Depression and health outcomes: An umbrella review of systematic reviews and meta-analyses of observational studies

Abstract

Abstract Background Currently, most studies of depression are limited to a single disease endpoint. Aims This study aimed to conduct an umbrella review to comprehensively assess the association between depression and health outcomes. Method Until December 17, 2024, we conducted a systematic search of systematic reviews and meta-analyses in PubMed, Embase, and Web of Science. We reanalyzed the summary effects and 95% confidence intervals for each study using random models. We assessed the methodological quality and evidence quality of the research with A Measurement Tool to Assess Systematic Reviews 2 and Grade of Recommendations, Assessment, Development and Evaluation, classifying studies into four categories based on evidence classification criteria. Results We selected a total of 72 articles from 27,150 resulting in 114 meta-analyses and 109 health outcomes. Depression exposure was associated with 23 mortality, 21 cardiovascular outcomes, 15 offspring outcomes, 9cancer outcomes, 9 neurological outcomes, 5 endocrine outcomes, 5 dental outcomes, 3 digestive outcomes, and 19 other health outcomes. Moderate-quality evidence linked depression to specific mortality in bladder cancer (Class IV), all-cause mortality in myocardial infarction (Class III), mortality within 2 years of initial assessment in coronary artery disease (Class IV), major adverse cardiovascular events after percutaneous coronary intervention (Class III), irritable bowel syndrome (insignificant), fear of falling (Class III), and frailty (Class III). Conclusions Depression has a significant impact on health outcomes, primarily mortality and cardiovascular outcomes. However, more definitive conclusions still require randomized controlled trials or prospective studies for validation.