Depression as a risk factor for the development of rheumatoid arthritis: a population-based cohort study

RMD Open
Isabelle A VallerandCheryl Barnabe

Abstract

Major depressive disorder (MDD) is associated with increased levels of systemic proinflammatory cytokines, including tumour necrosis factor alpha. As these cytokines are pathogenic in autoimmune diseases such as rheumatoid arthritis (RA), our aim was to explore on a population-level whether MDD increases the risk of developing RA. A retrospective cohort study was conducted using The Health Improvement Network (THIN) database (from 1986 to 2012). Observation time was recorded for both the MDD and referent cohorts until patients developed RA or were censored. Cox proportional hazards models were used to determine the risk of developing RA among patients with MDD, accounting for age, sex, medical comorbidities, smoking, body mass index and antidepressant use. A cohort of 403 932 patients with MDD and a referent cohort of 5 339 399 patients without MDD were identified in THIN. Cox proportional hazards models revealed a 31% increased risk of developing RA among those with MDD in an unadjusted model (HR=1.31, 95% CI 1.25 to 1.36, p<0.0001). When adjusting for all covariates, the risk remained significantly increased among those with MDD (HR=1.38, 95% CI 1.31 to 1.46, p<0.0001). Antidepressant use demonstrated a confounding effect tha...Continue Reading

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Citations

Feb 23, 2019·Current Opinion in Rheumatology·Isabelle A VallerandCheryl Barnabe
Sep 17, 2020·Arthritis Care & Research·Jeffrey A SparksKaren H Costenbader
Oct 18, 2020·Journal of Affective Disorders·Yeqing GuKaijun Niu
May 2, 2021·Joint, Bone, Spine : Revue Du Rhumatisme·Eric Fakra, Hubert Marotte
May 27, 2021·Liver International : Official Journal of the International Association for the Study of the Liver·Abdel Aziz ShaheenMark G Swain

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