A bidirectional relationship between depression and the autoimmune disorders - New perspectives from the National Child Development Study.
A bidirectional relationship between depression and the autoimmune disorders - New perspectives from the National Child Development Study.
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DOI：
10.1371/journal.pone.0173015
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Maughan B
中科院分区：
文献类型：
--
作者：
Euesden J;Danese A;Lewis CM;Maughan B
抑郁症和自身免疫性疾病是并存的--这两类疾病在同一个人身上重叠的频率比偶然性高。免疫系统可能影响抑郁症的病理过程；了解这种共病的起源可能有助于剖析这些疾病的机制。我们使用了1958年英国出生队列研究(国家儿童发展研究)的人口队列数据来调查抑郁症和23种自身免疫性疾病的发病年龄。我们使用自我报告数据来确定抑郁症、自身免疫性疾病的终生病史及其发病年龄。我们模拟了抑郁症的发病对随后的自身免疫性疾病发病的影响，反之亦然，并纳入了抑郁症和自身免疫性疾病风险的多基因风险评分。在我们对8174人的分析样本中，315人报告曾被诊断为自身免疫性疾病(3.9%)，1499人报告曾经历过抑郁症(18.3%)。抑郁与自身免疫性疾病有显著的共病关系(OR=1.66，95%CI=1.27~2.15)。自身免疫性疾病的发病与抑郁症发病的风险增加相关(HR=1.39，95%CI=1.11~1.74，P=0.0037)，与抑郁症遗传风险无关。最后，抑郁增加了自身免疫疾病发病的后续风险(HR=1.4，95%CI=1.09-1.8，P=0.0095)，与自身免疫疾病的遗传风险无关。我们的结果指出了抑郁症和自身免疫性疾病之间的双向关系。这表明共同的风险因素可能有助于这种关系，包括共同的环境暴露增加基线炎症水平，以及共同的遗传因素。
Depression and the autoimmune disorders are comorbid—the two classes of disorders overlap in the same individuals at a higher frequency than chance. The immune system may influence the pathological processes underlying depression; understanding the origins of this comorbidity may contribute to dissecting the mechanisms underlying these disorders. We used population cohort data from the 1958 British birth cohort study (the National Child Development Study) to investigate the ages at onset of depression and 23 autoimmune disorders. We used self-report data to ascertain life-time history of depression, autoimmune disorders and their ages at onset. We modelled the effect of depression onset on subsequent autoimmune disorder onset, and vice versa, and incorporated polygenic risk scores for depression and autoimmune disorder risk. In our analytic sample of 8174 individuals, 315 reported ever being diagnosed with an autoimmune disorder (3.9%), 1499 reported ever experiencing depression (18.3%). There was significant comorbidity between depression and the autoimmune disorders (OR = 1.66, 95% CI = 1.27–2.15). Autoimmune disorder onset associated with increased subsequent hazard of depression onset (HR = 1.39, 95% CI = 1.11–1.74, P = 0.0037), independently of depression genetic risk. Finally, depression increased subsequent hazard of autoimmune disorder onset (HR = 1.40, 95% CI = 1.09–1.80, P = 0.0095), independently of autoimmune disorder genetic risk. Our results point to a bidirectional relationship between depression and the autoimmune disorders. This suggests that shared risk factors may contribute to this relationship, including both common environmental exposures that increase baseline inflammation levels, and shared genetic factors.