Search

This cohort study examines data from the UK Biobank and 2 Finnish cohorts to gauge the association between depression and an array of physical conditions requiring hospital treatment. Key Points: Question: What are the most common conditions requiring hospital treatment in people with depression? Findings: In this cohort study that included 240 433 individuals, depression was associated with an increased risk of 29 hospital-treated conditions. For 12 of these conditions, there was evidence for a bidirectional relationship with depression; the highest cumulative incidence was observed for diseases of the endocrine, musculoskeletal, and circulatory systems. Meaning: In this study, the main causes of excess hospitalizations in people with depression were endocrine, musculoskeletal, and vascular diseases. 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. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the impact of patient-overcrowding in hospital wards on diagnosis-specific mental disorders among hospital staff. In the study, researchers used routinely recorded patient bed occupancy rates between 2003 and 2004 in Finland. They found that hospital staff working in wards with a patient occupancy level 10 percentage units above the optimal during the initial year showed twice the risk of sickness absence because of depression.