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OBJECTIVE: In this study, we aimed to quantify posture and body image in patients with major depressive disorder during episodes and after drug treatment, comparing the results with those obtained for healthy volunteers. METHOD: Over a 10-week period, we evaluated 34 individuals with depression and 37 healthy volunteers. Posture was assessed based on digital photos of the subjects; CorelDRAW software guidelines and body landmarks were employed. Body image was evaluated using the Body Shape Questionnaire. RESULTS: During depressive episodes (in comparison with the post-treatment period), patients showed increased head flexion (p < 0.001), increased thoracic kyphosis (p < 0.001), a trend toward left pelvic retroversion (p = 0.012) and abduction of the left scapula (p = 0.046). During remission, patient posture was similar to that of the controls. At week 1 (during the episode), there were significant differences between the patients and the controls in terms of head flexion (p < 0.001) and thoracic kyphosis (p < 0.001); at weeks 8-10 (after treatment), such differences were seen only for shoulder position. The mean score on the Body Shape Questionnaire was 90.03 during the depressive episode, compared with 75.82 during remission (p = 0.012) and 62.57 for the controls. CONCLUSION: During episodes of depression, individuals with major depressive disorder experience changes in posture and mild dissatisfaction with body image. The findings demonstrate that the negative impact of depression includes emotional and physical factors.

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In clinical and research settings, psychopathological conditions are often evaluated through verbal measures, such as, questionnaires, scales, clinical interviews, that focus on the presence of set of symptoms (ex: affective, cognitive and social). However, patients sometimes are not able to precisely communicate their problems. They can avoid the description for the clinicians and researchers of some symptoms or other relevant information because of private feelings, such as shame, social desirability, or other reasons. Other times, patients cannot recognize what exactly happen with them that cause emotional and social problems, what impairs their verbal report and treatment.