Summary: A large UK population study finds that people with autoimmune diseases face almost twice the risk of persistent mental health disorders—such as depression, anxiety, and bipolar disorder—compared with the general population. The link appears strongest in women, suggesting chronic inflammation and sex-related biological factors could be important contributors.
Researchers analyzed data from more than 1.5 million participants and report a marked increase in affective disorders among people with autoimmune conditions. Women with autoimmune disease showed particularly high rates of mood and anxiety disorders, supporting calls for routine mental health screening and earlier intervention for this group.
Key Facts:
- Inflammation link: Chronic systemic inflammation associated with autoimmune disease may help explain higher rates of mood and anxiety disorders.
- Gender disparity: Women with autoimmune conditions are substantially more likely than men with the same conditions to report depression, anxiety, or bipolar disorder.
- Prevalence increase: Affective disorders were reported in 29% of people with autoimmune conditions versus 18% in those without such conditions.
Source: BMJ
Living with an autoimmune disease is associated with nearly doubled odds of persistent mental health problems—including depression, generalized anxiety, and bipolar disorder—according to a large UK study published in BMJ Mental Health.
Growing evidence links inflammation to mental health conditions, but many earlier studies used small samples that limited their conclusions. To address this gap, researchers used data from the Our Future Health dataset, which includes over 1.5 million adults across the UK. Participants had an average age of 53 years, 57% were women, and 90% identified as White. At enrolment they completed comprehensive baseline questionnaires covering health, lifestyle, and family medical history.
The analysis included six autoimmune conditions: rheumatoid arthritis, Graves’ disease (a thyroid disorder), inflammatory bowel disease, lupus, multiple sclerosis, and psoriasis. Affective disorders were defined for the study as self-reported lifetime diagnoses of depression, bipolar disorder, or anxiety disorders.
Among participants, 37,808 reported at least one autoimmune condition while 1,525,347 did not. Those with autoimmune disease were disproportionately female (74.5% versus 56.5%) and were more likely to report parental histories of affective disorders: 8% versus 5.5% for fathers and 15.5% versus 11% for mothers.
Using the presence of an autoimmune diagnosis as a proxy for chronic inflammation, the study found a higher lifetime prevalence of affective disorders among people with autoimmune disease: 29% compared with 18% in those without autoimmune disease. Separately, lifetime prevalence for depression was 25.5% versus just over 15%, and for anxiety it was just over 21% versus 12.5%. Though less common overall, bipolar disorder was nearly twice as prevalent in the autoimmune group (just under 1% versus 0.5%). Current symptoms of depression and anxiety were also more common among people with autoimmune conditions.
The study highlights a pronounced sex difference: among participants with any autoimmune condition, 32% of women reported an affective disorder compared with 21% of men. The researchers note that the reasons for this disparity are not yet clear. Potential explanations include sex hormones, chromosomal factors, differences in immune responses, and variations in circulating antibodies. Prior evidence indicates that women with depression often have higher concentrations of circulating cytokines and acute phase reactants than non-depressed women, suggesting that immune effects on mood could be stronger in women.
Overall, the odds of having an affective disorder were 87–97% higher for people with autoimmune disease, and these increases persisted after adjustment for age, household income, and parental psychiatric history. However, the study design has limitations. The data do not provide timing or duration of illnesses, so the analysis cannot determine whether autoimmune disease precedes, coincides with, or follows affective disorders. No direct measurements of inflammatory biomarkers were available, so the presence, severity, or timing of inflammation could not be confirmed.
Although observational, the findings are consistent with the hypothesis that chronic systemic inflammation may increase risk for mood and anxiety disorders. The authors recommend future research to identify potential biological, psychological, and social mechanisms—such as chronic pain, fatigue, sleep disruption, circadian disturbances, and social isolation—that could mediate the link between autoimmune conditions and mental health problems.
Clinically, the results support consideration of routine mental health screening for people diagnosed with autoimmune disease, particularly women, so that targeted interventions can be offered early and tailored to individual needs.
About this autoimmune disease and mental health research news
Author: Hannah Ahmed
Source: BMJ
Contact: Hannah Ahmed – BMJ
Image: Image credited to Neuroscience News
Original Research: Findings published in BMJ Mental Health