Autoimmune Disease Linked to Doubling in Depression, Anxiety, Bipolar Risks
Chronic exposure to systemic inflammation may explain associations, researchers say.
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A recent large-scale study in the UK has found that people with autoimmune diseases are at nearly double the risk of developing mental health conditions such as depression, generalized anxiety, and bipolar disorder. This risk appears to be higher in women than in men with similar autoimmune conditions.
The findings, published in BMJ Mental Health, suggest that chronic exposure to systemic inflammation caused by autoimmune diseases may help explain this increased risk.
Autoimmune disease and mental health
To investigate the relationship between autoimmune diseases and mental health, researchers utilized data from the "Our Future Health" dataset, which includes information from 1.5 million participants across the UK. The dataset includes demographic, lifestyle and health information, such as lifetime diagnoses of autoimmune and psychiatric conditions.
Six autoimmune diseases were studied – rheumatoid arthritis, Graves’ disease, inflammatory bowel disease, lupus, multiple sclerosis and psoriasis. The mental health conditions the team focused on were self-reported cases of affective disorders, including depression, anxiety and bipolar disorder.
The autoimmune cohort comprised 37,808 participants, compared to 1.5 million people without autoimmune conditions. Those with autoimmune diseases were more likely to be women and had a higher prevalence of psychiatric disorders in their family history.
Prevalence of mental health disorders
The researchers found that the prevalence of lifetime affective disorders was significantly higher in individuals with autoimmune diseases compared to the general population – 29% versus 18%.
Specific disorders showed similar trends: depression was more common in people with autoimmune diseases (25.5%) compared to the general population (15%), and anxiety disorders were also more prevalent (21% versus 12.5%). Though less common, the prevalence of bipolar disorder was still higher in the autoimmune group (1%) compared to the general population (0.5%).
Current depression and anxiety were also found to be more prevalent among people with autoimmune diseases. Notably, women with autoimmune conditions exhibited a significantly higher prevalence of affective disorders than men with the same conditions—32% versus 21%.
Possible explanations for the gender differences
Although the reasons for the higher prevalence of mental health conditions in women with autoimmune diseases are unclear, the researchers suggest that sex hormones, chromosomal factors and differences in immune responses could contribute.
For example, women with depression have been shown to exhibit higher concentrations of certain immune markers (cytokines) than their non-depressed counterparts, which may amplify the effects of immune responses on mental health.
Implications for future research and healthcare
While the study's observational design means that no definitive conclusions can be drawn about causality, the researchers argue that chronic inflammation could be a key factor in the observed increase in mental health risks. They recommend that future studies explore whether other factors – such as chronic pain, sleep disruption and social isolation – might serve as mechanisms connecting autoimmune diseases to affective disorders.
Given the significant mental health risks associated with autoimmune diseases, the researchers suggest that people diagnosed with these conditions, particularly women, may benefit from regular screening for mental health disorders. Early detection and tailored treatments could help improve the well-being of those affected.
Reference: Mudra Rakshasa-Loots A, Swiffen D, Steyn C, Marwick KFM, Smith DJ. Affective disorders and chronic inflammatory conditions: analysis of 1.5 million participants in Our Future Health. BMJ Ment Health. 2025;28(1):e301706. doi: 10.1136/bmjment-2025-301706
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