People living with multiple chronic health conditions are at a significantly greater risk of developing depression, new research shows.
A study undertaken by researchers at the University of Edinburgh found that specific disease pairings of illnesses, particularly cardiometabolic conditions such as diabetes and heart disease, can more than double the risk of a future diagnosis of depression.
The research is published in Nature Communications Medicine and highlights the importance of integrated care, which considers a patient’s mental and physical health.
Related Article: Increased risk of heart disease with adult-onset type 1 diabetes
Most multimorbidity studies have concentrated on physical disease in the past, but increasing numbers of research studies are showing the links between mental and physical health.
The researchers analysed data from over half a million people in the UK Biobank. Using cluster algorithms, they identified groups of participants aged 37-73 with similar patterns of illness. Of the 502,353 participants, 142,005 had linked general practice data with at least one baseline physical condition. The participants and their clusters of physical illness were then tracked in relation to the development and diagnosis of later depression.
Using four different statistical clustering methods to identify trends, the researchers found that people with any physical condition at the start of the study were more likely to develop depression than people without any physical condition. There was no single dominant illness but rather a mix of health conditions, and the risk varied depending on the specific combinations of comorbidities.
Understanding links between physical and mental health
The risk of developing depression was high in people with both heart disease and diabetes, and also in those with chronic lung conditions like asthma or chronic obstructive pulmonary disease (COPD). Liver and bowel conditions also showed a noticeable link to depression in both men and women. Women with joint conditions such as arthritis were particularly affected by depression.
In the highest-risk groups, about one in 12 people developed depression over the next ten years, compared with about one in 25 people without physical conditions.
Related Article: Adults with depression accrue long-term physical conditions at a faster rate
Lauren DeLong, lead author and PhD student at the University of Edinburgh’s School of Informatics, said: ‘We saw clear associations between physical health conditions and the development of depression, but this study is only the beginning. We hope our findings inspire other researchers to investigate and untangle the links between physical and mental health conditions.’
The researchers suggest that the link between physical and mental illness may lie beyond the biological burden of a disease and could be linked to social and systemic factors. Further research to investigate other factors which may link physical disease to depression is recommended.
Bruce Guthrie, Professor of General Practice at the University of Edinburgh, added: ‘Healthcare often treats physical and mental health as completely different things, but this study shows that we need to get better at anticipating and managing depression in people with physical illness.’
Related Article: Government seeks nurse views to underpin first-ever men’s health strategy
Reference: DeLong LN, Fleetwood K, Prigge R. et al. Cluster and survival analysis of UK biobank data reveals associations between physical multimorbidity clusters and subsequent depression. Commun Med 5, 156 (2025). https://doi.org/10.1038/s43856-025-00825-7
