Association between gout and depression: The United States National Health Nutrition and Examination Survey 2007-2016

Abstract

Introduction: Acute gout is painful and can lead to anxiety and depression. Whether gout leads to chronic depression is unclear. Methods: A total of 25 016 adult participants who responded to the 9-item Patient Health Questionnaire in the United States NHANES (National Health Nutrition and Examination Survey) 2007-2016 were included in this analysis. The diagnosis of gout was based on self-reporting. Results were analysed using SPSS complex sample module version 25. Logistic regression was used to study the association between gout and depression. Odds ratio (OR) and 95% confidence interval (CI) were estimated. Results: Although there was increased prevalence of depression among participants with gout (without gout vs gout: 7.9% [7.4%-8.5%] vs 9.8% [7.8%-12.4%]; P=0.003), gout was not independently associated with depression in both univariate (OR=1.27, 95% CI=0.99-1.63) and multivariate analysis (OR=1.15, 95% CI=0.84-1.56). Multivariate analysis showed that female sex (OR=1.75, 95% CI=1.51-2.04), education (college graduate vs <9th grade: OR=0.47 [95% CI=0.34-0.64]; college/associate degree vs <9th grade: 0.71 [0.56-0.91]; high school vs <9th grade: 0.74 [0.59-0.92]; 9-11th grade vs <9th grade: 0.94 [0.77-1.14]), alcohol consumption (OR=1.18, 95% CI=1.03-1.35), body mass index (OR=1.02, 95% CI=1.01-1.03), as well as the co-morbidities of gout, including diabetes (OR=1.23, 95% CI=1.03-1.35), hypertension (OR=1.52, 95% CI=1.27-1.82), and coronary heart disease (OR=1.63, 95% CI=1.12-2.38) were associated with depression. Conclusions: Gout is not independently associated with depression. However, physicians should still watch out for depression in patients with gout.