Depression linked to poorer physical health outcomes

Adults with a history of depression are likely to experience more long-term physical health conditions and develop physical health conditions up to 30% faster than those without, a new study reveals.

Researchers found that participants with depression not only entered the study with more physical health conditions but also accrued more physical conditions than participants without depression.

Across the seven-year study, arthritis, diabetes and high blood pressure were among the most common conditions among those with a history of depression.

A collaboration between Edinburgh, Dundee and Belfast researchers, the study emphasises importance of integrated physical and mental health services to support better health outcomes.

The researchers say their findings highlight the need for healthcare systems to shift to better recognise the way physical and mental health affect each other.

As mood disorders like depression are increasingly considered ‘whole-body’ conditions across the brain and body, study co-lead, Kelly Fleetwood from the University of Edinburgh’s Usher Institute said:

“People who’ve experienced depression are more likely to develop long-term physical health conditions such as heart disease, diabetes and arthritis.

“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.”

The study of 172,556 middle-aged and older adults involved in UK Biobank research found that those living with depression experienced a range of adverse physical health outcomes.

At the start of the study, people with a previous diagnosis of depression had an average of three long-term physical health conditions.

Meanwhile, people without a previous diagnosis of depression, meanwhile, had an average of two such conditions and were also less likely to report alcohol misuse – just 1.7% compared to 4.1% of participants with depression.

Chronic pain, sleeplessness, smoking, stressful life events and loneliness, and obesity were all more common amongst participants with a history of depression.

More than 40% of participants with depression also reported anxiety at the beginning of the study compared to just 6.3% of participants without depression.

Participants with depression accrued long-term physical health conditions at a faster rate than those without, which researchers say is partly driven by risk factors like smoking and physical activity.

During the seven-year study, researchers found for every three long-term physical health conditions a person without a history of depression developed, an equivalent participant with a history of depression will develop around four.

As those with depression reported higher rates of smoking, high BMI and low physical activity, the researchers point to opportunities for preventative care to improve future health.

This includes improving the involvement of mental health services in patients’ physical health when it comes to smoking, diet, exercise and obesity and better identification and management of depression in wider healthcare services.

Going forward, researchers recommend healthcare systems take a combined approach to managing both mental and physical health to improve care and outcomes.

Researchers point to collaborative care approaches shown to improve health and wellbeing for people with depression and common conditions like diabetes and heart disease.

They emphasise that these must be adapted to all services in order to support poor mental and physical health earlier, and improvements are ‘most needed’ in less affluent areas.

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