Risk of depression in chronic immune-mediated neuropathies: A nationwide cohort study in South Korea

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN) are among the most common immune-mediated neuropathies, characterized by a chronic, disabling disease course. While depression significantly impacts outcomes in various neurological disorders, its risk remains underexplored in patients with CIDP or MMN. This study aimed to investigate the association between CIDP or MMN and new-onset depression using a nationwide cohort in South Korea. Patients with CIDP or MMN were identified from the Korean National Health Insurance Service database between 2011 and 2021, using International Classification of Diseases, 10th Revision codes and registration in the Rare Intractable Disease program. After excluding individuals with pre-existing depression or events during a 1-year lag period, 720 patients with CIDP/MMN were included. A control cohort of 7200 individuals without CIDP/MMN was matched for age and sex at a 1:10 ratio. The incidence of newly diagnosed depression was compared using Cox proportional hazards models. The risk of developing depression was significantly higher in CIDP/MMN patients, with an adjusted hazard ratio (HR) of 2.51 (95 % confidence interval [CI]: 2.09-3.02). Stratified analyses revealed particularly elevated risks in male patients (p for interaction = 0.003) and in those with comorbid diabetes (p for interaction = 0.010). CIDP/MMN is associated with a significantly increased risk of new-onset depression, particularly among males and individuals with diabetes. These findings highlight the importance of mental health evaluations and tailored interventions in patients with CIDP/MMN, especially among high-risk groups.