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Association Between Depression and Physical Conditions Requiring Hospitalization

Frank, Philipp; Batty, G David; Pentti, Jaana; Jokela, Markus; Poole, Lydia; Ervasti, Jenni; Vahtera, Jussi; ... Kivimäki, Mika; + view all (2023) Association Between Depression and Physical Conditions Requiring Hospitalization. JAMA Psychiatry , 80 (7) pp. 690-699. 10.1001/jamapsychiatry.2023.0777. Green open access

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Abstract

IMPORTANCE: Depression is associated with an increased risk of physical illness, but the most common causes of hospitalization among people with depression are unclear. OBJECTIVE: To examine the association of depression with an array of physical conditions requiring hospital treatment. DESIGN, SETTING, AND PARTICIPANTS: In this outcomewide prospective multicohort study, primary analysis was based on data from the UK Biobank, a population-based study in the United Kingdom. Analyses were repeated in an independent data set of 2 cohorts in Finland, a population-based study and an occupational cohort. Data analysis was conducted between April and September 2022. EXPOSURES: Self-reported depression, recurrent severe major depression, recurrent moderate major depression, and a single major depressive episode. MAIN OUTCOMES AND MEASURES: A total of 77 common health conditions ascertained from linkage data to national hospital and mortality registries. RESULTS: The analytical sample of UK Biobank participants consisted of 130 652 individuals (71 565 women [54.8%]; 59 087 men [45.2%]; mean [SD] age at baseline, 63.3 [7.8] years). The pooled data from the Finnish replication cohorts included 109 781 participants (82 921 women [78.6%]; 26 860 men [21.4%]; mean [SD] age, 42 [10.8] years). In the main analysis, severe/moderately severe depression was associated with the incidence of 29 nonoverlapping conditions requiring hospital treatment during a 5-year follow-up. Twenty-five of these associations remained after adjustment for confounders and multiple testing (adjusted hazard ratio [HR] range, 1.52-23.03) and were confirmed in the analysis of the Finnish cohorts. These included sleep disorders (HR, 5.97; 95% CI, 3.27-10.89), diabetes (HR, 5.15; 95% CI, 2.52-10.50), ischemic heart disease (HR, 1.76; 95% CI, 1.36-2.29), chronic obstructive bronchitis (HR, 4.11; 95% CI, 2.56-6.60), bacterial infections (HR, 2.52; 95% CI, 1.99-3.19), back pain (HR, 3.99; 95% CI, 2.96-5.38), and osteoarthritis (HR, 1.80; 95% CI, 1.46-2.20). The highest cumulative incidence was observed for endocrine and related internal organ diseases (245 per 1000 persons with depression; risk difference relative to unaffected individuals: 9.8%), musculoskeletal diseases (91 per 1000 persons; risk difference, 3.7%), and diseases of the circulatory system and blood (86 per 1000 persons; risk difference, 3.9%). The cumulative incidence was lower for hospital-treated mental, behavioral, and neurological disorders (20 in 1000 persons; risk difference, 1.7%). Depression was also associated with disease progression in people with prevalent heart disease or diabetes, and for 12 conditions, there was evidence of a bidirectional relationship. CONCLUSIONS AND RELEVANCE: In this study, the most common causes of hospitalization in people with depression were endocrine, musculoskeletal, and vascular diseases, not psychiatric disorders. These findings suggest that depression should be considered as a target for the prevention of physical and mental disease.

Type: Article
Title: Association Between Depression and Physical Conditions Requiring Hospitalization
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1001/jamapsychiatry.2023.0777
Publisher version: http://dx.doi.org/10.1001/jamapsychiatry.2023.0777
Language: English
Additional information: © 2023 Frank P et al. JAMA Psychiatry. This is an open access article distributed under the terms of the CC-BY License (https://jamanetwork.com/pages/cc-by-license-permissions).
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Mental Health of Older People
URI: https://discovery.ucl.ac.uk/id/eprint/10169648
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