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Depression as a risk factor for the development of rheumatoid arthritis: a population-based cohort study.
Vallerand, Isabelle A; Lewinson, Ryan T; Frolkis, Alexandra D; Lowerison, Mark W; Kaplan, Gilaad G; Swain, Mark G; Bulloch, Andrew G M; Patten, Scott B; Barnabe, Cheryl.
Afiliación
  • Vallerand IA; Leaders in Medicine Program, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Lewinson RT; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Frolkis AD; Leaders in Medicine Program, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Lowerison MW; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Kaplan GG; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Swain MG; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Bulloch AGM; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Patten SB; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Barnabe C; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
RMD Open ; 4(2): e000670, 2018.
Article en En | MEDLINE | ID: mdl-30018804
OBJECTIVES: Major depressive disorder (MDD) is associated with increased levels of systemic proinflammatory cytokines, including tumour necrosis factor alpha. As these cytokines are pathogenic in autoimmune diseases such as rheumatoid arthritis (RA), our aim was to explore on a population-level whether MDD increases the risk of developing RA. METHODS: A retrospective cohort study was conducted using The Health Improvement Network (THIN) database (from 1986 to 2012). Observation time was recorded for both the MDD and referent cohorts until patients developed RA or were censored. Cox proportional hazards models were used to determine the risk of developing RA among patients with MDD, accounting for age, sex, medical comorbidities, smoking, body mass index and antidepressant use. RESULTS: A cohort of 403 932 patients with MDD and a referent cohort of 5 339 399 patients without MDD were identified in THIN. Cox proportional hazards models revealed a 31% increased risk of developing RA among those with MDD in an unadjusted model (HR=1.31, 95% CI 1.25 to 1.36, p<0.0001). When adjusting for all covariates, the risk remained significantly increased among those with MDD (HR=1.38, 95% CI 1.31 to 1.46, p<0.0001). Antidepressant use demonstrated a confounding effect that was protective on the association between MDD and RA. CONCLUSION: MDD increased the risk of developing RA by 38%, and antidepressants may decrease this risk in these patients. Future research is necessary to confirm the underlying mechanism of MDD on the pathogenesis of RA.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: RMD Open Año: 2018 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: RMD Open Año: 2018 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido