Depression patients usually hospitalized with endocrine, musculoskeletal and vascular diseases: JAMA

A new study published in the Journal of American Medical Association Psychiatry suggests that rather than mental problems, endocrine, musculoskeletal, and circulatory ailments were the most frequent reasons for hospitalization among depressed patients.

Although there is evidence that depression raises the risk of physical illness, it is unclear what hospitals are most frequently visited by those who are depressed. Philipp Frank and colleagues undertook this study to investigate the relationship between depression and a variety of health illnesses necessitating hospitalization.

The core analysis of this outcomewide prospective multicohort study was based on data from the UK Biobank, a population-based study in the United Kingdom. The analyses were performed in an independent data set from two cohorts in Finland, one population-based and one occupational. The data was analyzed between April and September 2022. Self-reported depression, recurring moderate major depression, recurrent severe major depression, and a single major depressive episode were the key exposure criteria. A total of 77 prevalent health disorders were identified through data connection to national hospital and death registries.

The key findings of this study were:

1. The analytical sample of UK Biobank members included 130 652 people.

2. There were 109 781 people in the pooled data from the Finnish replication cohorts.

3. During a 5-year follow-up, severe/moderately severe depression was related with the occurrence of 29 nonoverlapping illnesses needing hospital care in the primary analysis.

4. After adjusting for covariates and repeated testing, twenty-five of these correlations persisted and were confirmed in the analysis of the Finnish cohorts.

5. Sleep difficulties, ischemic heart disease, diabetes, bacterial infections, chronic obstructive bronchitis, back discomfort, and osteoarthritis were among them. Endocrine and associated internal organ disorders, musculoskeletal diseases, and circulatory and blood diseases had the highest cumulative incidence.

6. The cumulative incidence of hospital-treated mental, behavioral, and neurological problems decreased.

7. Depression was also linked to disease development in patients with pre-existing heart disease or diabetes, with evidence of a bidirectional association for 12 illnesses.

In conclusion, depression is linked to a variety of medical diseases across several organ systems. Endocrine, musculoskeletal, and vascular illnesses were the most prevalent reasons for hospitalization in our group of adults with depression. This implies that depression should be addressed more broadly as a target for the prevention and treatment of somatic diseases.

Reference:

Frank, P., Batty, G. D., Pentti, J., Jokela, M., Poole, L., Ervasti, J., Vahtera, J., Lewis, G., Steptoe, A., & Kivimäki, M. (2023). Association Between Depression and Physical Conditions Requiring Hospitalization. In JAMA Psychiatry. American Medical Association (AMA). https://doi.org/10.1001/jamapsychiatry.2023.0777