title: A bidirectional relationship between depression and the autoimmune disorders - New perspectives from the National Child Development Study.
abstract: BACKGROUND
  Depression and the autoimmune disorders are comorbid-the two classes of disorders overlap in the same individuals at a higher frequency than chance. The immune system may influence the pathological processes underlying depression; understanding the origins of this comorbidity may contribute to dissecting the mechanisms underlying these disorders.
  
  
  METHODS
  We used population cohort data from the 1958 British birth cohort study (the National Child Development Study) to investigate the ages at onset of depression and 23 autoimmune disorders. We used self-report data to ascertain life-time history of depression, autoimmune disorders and their ages at onset. We modelled the effect of depression onset on subsequent autoimmune disorder onset, and vice versa, and incorporated polygenic risk scores for depression and autoimmune disorder risk.
  
  
  RESULTS
  In our analytic sample of 8174 individuals, 315 reported ever being diagnosed with an autoimmune disorder (3.9%), 1499 reported ever experiencing depression (18.3%). There was significant comorbidity between depression and the autoimmune disorders (OR = 1.66, 95% CI = 1.27-2.15). Autoimmune disorder onset associated with increased subsequent hazard of depression onset (HR = 1.39, 95% CI = 1.11-1.74, P = 0.0037), independently of depression genetic risk. Finally, depression increased subsequent hazard of autoimmune disorder onset (HR = 1.40, 95% CI = 1.09-1.80, P = 0.0095), independently of autoimmune disorder genetic risk.
  
  
  CONCLUSIONS
  Our results point to a bidirectional relationship between depression and the autoimmune disorders. This suggests that shared risk factors may contribute to this relationship, including both common environmental exposures that increase baseline inflammation levels, and shared genetic factors.
authors.affiliation: MRC SGDP Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.|Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom.
authors.forename: Jack
authors.identifier: http://orcid.org/0000-0002-6790-1925
authors.initials: J
authors.lastname: Euesden
authors.affiliation: MRC SGDP Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.|Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
authors.forename: Andrea
authors.initials: A
authors.lastname: Danese
authors.affiliation: MRC SGDP Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.|Division of Genetics and Molecular Medicine, King's College London, London, United Kingdom.
authors.forename: Cathryn M
authors.initials: CM
authors.lastname: Lewis
authors.affiliation: MRC SGDP Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
authors.forename: Barbara
authors.initials: B
authors.lastname: Maughan
mesh_terms: D000328:Adult; D000367:Age Factors; D001327:Autoimmune Diseases / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D002657:Child Development; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000150:complications* / Q000523:psychology*; D004777:Environment; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D020641:Polymorphism, Single Nucleotide; D011159:Population Surveillance; D018570:Risk Assessment; D012307:Risk Factors; D057566:Self Report