Depression may hasten development of chronic health conditions in adults

Key takeaways:

• People with depression acquired more additional physical health conditions each year during a 7-year follow-up period.
• Depression should be looked at as a ‘whole body’ condition, researchers said.

Adults with a history of depression gained long-term physical health conditions at a rate 30% faster than those without such a history, an analysis of a UK-based nationwide cohort study in PLoS Medicine showed.

Lifestyle factors like low physical activity and smoking helped drive this accelerated rate, the researchers noted.

Depression’s role as a possible risk factor for physical multimorbidity has been under-researched, “with only half of multimorbidity studies including depression in their condition count,” according to Kelly J. Fleetwood, a statistician at the University of Edinburgh in Scotland, and colleagues.

In the current analysis, the researchers examined a cohort of 172,556 participants from the U.K. Biobank, who were aged between 40 and 71 years during baseline assessment from 2006 to 2010, to determine the effect depression has on acquiring physical comorbid conditions.

They identified 69 kinds of physical morbidities while following the participants for almost 7 years.

At baseline, 18% of the cohort received a diagnosis of depression, with a mean number of physical conditions possessed of 2.9 for people with depression and 2.1 for those without.

People with and without depression gained a mean 0.2 and 0.16 additional conditions a year, respectively, during the follow-up period.

The researchers found that people with depression gained physical morbidity faster vs. those without depression (RR = 1.32; 95% CI, 1.31-1.34) after they adjusted for age and sex.

The rate of accruement remained faster in those with depression (RR = 1.3; 95% CI, 1.28-1.32), even after Fleetwood and colleagues further adjusted for all sociodemographic characteristics.

The researchers reported an attenuated rate that remained statistically significant after adjusting for baseline condition count and lifestyle and social factors (RR = 1.1; 95% CI, 1.09-1.12).

The most common new conditions gained during follow-up included:

• osteoarthritis (15.7% of those with depression at baseline vs. 12.5% without);
• hypertension (12.9% of those with depression at baseline vs. 12% without) and
• gastroesophageal reflux disease (13.8% of those with depression at baseline vs 9.6% without).

The rate of accrual being influenced by several modifiable risk factors means “that there are potential opportunities for preventive care to improve future health,” the researchers wrote. “Better identification and management of depression in physical health care is needed, but mental health services also need to involve themselves in supporting their patients to maintain or improve their physical health in relation to smoking, diet, obesity and exercise, for example.”

Fleetwood and colleagues identified some study limitations, such as a possible underestimation of the strength of the association between depression and physical morbidity accrual.

They also noted that U.K. Biobank participants are generally healthier and less likely to live in deprived areas vs. the general population, hurting the general applicability of the findings.

The results show that depression should be looked at as a “‘whole body’ condition, as well as the importance of integrated approaches to managing both mental and physical health outcomes,” the researchers wrote.

References:

• Depression linked with higher risk of long-term physical health conditions. Available at: https://www.eurekalert.org/news-releases/1073073?. Published Feb. 13, 2025. Accessed March 3, 2025.
• Fleetwood K, et al. PLoS Med. 2025;doi:10.1371/journal.pmed.1004532.