ArticleTranslational psychiatry2023
Treatment-resistant depression and risk of autoimmune diseases: evidence from a population-based cohort and nested case-control study.
Article in Translational psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 26 citations in OpenAlex.
- Cost-effectiveness of esketamine versus alternative treatment strategies for treatment-resistant depression in Hong Kong: A multi-armed modeling study.PLoS medicine · 2026Article
- Sleep quality and the biological stress system during an internet-based intervention for major depressive disorder.Comprehensive psychoneuroendocrinology · 2025Article
- Networks and clusters of immunometabolic biomarkers and depression-associated features in middle-aged and older community-dwelling US adults with and without depression.Brain, behavior, & immunity - health · 2025Article
- Epigenetics and immunology: Under-recognized aspects of suicidality.World journal of psychiatry · 2025Review
- Mechanisms Underlying Treatment-Resistant Depression: Exploring Sex-Based Biological Differences.Journal of neurochemistry · 2025Review
- Article
- Beyond the Surface: Tracing the Evolution of Inflammatory Mechanism in Depression through Bibliometric Analysis.Endocrine, metabolic & immune disorders drug targets · 2025Review
- Elucidation and application of the neuroimmune axis between depression and autoimmune diseases: A genome wide and cohort study.PloS one · 2025Article
- Comorbidity, Treatment, and Service Utilization Patterns in Difficult-to-Treat Depression Patients: A Retrospective Study in a Portuguese Community Mental Health Team.Medicina (Kaunas, Lithuania) · 2024Observational
- A social science: Using psychoneuroimmunology principles to promote career longevity, productivity, and meaning.Comprehensive psychoneuroendocrinology · 2024Article
- Article
- Projecting the 10-year costs of care and mortality burden of depression until 2032: a Markov modelling study developed from real-world data.The Lancet regional health. Western Pacific · 2024Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Recent literature indicates that patients with depression had increased immune activation. We hypothesised that treatment-resistant depression (TRD), an indicator of non-responsive depression with long-term dysregulated inflammation, could be an independent risk factor for subsequent autoimmune diseases. We performed a cohort study and a nested case-control study to examine the association between TRD and risk of autoimmune diseases, and to explore potential sex-specific difference. Using electronic medical records in Hong Kong, we identified 24,576 patients with incident depression between 2014 and 2016 without autoimmune history and followed up from diagnosis to death or December 2020 to identify TRD status and autoimmune incidence. TRD was defined as having at least two antidepressant regimens and the third regimen to confirm previous treatment failures. Based on age, sex and year of depression, we matched TRD patients 1:4 to the non-TRD in the cohort analysis using nearest-neighbour matching, and matched cases and controls 1:10 using incidence density sampling in the nested case-control analysis. We conducted survival analyses and conditional logistic regression respectively for risk estimation, adjusting for medical history. Across the study period, 4349 patients without autoimmune history (17.7%) developed TRD. With 71,163 person-years of follow-up, the cumulative incidence of 22 types of autoimmune diseases among the TRD patients was generally higher than the non-TRD (21.5 vs. 14.4 per 10,000 person-years). Cox model suggested a non-significant association (HR:1.48, 95% CI: 0.99-2.24, p = 0.059), whereas conditional logistic model showed a significant association (OR: 1.67, 95% CI: 1.10-2.53, p = 0.017) between TRD status and autoimmune diseases. Subgroup analysis showed that the association was significant in organ-specific diseases but not in systemic diseases. Risk magnitudes were generally higher among men compared to women. In conclusion, our findings provide evidence for an increased risk of autoimmune diseases in patients with TRD. Controlling chronic inflammation in hard-to-treat depression might play a role in preventing subsequent autoimmunity.
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