People with depression at higher risk for long-term physical health conditions

Adults with a history of depression gain long-term physical conditions around 30% faster than those without, according to research publishing February 13^th in the open-access journal PLOS Medicine. Kelly Fleetwood of the University of Edinburgh, United Kingdom, and colleagues argue that their study suggests depression should be viewed as a 'whole body' condition, and integrated approaches should be used to manage mental and physical health.

Depression is the most common mental health condition and is associated with a range of adverse physical health outcomes such as heart disease and diabetes. Past research has compared people with and without depression to see how many physical conditions they develop over time, but most studies look at a small number of illnesses. Fleetwood and colleagues aimed to quantify the association between depression and the rate at which conditions accrued in midlife and older age.

The team included 172,556 volunteers in the UK Biobank study, aged 40-71 years, who completed a baseline assessment between 2006 and 2010. They selected 69 physical conditions and followed participants for an average of 6.9 years. Initially, those with depression had an average of three physical conditions compared with an average of two in those without. Over the study period, adults with a history of depression accrued an average of 0.2 additional physical conditions per year, while those without accrued 0.16. The most common new conditions were osteoarthritis (15.7% of those with depression at baseline vs 12.5% without), hypertension (12.9% vs 12.0%) and gastroesophageal reflux disease (13.8% vs 9.6%).

The results highlight that previous diagnosis of depression is a marker of risk for development of long-term physical health conditions during middle and older-age. Most healthcare systems are designed to treat individual conditions rather than individuals with multiple conditions, and the authors believe that integrated approaches to managing both mental and physical health could improve care and outcomes.

The authors add, "People who've experienced depression are more likely to develop long-term physical health conditions such as heart disease and diabetes; however, existing healthcare systems are designed to treat individual conditions, instead of individual people with multiple conditions. We need healthcare services to take an integrated approach to caring for people who have both depression and long-term physical health conditions."