Sex differences in the rate and factors for elevated depressive symptoms in multiple sclerosis, inflammatory bowel disease, and rheumatoid arthritis

In immune-mediated inflammatory diseases (IMID), females report elevated depressive symptoms more frequently than males. We examined clinical and sociodemographic factors associated with elevated depressive symptoms in IMID and whether endorsement of individual depressive symptoms differed by sex. This study included 652 individuals with an IMID from Manitoba, Canada. Depressive symptoms were measured using the PHQ-9 and HADS-D, with IMID-specific cut-offs to identify elevated depression. Elevated depressive symptoms were present in 234 participants (36%). Females did not show higher odds of elevated depression than males. Males were more likely to endorse the HADS-D item on cheerfulness. Smoking and anxiety symptoms, but not sex, were associated with elevated depressive symptoms. These findings may help identify high-risk individuals with an IMID and comorbid elevated depressive symptoms and guide intervention.