Results: Depression was especially associated with obesityrelated metabolic components (e.g. abdominal obesity and dyslipidemia). In addition, systemic inflammation and hyperactivity of the HPA-axis have been consistently observed among depressed patients. Less consistent observations are for autonomic dysregulation among depressed patients. However, clear pathophysiological differences were observed for melancholic versus atypical depressed patients. Metabolic syndrome and inflammation upregulations appear more specific to the atypical depression subtype, whereas hypercortisolemia appears more specific for melancholic depression. I will illustrate the extent to which these differential dysregulations may explain the increased risk for cardiovascular health outcomes among depressed patients. Discussion: Our results confirm the presence of a downward spiral in which different depressive symptom profiles and biological dysregulations may impact on each other and interact with cardiovascular – but also more general – health decline.