemographic and clinical variables, stratified by age range Young people: OR= 1.78; CI 95% 1.16; 2.74* Adults: OR= 2.10; CI 95% 1.61; 2.74* Elderly: OR= 2.34; CI 95% 1.30; 4.23* – Adjusted for sociodemographic and clinical variables, stratified by nutritional state Low weight: OR= 5.2; CI 95% 1.77; 15.26* Eutrophy: OR= 1.89; CI 95% 1.39; 2.59* Overweight: OR= 2.0; CI 95% 1.41; 2.83* Obesity: OR= 1.97; CI 95% 1.1; 3.51*
Kim et al.²⁵25. Kim Y, Austin SB, Subramanian SV, Kawachi I. Body weight perception, disordered weight control behaviors, and depressive symptoms among Korean adults: the Korea National Health and Nutrition Examination Survey 2014. PLoS One. 2018;13(6):e0198841. (2018)	– To investigate the association between perception of body weight and depressive symptoms among Korean adults and potential differential association by gender	Regression coefficient (β)	Women – Underestimation of weight status (vs accurate perception) and depressive symptoms Total sample: β =0.19; CI 95% −0.40; 0.76 Obese: β =-1.25; CI 95% −2.44; −0.01* Eutrophic: β =0.14; CI 95% −0.55; 0.84 – Overestimation of weight status (vs accurate perception) and depressive symptoms Total sample: β =0.45; CI 95% 0.10; 0.79* Obese: not informed Eutrophic: β =1.00; CI 95% 0.54; 1.45* Men – Underestimation of weight status (vs accurate perception) and depressive symptoms Total sample: β =0.14; CI 95% −0.25; 0.52 Obese: β =0.01; CI 95% −0.62; 0.64 Eutrophic: β =0.30; CI 95% −0.25; 0.85 – Underestimation of weight status (vs accurate perception) and depressive symptoms Total sample: β =-0.09; CI 95% −0.62; 0.44 Obese: not informed Eutrophic: β =-0.21; CI 95% −0.78; 0.38
Paans et al. (2018)	14 -To examine whether depressive disorder, depressive symptoms, and BMI are associated with the self-perception of body image and dissatisfaction with body image – To evaluate the association between depression and obesity along with body size, perception of body image, and dissatisfaction with body image	Regression coefficient (β)	Depression and self-perception of body image (Outcome 1) – Diagnosis of depression, adjusted for BMI Healthy controls: Reference Patients in remission: β=0.07 p=0.25 Patients with current depression: β=0.14 p=0.08 – Severity of depression, adjustment for BMI: Severity of depression: β=0.07 p=0.007* Depression and dissatisfaction with body image (Outcome 2) – Diagnosis of depression, adjustment for BMI Healthy controls: Reference Remitted patients: β=0.12 p=0.01* Current patients: β=0.21 p=0.001* – Severity of depression, adjustment for BMI Severity of depression: β=0.11 p< 0.001*

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[1] CORRESPONDING AUTHOR: Daniela Silva, Avenida Marechal Campos, 1468 Maruípe – Vitoria – ES – Brasil – 29075-910, E-mail: daniela.nut@gmail.com