Temporal and demographic trends in deaths with co-recorded depressive disorders and digestive system diseases among U.S. adults: a 26-year nationwide analysis (1999–2024)

Background Depression and digestive diseases are common public health concerns and may coexist through shared clinical and behavioral pathways. However, national mortality trends involving both conditions remain insufficiently characterized. This study examined temporal and demographic trends in deaths with co-recorded depressive disorders and digestive diseases among U.S. adults from 1999 to 2024. Methods This population-based retrospective cross-sectional study used the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death database. Deaths among adults aged ≥15 years were included when both depressive disorders (ICD-10 F32/F33) and digestive diseases (ICD-10 K00–K92) were recorded on death certificates. Crude mortality rates and age-adjusted mortality rates (AAMRs) were calculated per 100,000 population. Temporal trends were assessed using Joinpoint regression, and analyses were stratified by demographic and geographic characteristics. Disease-specific temporal trends were additionally evaluated for major digestive disease categories. Results From 1999 to 2024, 51,693 deaths with co-recorded depressive disorders and digestive diseases were identified. Annual deaths increased from 1,269 to 3,268, and the AAMR increased from 0.61 to 0.95 per 100,000 population. Joinpoint analysis identified significant increases during 1999–2003 (APC, 3.70%), 2010–2017 (APC, 2.51%), and 2017–2021 (APC, 10.94%), with declines during 2003–2010 (APC, −3.16%) and 2021–2024 (APC, −3.20%). Females had higher AAMRs than males, and older adults experienced the highest crude mortality rates. Mortality rates were higher among non-Hispanic White individuals and nonmetropolitan populations. The AAMR increased sharply during 2020–2021 and remained elevated in 2024 compared with the pre-pandemic level. Disease-specific analyses showed significant full-period increases for liver diseases (K70–K76; AAPC, 4.76%), gallbladder, biliary tract, and pancreatic diseases (K80–K86; AAPC, 3.04%), and esophageal, gastric, and duodenal diseases (K20–K31; AAPC, 2.48%). Conclusions Deaths with co-recorded depressive disorders and digestive diseases increased among U.S. adults from 1999 to 2024, with substantial demographic, geographic, and disease-specific heterogeneity. These findings support integrated management of mental health and digestive diseases in high-risk populations. Because this study used aggregate death-certificate data and included only co-recorded cases, the findings describe mortality patterns rather than associations or causal relationships between depressive disorders and digestive diseases.