Depression among patients with recurrent Clostridioides difficile infection: a nationwide inpatient analysis

Clostridioides difficile infection (CDI) frequently recurs and impacts quality of life, yet its relationship with mental illness remains understudied.

Using the National Inpatient Sample (2018-2019), we calculated depression rates among adults with recurrent CDI (rCDI) and assessed the odds of codiagnosed depression compared to other chronic medical conditions.

Among 84,055 hospitalizations with rCDI, 21.5% had a codiagnosis of depression. In a population without CDI, depression prevalence was 14.2%. CDI patients had a 56% greater chance of having a diagnosis of depression compared with the general population (odds ratio [OR] 1.56, 95% confidence interval 1.5-1.6). When compared to those with common chronic medical comorbidities, patients with CDI had significantly higher odds of having depression than those with heart failure (OR 1.4), diabetes (OR 1.3), end-stage kidney disease (OR 1.5), and metastatic cancer (OR 1.9). Patients with fibromyalgia, multiple sclerosis, and alcohol-related disorders had higher rates of depression compared with those with CDI.

Patients with rCDI appear to have remarkably high depression rates, higher than those of patients with many other common chronic medical conditions. Further studies are needed to evaluate the causation of this potential association and to consider the benefit of implementing depression screening programs in this vulnerable population.