QUESTION Collective evidence for the bidirectional association between depression and autoimmune diseases (ADs) is scarce, especially for subgroups of patients with specific ADs. We conducted a meta-analysis to determine the incidence rates and relative risks (RRs) of depression among patients with ADs, and vice versa. STUDY SELECTION AND ANALYSIS PubMed, Embase, Web of Science, Ovid, PsycNet and Cochrane were searched up to 10 September 2024. Cohort studies evaluating longitudinal risks between ADs and depression were included. Incidence rates and RRs of depression among patients with ADs and vice versa were pooled. FINDINGS The analysis included 47 studies, involving over 40.77 million participants. The pooled incidence rate of depression among patients with ADs was 6.71% (95% CI 5.10% to 8.77%), with an RR of 1.85 (95% CI 1.57 to 2.19), higher in patients aged over 45 (2.30; 95% CI 1.62 to 3.26) and females (1.88; 95% CI 1.61 to 2.20). Conversely, the pooled incidence rate of ADs among depression was 0.54% (95% CI 0.24% to 1.19%), with an RR of 1.84 (95% CI 1.10 to 3.09). The incidence rate and RRs also varied across subgroups with the highest incidence rate in the musculoskeletal system and connective tissue (1.36; 95% CI 0.50 to 3.63) and RR in the genitourinary system (2.23; 95% CI 1.98 to 2.51). CONCLUSIONS This study identified a bidirectional association between depression and ADs, with higher RRs among patients aged over 45 and females. Especially higher risks were also found for specific types of ADs including endocrine, nutritional, and metabolic diseases, genitourinary system, and skin and subcutaneous tissue. PROSPERO REGISTRATION NUMBER CRD42024541053.

中文翻译：

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阐明自身免疫性疾病与抑郁症之间的双向关联：系统评价和荟萃分析。


问题 关于抑郁症与自身免疫性疾病 （AD） 之间双向关联的集体证据很少，尤其是对于具有特定 AD 的患者亚组。我们进行了一项荟萃分析，以确定 AD 患者抑郁的发生率和相对风险 （RRs），反之亦然。研究选择和分析检索了截至 2024 年 9 月 10 日的 PubMed、Embase、Web of Science、Ovid、PsycNet 和 Cochrane。纳入评估 AD 与抑郁之间纵向风险的队列研究。合并 AD 患者抑郁的发生率和 RRs，反之亦然。结果 该分析包括 47 项研究，涉及超过 4077 万名参与者。AD 患者抑郁的汇总发生率为 6.71%（95% CI 5.10% 至 8.77%），RR 为 1.85（95% CI 1.57 至 2.19），45 岁以上患者（2.30;95% CI 1.62 至 3.26）和女性患者（1.88;95% CI 1.61 至 2.20）更高。相反，抑郁症中 AD 的合并发生率为 0.54% （95% CI [0.24%， 1.19%]，RR 为 1.84 （95% CI [1.10%， 3.09]）。发病率和 RRs 也因亚组而异，其中肌肉骨骼系统和结缔组织发生率最高 （1.36;95% CI 0.50 至 3.63），泌尿生殖系统发生率最高 （2.23;95% CI 1.98 至 2.51）。结论 本研究确定了抑郁症与 ADs 之间的双向关联，45 岁以上患者和女性的 RRs 较高。特定类型的 AD 风险尤其更高，包括内分泌、营养和代谢疾病、泌尿生殖系统以及皮肤和皮下组织。PROSPERO 注册号 CRD42024541053。