Just-published research out of the United Kingdom contends that people living with multiple physical health conditions face a much higher depression risk than the rest of us.
The authors of the Communications Medicine paper, who dove into health data from more than 142,000 participants pulled from the UK Biobank, write that this new insight can help us better understand individual diseases, as well as how certain illness combinations can wreak havoc on our mental health.
“We saw clear associations between physical health conditions and the development of depression, but this study is only the beginning,” lead author and University of Edinburgh PhD student Lauren DeLong explained. “We hope our findings inspire other researchers to investigate and untangle the links between physical and mental health conditions.”
Methodology
The study, drafted by a team of University of Edinburgh researchers, tackles a growing healthcare problem head on – namely, the growing number of patients living with multiple chronic conditions.
In their search for patterns, the researchers applied four different computational clustering methods to isolate patients based on their existing physical health conditions. Among these, the researchers wrote that the k-modes clustering method performed best. It easily identified groups of conditions that typically occur together and matched established medical patterns.
A cluster of patients with cardiometabolic conditions (such as cardiovascular disease and diabetes) emerged as one of the largest they found. These cardiometabolic clusters comprised 15.5% of the total cohort, including nearly a quarter of the men in the study. Notably, nearly all identified clusters featured links to high depression rates compared to those with no baseline physical conditions.
The strength of this link varied. For example, hazard ratios ranged from 1.29 (indicating a 29% higher risk) to 2.67 (pointing to a 167% higher risk). This suggests that some clusters are more likely to lead to depression than others.
While previous research has established a connection between chronic conditions and depression, this study offers a more nuanced look at how specific disease groupings can elevate that risk. For example, clusters with a higher average number of conditions typically showed stronger ties to depression, which could speak to the greater everyday burden that these individuals face.
A Couple of Caveats
The researchers add that these findings must be taken with a grain of demographic salt.
Multimorbidity is more common among women, older adults, and members of lower socioeconomic backgrounds. And every one of these groups already experiences higher rates of depression.
Additionally, the participants included in this study appeared to be more affluent and less ethnically diverse than the UK population overall. That could skew the results.
The authors add that there needs to be better consistency in how we study multimorbidity. Much of the existing literature depends on a single clustering method, which lacks detail about which conditions dominate each cluster. This can cloud the results.
Real-world Applications
But this study didn’t just compare a handful of clustering techniques. The researchers also sketched out the clusters, illustrating the over- and under-represented conditions. It’s an approach that the authors say makes it easier to interpret the results and make use of them in a clinical setting.
Ultimately, the authors argue that these results back a mounting body of evidence that points to the complex relationship between mental and physical health. As such, they insist that clinicians must keep this relationship in mind when they face patients with multiple chronic illnesses.
Finally, the researchers push for future research that investigates the biological explanations and social ramifications of life with multiple chronic health conditions. As health systems grapple with rising multimorbidity rates, this research underscores the importance of sophisticated data analysis to uncover hidden patterns. It also highlights the way toward more integrated approaches to care that address physical and mental health needs together.
“Healthcare often treats physical and mental health as completely different things, but this study shows that we need to get better at anticipating and managing depression in people with physical illness,” University of Edinburgh professor of general practice and co-author Bruce Guthrie said.
Further Reading
Weekly Sex Could Be a Natural Antidepressant
Lower Costs Boosted Senior Mental Health Care. Screening Could Do More.
