Trial Report Investigating causal links between chronic physical illness and major depressive disorder and anxiety disorders in youth, 2023, Shakeshaft

https://www.sciencedirect.com/science/article/abs/pii/S0924977X23001864

European Neuropsychopharmacology
Volume 75, Supplement 1, October 2023, Page S13
European Neuropsychopharmacology

INVESTIGATING CAUSAL LINKS BETWEEN CHRONIC PHYSICAL ILLNESS AND MAJOR DEPRESSIVE DISORDER AND ANXIETY DISORDERS IN YOUTH

Amy Shakeshaft 1, Jessica Mundy 2, Charlotte Dennison 1, Daniela Bragantini 3, Laurie Hannigan 3, Ole Andreassen 4, Katherine L Musliner 2, Alexandra Havdahl 5, Anita Thapar 1

1
Cardiff University
2
Aarhus University
3
Nic Waals Institute, Lovisenberg Diaconal Hospital
4
University of Oslo
5
Norwegian Institute of Public Health


https://doi.org/10.1016/j.euroneuro.2023.08.032

Introduction
Children with chronic physical illnesses, such as asthma, diabetes and migraine, have a higher rate of mental disorders, including depression and anxiety, than their physically healthy counterparts. With chronic illnesses estimated to affect around 25% of children, it is important to consider how these conditions contribute to early-onset mental disorders. Whilst previous studies have indicated associations between chronic illness and mental ill-health, causality has not been determined and cannot be concluded due to the potential of reverse causality or confounding factors (e.g. poverty, preterm birth). Therefore, we aim to use genetic approaches to investigate causal links between childhood chronic physical illness and major depressive and anxiety disorders in youth.

Method
Using data from the Norwegian Mother, Father and Child cohort study (MoBa) and the Norwegian National Patient Registry, we first investigated epidemiological associations between maternal reports of child chronic illnesses by 14 years (arthritis, asthma, cerebral palsy, chronic fatigue syndrome (CF), coeliac disease, diabetes, epilepsy, migraine and hearing loss) with a depression diagnosis (ICD-10: F32/F33) and anxiety disorder diagnosis (ICD-10: F40/41) prior to 18 years, including birth year and sex as covariates where appropriate. Two-sample Mendelian randomisation (MR) analysis was conducted using SNPs associated with common childhood chronic physical illnesses from existing GWAS. Initial analyses using outcome data from the largest depression and anxiety GWASs were undertaken. We will extend this analysis using outcome data from a GWAS of child/adolescent-onset depression (

Results
Childhood arthritis (OR = 3.1 [1.1-7.1], p=0.02), cerebral palsy (OR = 3.1 [1.1-6.9], p = 0.02), CF (OR = 2.7 [0.9-6.3], p=0.03), epilepsy (OR = 2.9 [1.6-5.0], p=3 × 10-4) and migraine (OR = 1.4 [1.0-1.8], p=0.02) were associated with a diagnosis of anxiety disorder by 18 years. CF was the only illness also associated with a depression diagnosis (OR = 6.2 [2.5-13.0], p=1 × 10-5). Initial MR results did not indicate causal associations between juvenile arthritis, childhood-onset asthma, type 1 diabetes and eczema and major depressive disorder (MDD). However, migraine genetic liability was associated with MDD (b=2.0 ±0.99, p=0.04). For anxiety disorders, genetic liability to type 1 diabetes had a weak protective effect (b=-0.04 ±0.02, p=0.03), but there was no causal association for juvenile arthritis, childhood-onset asthma, eczema, nor migraine.

Discussion
Having a chronic physical health condition is associated with mental ill-health in young people, however, initial MR analysis indicates the majority of these conditions are not causally associated with depression nor anxiety disorders. However current GWAS do not focus on early-onset depression so MR findings using these data will also be presented.

 

Having a horrible illness is a risk factor for depression. Shocking.

 

Given that a couple of authors are based at Aarhus I'm surprised that they reported the negative association.

 

[sarcasm on] But being ill and depressed makes life so much more unpleasant for everyone else who is well and wants to enjoy life! I should think of them and smile while in their presence! [sarcasm off]

 

That's because the standard questionnaires have multiple questions about physical symptoms, which gives false positives on purpose.

The problem isn't overlapping answers, it's overlapping questions. And the questions overlap deliberately to conflate many chronic illnesses as mental illness using correlations and arguing them to be causative in a preferred way, because otherwise psychosomatic ideology would have hit a brick wall decades ago.

This is all getting beyond silly. It's become as ridiculous as the very poor attempts in the early 20th century to define the morphology of intelligence and whatnot entirely based around some common European facial features and somehow 'finding' that other races are less intelligent, because that's the way they were defined.

Good grief AI can't soon enough take over most of medicine from all of this bias and ideology. It's just people running around in circles marveling at how far their pedometer is telling them they walked while refusing to consider the GPS data telling them they didn't actually move at all.

 

I couldn’t agree more with all above. Context and process. In the following sentence you explain it exactly-

the questions overlap deliberately to conflate many chronic illnesses as mental illness using correlations and arguing them to be causative

It wouldn’t be possible to pass this-brazenly obvious skewing tactic out there in print for all to see-off as an ethical and public health supporting avenue of research if virtually the totality of authorities and colleagues weren’t prepared to look away from the dirty work and return focus with enthusiasm when the usually reliable and pleasing results came back in. It’s mostly in the mind, it’s mostly not necessary to burden the health services with service users requiring chemical and mechanics and fully qualified doctors as resources. No a health care practitioner of some nonspecific variety will do. A fact sheet explaining that it’s up to the patient to cope will be sufficient. This may be delivered in the form of patchy photocopy but that’s still resources given directly to the patient, even better suggest that they look it up online.

But I’d have to disagree re how useful AI will be, landing as it does into this flourishing industry of economically useful and life destroying bullshit. I do think there will be faster data analysis which for good research helps us. But you get out what you put in, the quality of the data going in is going to influence the quality of the data that comes out. Just as it does now.

 

Having a neuroimmune illness is a risk factor for.... well, a neuroimmune illness.