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Association with severe and treatment-resistant depression among patients with inflammatory joint disease. Nationwide nested case-control study in Swedish registers

Published online by Cambridge University Press:  01 September 2022

P. Brenner ,
J. Askling ,
P. Stang ,
L. Brandt ,
D. Hägg  and
J. Reutfors
P. Brenner*
Affiliation:
Karolinska Institutet, Medicine Solna, Stockholm, Sweden
J. Askling
Affiliation:
Karolinska Institutet, Medicine Solna, Stockholm, Sweden
P. Stang
Affiliation:
Janssen, Global Services, Titusville, United States of America
L. Brandt
Affiliation:
Karolinska Institutet, Medicine Solna, Stockholm, Sweden
D. Hägg
Affiliation:
Karolinska Institutet, Medicine Solna, Stockholm, Sweden
J. Reutfors
Affiliation:
Karolinska Institutet, Medicine Solna, Stockholm, Sweden
*
*Corresponding author.

Abstract

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Introduction

Treatment resistant depression (TRD) and severe depression (SD) are common among patients with depression. Patients with inflammatory joint disease (IJD) are at higher risk for developing depression compared to the general population; however, the risk for SD or TRD is not known.

Objectives

To examine the odds of patients with IJD for developing SD and TRD compared to non-severe and non-TRD depression.

Methods

This case-control study was nested within a cohort of patients with incident depression (n=443,384) identified in nationwide Swedish registers 2006-2018. Patients with SD (n=42,975) were identified through the ICD-10 code specifier, through psychiatric hospitalization and/or through suicide attempts. Patients who started a third consecutive treatment for depression were identified with TRD (n=33,830). Each patient was matched with five non-SD - or non-TRD - patients by sociodemographics and year of cohort entry. Crude and adjusted odds ratios (aOR) were calculated by conditional logistic regression with regard to a history of any IJD and specific IJDs prior to depression onset.

Results

Among patients with depression, those with a history of IJD did not have higher odds for developing SD (aOR 1.09 (95%CI 1.00-1.20)) or TRD (aOR 1.03 (0.93 - 1.14)) compared to patients without IJD. A history of rheumatoid arthritis was associated with a significantly higher odds for SD among patients aged 18-29 (aOR 1.55 (1.01-2.36)) and for TRD among patients aged 30-49 (aOR 1.33 (1.05-1.67).

Conclusions

Overall, no association was observed between history of IJD and developing SD/TRD; with the exception of younger age strata in rheumatoid arthritis.

Disclosure

PB, JA, DH, LB, and JR are affiliated to or employees at The Unit for Clinical Epidemiology, Karolinska Institutet, which receives grants from several entities (pharmaceutical companies, regulatory authorities, contract research organizations) for the per

Keywords

RheumatologyInflammatory joint diseaseEpidemiologyDepression
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S111
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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