Venous thromboembolism and risk of depression: a population-based cohort study

Background: The psychologic consequences of acute venous thromboembolism (VTE) have not been investigated in depth. Objectives: We aimed to examine the association between VTE and the risk of sub-sequent depression.Methods: Using Danish nationwide registries, we established a population-based cohort of 64 596 individuals with incident VTE during 1996 to 2016 and a compari-son cohort (n = 322 999) selected randomly from the general population and individ-ually matched by birth year, sex, and calendar year of VTE. The participants were followed up for 3 years, and depression was defined as any hospital diagnosis of depression or & GE;1 prescription for antidepressants. Incidence rates were computed as the number of events per 1000 person-years, and hazard ratios with 95% CIs were computed as estimates of the risk conferred by VTE using the comparison cohort as reference. We estimated absolute risks using cumulative incidence functions, treating death as a competing event.Results: Depression was observed in 6225 individuals after VTE and 16 363 members of the comparison cohort (incidence rates of 44.4 and 19.4 per 1000 person-years, respectively). The absolute risk of depression was 10.3% (95% CI, 10.1%-10.6%) in the VTE cohort and 5.6% (95% CI, 5.5%-5.6%) in the comparison cohort, corresponding to 4.7 excess cases of depression per 100 individuals with VTE. VTE was associated with a 2.35-fold (95% CI, 2.28-2.43) increased risk of depression compared with that in the comparison cohort. The association was attenuated after adjustments for socio-economic status and comorbidities (hazard ratio, 1.91; 95% CI, 1.85-1.97). Conclusion: VTE was associated with an increased risk of depression after adjustment for comorbidities.

Automated summary

This study examines the association between acute venous thromboembolism (VTE) and the risk of subsequent depression. Based on Danish nationwide registries, a population-based cohort of 64,596 individuals with incident VTE and a comparison cohort of 322,999 randomly selected individuals were established. The results show that VTE is associated with a 2.35-fold increased risk of depression compared to the comparison cohort, even after adjusting for socioeconomic status and comorbidities.