Background

Associations between depression and non-communicable disease have been well-described. However, the evidence for its role in the development of infectious disease is less understood. We aimed to examine prospective associations between depression and risk of hospitalisation for infection in middle-aged adults from the UK Biobank (linked with Hospital Episode Statistics) and assessed the role of several depression-related factors.

Methods

We assessed prospective associations between depression status at the baseline assessment (2006–2010) and hospitalisations for infection up to the end of March 2016 in 460,418 middle-aged adults enrolled in the UK Biobank (mean age = 56.23 ± 8.11 years, 53.5% female). Cox regression was used to assess associations between depression and subsequent hospitalisations for any infections, as well as infection subtypes, viral infections, and bacterial infections. Amongst those with depression, we also examined the role of depression duration, the age of onset, and the use of antidepressants in hospitalisation risk.

Results

Depression at baseline was prospectively associated with an increased risk of hospitalisation for infection (adjusted hazard ration (aHR) = 1.20, 95% confidence interval (CI) = 1.16 to 1.25). This association was found for all infection subtypes apart from infections of the central nervous system (p = 0.911) and the skin (p = 0.313). Receipt of a depression diagnosis in late adulthood and use of antidepressants (but only in those with none/mild depressive symptoms at baseline) increased the risk of hospitalisation for infection amongst those with depression.

Conclusions

These findings suggest that depression might be a risk factor which could be used to identify those at risk of hospitalisation for infection. Future research is required to understand the underlying factors that might result in this increased risk, so that targeted interventions can be developed.

Funding

AD and AR are funded by Guy’s Charity grant number EIC180702 (MLTC Challenge Fund); AD and JAT are co-funded by MRC and NIHR through grant number MR/S028188/1. IB is supported by the NIHR Maudsley BRC and by the NIHR Collaboration for Leadership in Applied Health Research and Care South Londnoo at King's College Hospital NHS Foundation Trust, King's College London. The views expressed are those of the author[s] and not necessarily those of the ESRC, NIHR, the Department of Health and Social Care or King’s College London.

中文翻译：

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抑郁症与感染住院风险之间的前瞻性关联：来自英国生物银行的调查结果

背景

抑郁症与非传染性疾病之间的关联已得到很好的描述。然而，关于其在传染病发展中的作用的证据知之甚少。我们旨在研究来自英国生物银行（与医院事件统计相关）的中年成年人抑郁症与感染住院风险之间的前瞻性关联，并评估了几种抑郁症相关因素的作用。

方法

我们评估了基线评估（2006-2010 年）抑郁状态与截至 2016 年 3 月末感染住院之间的前瞻性关联，研究对象为在英国生物银行登记的 460,418 名中年成年人（平均年龄 = 56.23 ± 8.11 岁，53.5% 为女性） ）。Cox 回归用于评估抑郁症与任何感染的后续住院治疗以及感染亚型、病毒感染和细菌感染之间的关联。在抑郁症患者中，我们还检查了抑郁症持续时间、发病年龄和抗抑郁药使用对住院风险的影响。

结果

基线时的抑郁与感染住院风险增加具有前瞻性相关（调整后的风险比 (aHR) = 1.20，95% 置信区间 (CI) = 1.16 至 1.25）。除了中枢神经系统感染 ( p  = 0.911) 和皮肤感染 ( p  = 0.313) 之外，所有感染亚型都发现了这种关联。在成年晚期接受抑郁症诊断并使用抗抑郁药（但仅限于基线时没有/轻度抑郁症状的人）增加了抑郁症患者因感染而住院的风险。

结论

这些研究结果表明，抑郁症可能是一个风险因素，可用于识别那些有住院感染风险的人。未来的研究需要了解可能导致这种风险增加的潜在因素，以便制定有针对性的干预措施。

资金

AD 和 AR 由 Guy 的慈善赠款编号 EIC180702（MLTC 挑战基金）资助；AD 和 JAT 由 MRC 和 NIHR 通过拨款号 MR/S028188/1 共同资助。IB 得到了 NIHR Maudsley BRC 和伦敦国王学院国王学院医院 NHS 基金会信托的 NIHR 应用健康研究和护理南隆德诺领导力合作组织的支持。所表达的观点是作者的观点，不一定是 ESRC、NIHR、卫生和社会保健部或伦敦国王学院的观点。