Autoimmune diseases increase risk of affective disorders, finds study

By Melanie Hinze

A new study of more than 1.5 million participants has found that patients with autoimmune disorders are at significantly higher risk of affective disorders, including depression, anxiety and bipolar disorder, compared with the general population.

Published in BMJ Mental Health, the research included UK adults from the Our Future Health research cohort. A total of 37,808 participants with self-reported autoimmune conditions (rheumatoid arthritis, Graves’ disease, inflammatory bowel disease, lupus, multiple sclerosis or psoriasis) were compared with 1.52 million participants without autoimmune conditions. The mean age of the participants was 53 years, and 57% were women.

The lifetime prevalence of affective disorders was 28.8% in the autoimmune group compared with 17.9% in the general population group. Current depression symptoms according to the 9-item Patient Health Questionnaire were 18.6% in the autoimmune group versus 10.5% in the general population group. Current anxiety symptoms according to the 7-item Generalised Anxiety Disorder Scale were 19.9% in the autoimmune group and 12.9% in the general population group. Women had consistently higher risks than men in all groups.

The odds of having an affective disorder in the autoimmune group remained increased even after adjusting for factors such as age, sex, income, chronic pain and social isolation.

Deakin Distinguished Professor of Psychiatry, Michael Berk, said that this research essentially confirmed and expanded what was already understood.

Professor Berk, who is Director of the Institute for Mental and Physical Health and Clinical Translation (IMPACT) and Professor at the Geelong Clinic and Barwon Health, Melbourne, said, ‘Medical conditions associated with increased inflammation, particularly autoimmune disorders, place people at significantly greater risk of mood disorders.’ He added that, ‘By implication, this paper also supports the notion that at least for a subset of people, elevated inflammation forms part of the risk pathways for the development of depression.’

Professor Berk said it was important to be extra aware of the presence of depression in people presenting with autoimmune disorders and other medical disorders associated with elevated inflammation. He also told Medicine Today that although some drivers of inflammation were not easily amenable to intervention, others such as lifestyle determinants were potentially plastic and might be usefully targeted by practitioners.

‘This link also suggests that interventions that reduce inflammation might have theoretical and practical benefit for people suffering from depression,’ he said. ‘The evidence behind this is, so far, preliminary but some agents like COX inhibitors and statins have potential,’ he added.

BMJ Ment Health 2025; 28: 1-7; doi: 10.1136/bmjment-2025-301706.