Children and adolescents with depression are at higher risk for a host of somatic diseases and premature death in early adulthood, according to a study published in JAMA Psychiatry.
These findings support the hypothesis that youth depression is linked to more than other psychiatric and neurologic disorders, impacting their quality of life and posing public health challenges, according to corresponding author Sarah E. Bergen, Ph.D., of the Karolinska Institutet in Sweden and colleagues. “Consequentially, clinical efforts to comprehensively manage both psychiatric and somatic diagnoses are needed.”
Bergen and colleagues conducted a cohort study of nearly 1.5 million Swedish individuals born between 1982 and 1996, with follow-up through 2013. Using data on clinical diagnoses from the National Patient Register and deaths noted in the Cause of Death Register, they compared outcomes in people who were diagnosed with depression between the ages of 5 and 19 (defined by authors as youth depression) with those who were not diagnosed with depression as youth. (The observation period began when patients were aged 5 because pediatric depression is rarely diagnosed during the first years of life, the authors wrote.) The patients’ age at the end of the follow-up period was between 17 and 31 years.
The authors specifically focused on causes of death and the diagnoses of 69 somatic diseases, including gastrointestinal, respiratory, and genitourinary diseases; autoimmune diseases; and endocrine and metabolic disorders.
In total, 360 patients (1.0%) with youth depression died during follow-up compared with 6,254 individuals (0.4%) in the group without history of depression. Intentional self-harm was the leading cause of death among those with youth depression. Those participants also had a significantly higher risk of being diagnosed with 66 of the 69 somatic diseases included in the study at any time after their first inpatient or outpatient recorded depressive episode.
The strongest risk for an injury was among females with youth depression, who were 14 times more likely to experience an injury from self-harm than females not diagnosed with youth depression. Females with youth depression also had a higher risk of genitourinary infections, while males had a higher risk for obesity, thyroid disease, and other endocrine gland disorders. Both sexes, however, had an increased risk for type 2 diabetes, viral hepatitis, kidney disease, and liver disease. When adjusted for psychiatric comorbidity, all the associations that the authors identified were weaker, but persisted.
“More research is needed to identify whether depression at a young age leads to adverse health outcomes or common causes underlie both,” the authors concluded. “Discovery of disease mechanisms that may serve as intervention targets in early life should be prioritized in light of the substantial disease burden associated with youth depression diagnoses.”
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