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.

中文翻译：

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抑郁症与需要住院治疗的身体状况之间的关联。


重要性 抑郁症与身体疾病的风险增加有关，但抑郁症患者住院的最常见原因尚不清楚。目的 研究抑郁症与一系列需要住院治疗的身体状况之间的关系。设计、设置和参与者 在这项结果广泛的前瞻性多队列研究中，主要分析基于英国生物银行的数据，这是一项在英国进行的基于人群的研究。在芬兰的两个队列（一项基于人群的研究和一个职业队列）的独立数据集中重复进行了分析。数据分析于 2022 年 4 月至 9 月期间进行。暴露 自我报告的抑郁症、复发性重度抑郁症、复发性中度抑郁症和单次抑郁症发作。主要成果和措施 通过与国家医院和死亡登记处的关联数据确定了总共 77 种常见健康状况。结果 英国生物银行参与者的分析样本由 130 652 人组成（71 565 名女性 [54.8%]；59 087 名男性 [45.2%]；基线平均 [SD] 年龄为 63.3 [7.8] 岁）。来自芬兰复制队列的汇总数据包括 109 781 名参与者（82 921 名女性 [78.6%]；26 860 名男性 [21.4%]；平均 [SD] 年龄，42 [10.8] 岁）。在主要分析中，重度/中度重度抑郁症与 5 年随访期间需要住院治疗的 29 种非重叠病症的发生率相关。在调整混杂因素和多重测试（调整后的风险比 [HR] 范围，1.52-23.03）后，其中 25 个关联仍然存在，并在芬兰队列的分析中得到证实。其中包括睡眠障碍（HR，5.97；95% CI，3.27-10.89）、糖尿病（HR，5.15；95% CI，2.52-10）。50）、缺血性心脏病（HR，1.76；95% CI，1.36-2.29）、慢性阻塞性支气管炎（HR，4.11；95% CI，2.56-6.60）、细菌感染（HR，2.52；95% CI，1.99- 3.19）、背痛（HR，3.99；95% CI，2.96-5.38）和骨关节炎（HR，1.80；95% CI，1.46-2.20）。累积发病率最高的是内分泌及相关内脏器官疾病（每 1000 名抑郁症患者 245 例；相对于未受影响个体的风险差异：9.8%）、肌肉骨骼疾病（每 1000 人 91 例；风险差异为 3.7%）和疾病循环系统和血液（每 1000 人 86 人；风险差异，3.9%）。住院治疗的精神、行为和神经系统疾病的累积发生率较低（每 1000 人中 20 例；风险差异为 1.7%）。抑郁症还与患有心脏病或糖尿病的人的疾病进展相关，并且对于 12 种疾病，有证据表明存在双向关系。结论和相关性 在这项研究中，抑郁症患者住院的最常见原因是内分泌、肌肉骨骼和血管疾病，而不是精神疾病。这些发现表明抑郁症应被视为预防身心疾病的目标。