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The association between atopic disorders and depression
The Northern Finland 1966 Birth Cohort Study
Department of Psychiatry, Oulu University Hospital
Faculty of Medicine, Department of Public Health Science and General Practice, University of Oulu
Academic Dissertation to be presented with the assent of the Faculty of Medicine, University of Oulu, for public discussion in the Väinö Pääkkönen Hall of the Department of Psychiatry, on November 7th, 2003, at 12 noon.
Copyright © 2003
University of Oulu
Professor Hasse Karlsson
Professor Jari Tiihonen
UNIVERSITY OF OULU, OULU FINLAND 2003
ISBN 951-42-7155-6 (PDF)
ISSN 1796-2234 (Online)
An excess of atopic allergies has been found in patients with depression, and conversely, increased amounts of depressive symptoms have been reported in patients with atopic disorders. Thus far, however, the findings have mainly been based on clinical samples. In this thesis, the association between atopic disorders and depression was investigated at epidemiological level by using data from the Northern Finland 1966 Birth Cohort.
An unselected cohort of 12058 liveborn children was followed prospectively from prenatal stages until 1997. During the 31-year follow-up, 6025 cohort members underwent skin prick tests. Data on lifetime depression diagnoses and atopic conditions were obtained from postal questionnaires and Finnish Hospital Discharge Registers, and the severity of the depressive symptoms was assessed with Hopkins Symptom Checklist-25. Information on the family histories of the atopic disorders was obtained from questionnaires of the 31-year follow-up.
Females with positive skin prick test responses and self-reported histories of allergic symptoms exhibited a 2.7-fold probability of developing lifetime depression. The corresponding probability increased in line with the increased severity of depressive symptoms in atopic but not in non-atopic females, ranging from 3.0 to 4.7-fold. Among males, the atopy-depression association was seen only in the highest depression scores, the odds ratio being up to 6.3-fold. While the most severe, hospital-treated manifestations of both disorders were considered, atopic disorders increased the risk of depression 3-fold independently of the subject's gender and sociodemographic characteristics. When investigating the effect of familial atopy on a child's depression, maternal atopy increased the probability of lifetime depression nearly 2-fold in females, and over 4-fold, when a female cohort member's own atopy was also present.
At epidemiological level, the presence of atopic conditions seemed to increase the probability of lifetime depression especially in females. Since both atopic disorders and depression are illnesses of major public health importance in Western countries, also the co-morbidity between these disorders should be seriously taken into account in clinical practice. Further investigations are called for in evaluating whether this association is specific to atopic disorders, since increased risks of depression have been noted in connection with many other physical diseases as well.
Keywords: allergic conjunctivitis, allergic rhinitis, allergy, asthma, atopic disorders, atopic eczema, atopy, cohort study, depression, depressive, hayfever, inheritance
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