Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Health Management Center, General Practice Medical Center, Medical Device Regulatory Research and Evaluation Center, West China Hospital, Sichuan University, Chengdu, China
Jenny Hallberg
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden Sachs’ Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
Natalia Hernandez-Pacheco
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
Sandra Ekström
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Respiratory, Allergy and Sleep Research, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
Ellen Vercalsteren
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
Bronwyn K. Brew
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health and School of Clinical Medicine, University of New South Wales, Kensington, New South Wales, Australia
Catarina Almqvist
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden Pediatric Allergy and Pulmonology Unit, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
Christer Janson
Respiratory, Allergy and Sleep Research, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
Inger Kull
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden Sachs’ Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
Anna Bergström
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
Erik Melén
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden Sachs’ Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
Donghao Lu
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Health Management Center, General Practice Medical Center, Medical Device Regulatory Research and Evaluation Center, West China Hospital, Sichuan University, Chengdu, China
Background Both depression and respiratory disease are common today in young populations. However, little is known about the relationship between them. Aims This study aims to explore the association between depression in childhood to early adulthood and respiratory health outcomes in early adulthood, and the potential underlying mechanisms. Method A prospective study was conducted based on the Swedish BAMSE (Barn, Allergi, Miljö, Stockholm, Epidemiologi [Children, Allergy, Milieu, Stockholm, Epidemiology]) birth cohort (n = 4089). We identified clinically diagnosed depression through the dispensation of antidepressants, using national register data confirmed by self-reported diagnosis. At the 24-year follow-up, respiratory health was assessed via questionnaires and clinical evaluation. Metabolic and inflammatory profiles were analysed to explore potential mechanisms. Results Among the 2994 participants who provided study data, 403 (13.5%) had depression at any time point from around age 10 to 25 years. Depression was associated with higher risks of any chronic bronchitis symptoms (odds ratio = 1.58, 95% CI 1.21–2.06) and respiratory symptoms (odds ratio = 1.41, 95% CI 1.11–1.80) in early adulthood, independent of body mass index (BMI) and smoking status. Compared to individuals without depression, those with depression had a higher fat mass index (FMI (β = 0.48, 95% CI 0.22–0.74)) and increased blood levels of fibroblast growth factor 21 and Interleukin-6 in early adulthood. These markers together with FMI were found to partly mediate the association between depression and respiratory symptoms (total mediation proportion: 19.8 and 15.4%, respectively, P < 0.01). Conclusions Depression in childhood to early adulthood was associated with an increased risk of respiratory ill-health in early adulthood, independently of smoking. Metabolic and inflammatory dysregulations may underlie this link.
