Previous studies using magnetic resonance imaging (MRI) and functional MRI to study depression have primarily focused on proton magnetic resonance spectroscopy (H-1-MRS) appearance in various areas of the brain and volume measurements in the limbic system. However, results have not been consistent. To the best of our knowledge, very little is known about the relationship between H-1-MRS appearance and depression inventory. In the present study, the relationship between H-1-MRS appearance in depressive patients and Minnesota Multiphasic Personality Inventory-2 scale was analyzed. MRI and H-1-MRS exhibited widened sulci and cisterns, as well as an absence of abnormal signals in depressive patients. In addition, N-acetyl aspartate/total creatine ratios in bilateral hippocampi and dorsolateral prefrontal cortex were significantly less in depressive patients than in control subjects (P < 0.01). In contrast, choline-containing compounds/total creatine ratios in the dorsolateral prefrontal cortex were significantly greater in depressive patients than in control subjects (P < 0.01). These ratios significantly and positively correlated with patient total depression scores as assessed using the Minnesota Multiphasic Personality Inventory-2 scale (r = 0.934 7, 0.878 7, P < 0.01). These results suggested that H-1-MRS could be used to reveal a reduced number of neurons in the hippocampus and dorsolateral prefrontal cortex, as well as altered membrane phospholipid metabolism in the dorsolateral prefrontal cortex, in patients with depressive disorder. Abnormal mechanisms partially reflected severity of depressive disorder.