Mendel randomization confirmed gastroesophageal reflux disease may increase the risk of mental disorders.
Yang Wu, Tian Li, Yanan Zhang et al.
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In 30 seconds
This Mendelian randomization analysis used genome-wide association study summary data to assess whether genetic liability to gastroesophageal reflux disease (GERD) was causally related to six mental disorders. The inverse-variance weighted analysis found higher odds of bipolar disorder (OR = 1.70, 95%CI = 1.39-2.09, P < 0.05) and very small increases in odds of major depression and anxiety. It also reported lower odds of anorexia nervosa, although the authors’ conclusion states that evidence for this relationship was unclear. No causal relationship was supported for Alzheimer’s disease or obsessive-compulsive disorder.
Key findings
- GERD was associated with higher odds of bipolar disorder (OR = 1.70, 95%CI = 1.39-2.09, P < 0.05).
- The reported associations with major depression (OR = 1.01, 95%CI = 1.01-1.02, P < 0.05) and anxiety (OR = 1.01, 95%CI = 1.01-1.01, P < 0.05) were described as weak.
- IVW estimated lower odds of anorexia nervosa (OR = 0.71, 95%CI = 0.52-0.99, P < 0.05), but the authors’ conclusion found no clear causal evidence.
- No causal relationship was supported for Alzheimer’s disease (OR = 0.95, 95%CI = 0.87-1.03, P > 0.05) or obsessive-compulsive disorder (OR = 0.95, 95%CI = 0.67-1.36, P > 0.05).
Why it matters
The analysis suggests that GERD-related genetic liability may be relevant to the risk of some mental disorders, particularly bipolar disorder, while estimates for other outcomes are small, inconsistent, or unsupported. These findings can inform understanding of possible links between physical and mental health, but they do not establish that GERD itself causes these disorders or that treating GERD changes psychiatric risk.
What to keep in mind
The analysis relies on genetic instruments and GWAS summary data, so its causal interpretation depends on the validity of those instruments. Heterogeneity was reported for major depression, Alzheimer’s disease, and anorexia nervosa.