Key result
Major depressive disorder was associated with a 38% increased risk of developing rheumatoid arthritis (HR 1.38; 95% CI 1.31 to 1.46; p<0.0001).
Why the study?
Does Major Depressive Disorder increase the risk of developing rheumatoid arthritis?
Cohort (n=5,743,331)
Does Major Depressive Disorder increase the risk of developing rheumatoid arthritis?
Hazard Ratio: 1.38 (95% CI 1.31–1.46)
p-value: p=<0.0001
Major depressive disorder is associated with a 38% increased risk of developing rheumatoid arthritis, highlighting a potential inflammatory link between the two conditions.
MDD-RA association supports clinical vigilance in depression; leaves open causality and whether treatment modifies risk.
OBJECTIVES: 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. METHODS: 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. RESULTS: 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 that was protective on the association between MDD and RA. CONCLUSION: MDD increased the risk of developing RA by 38%, and antidepressants may decrease this risk in these patients. Future research is necessary to confirm the underlying mechanism of MDD on the pathogenesis of RA.
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Vallerand et al. (2018) conducted a cohort in Major depressive disorder (MDD) (n=5,743,331). Major depressive disorder (MDD) vs. Patients without MDD was evaluated on Development of rheumatoid arthritis (RA) (HR 1.38, 95% CI 1.31 to 1.46, p=<0.0001). Major depressive disorder was associated with a 38% increased risk of developing rheumatoid arthritis (HR 1.38; 95% CI 1.31 to 1.46; p<0.0001).
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