People with depression commonly hospitalized for physical medical conditions

Key takeaways:

• People with depression were most likely to be hospitalized for an endocrine, musculoskeletal or vascular disease.
• Depression was also linked to the progression of heart disease and diabetes.

Among people with depression, the most common reasons for hospitalization were physical conditions rather than psychiatric ones, according to findings published in JAMA Psychiatry.

Philipp Frank, PhD, a doctoral researcher at the University College London, and colleagues analyzed data from the U.K. Biobank, the Finnish Health and Social Support Study (HeSSup) and the Finnish Public Sector Study (FPS) to identify associations between self-reported or physician-diagnosed depression and reason for hospitalization.

In the initial analyses of the U.K. Biobank cohort, researchers found associations between severe or moderately sever depression and 25 separate medical conditions, which were confirmed by analyses of the two other studies.

Specifically, depression was associated with hospitalization within 5 years for sleep disorders (HR = 1.76; 95% CI, 3.27-10.89), diabetes (HR = 5.15; 95% CI, 2.52-10.5), ischemic heart disease (HR = 1.76; 95% CI, 1.36-2.29), chronic obstructive bronchitis (HR = 4.11; 95% CI, 2.56-6.6), 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 = 1.8; 95% CI, 1.46-2.2).

Compared with people who did not have severe or moderately severe depression, those who had severe or moderately severe depression had the highest 4-year cumulative incidence rate of hospitalization for endocrine diseases (147 vs. 245 per 1,000 people; absolute excess risk, 9.8%). People with depression also had higher cumulative incidence rates for musculoskeletal diseases (91 per 1,000 people; absolute excess risk, 3.7%) and circulatory system and blood diseases (86 per 1,000 people; absolute excess risk, 3.9%).

Notably, the cumulative incidence rate of hospitalization for mental, behavioral or neurological disorders was only 20 in 1,000 people among people with moderately severe or severe depression, the researchers reported.

Further analyses of the U.K. Biobank cohort revealed that the risk for indicated that depression was associated with heart disease progression. Specifically, people with heart conditions who had mild or moderate depression (HR = 1.26; 95% CI, 1.14-1.4) and severe or moderately severe depression (HR = 1.92; 95% CI, 1.52-2.43) had greater odds of hospitalization for circulatory conditions compared with participants who did not have depression.

Additionally, the risk for hospitalization for diabetes was greater among people with mild or moderate depression (HR = 2.35; 95% CI, 1.38-3.98) and severe or moderately severe depression (HR = 3.6; 95% CI, 1.46-8.9).

“Our findings show that the associations of depression with physical disease are widespread across multiple organ systems,” Frank and colleagues wrote. “This suggests that depression should be considered more widely as a target for somatic disease prevention and treatment.”