Association and Bidirectional Causal Relationship Between Depression and Osteoarthritis: Evidence From NHANES and
Mengli Chang1, Yung-Heng Lee2,3,4,5, Fei Dong6
1Department of Surgery and Field Surgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China.
International Journal of Rheumatic Diseases
|June 23, 2025
Summary
Depression and osteoarthritis (OA) are linked, with evidence suggesting a two-way causal relationship. This study confirms a significant positive correlation and bidirectional causality between these conditions.
Area of Science:
- Medical research
- Epidemiology
- Public health
Background:
- Depression is common in patients with arthritis and musculoskeletal conditions.
- While osteoarthritis's impact on depression is known, the reverse relationship is less explored.
Purpose of the Study:
- To investigate the correlation between depression and osteoarthritis (OA).
- To explore the potential bidirectional causal relationship between depression and OA.
Main Methods:
- Utilized the National Health and Nutrition Examination Survey (NHANES) database.
- Employed logistic regression to assess correlation and Mendelian randomization (MR) for causality.
- Performed subgroup, sensitivity, and heterogeneity analyses for robustness.
Main Results:
- A significant positive correlation was found between depression and OA (OR = 2.33).
- Mendelian randomization revealed a bidirectional causal relationship between depression and OA.
- Analyses confirmed the robustness and stability of the findings, with no significant pleiotropy or heterogeneity.
Conclusions:
- Depression and osteoarthritis share a correlation and a bidirectional causal relationship.
- Findings highlight the complex interplay between mental health and musculoskeletal conditions.
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