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Association between Ultraviolet B Exposure Levels and Depression in Taiwanese Adults: A Nested Case–Control Study

Author

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  • Ci-Wen Luo

    (Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
    Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan)

  • Shih-Pin Chen

    (Department of Internal Medicine, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
    Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
    These authors contributed equally to this work.)

  • Chen-Yu Chiang

    (Department of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan)

  • Wen-Jun Wu

    (Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
    Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan)

  • Chun-Jung Chen

    (Department of Education and Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan)

  • Wen-Ying Chen

    (Department of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan)

  • Yu-Hsiang Kuan

    (Department of Pharmacology, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
    Department of Pharmacy, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
    These authors contributed equally to this work.)

Abstract

Depression is a common mental disorder that affects more than 264 million people worldwide. Anxiety, diabetes, Alzheimer’s disease, myocardial infarction, and cancer, among other disorders, are known to increase the risk of depression. Exposure to ultraviolet B (UVB) can cause human serotonin levels to increase. The vitamin D pathway is one mechanism through which ultraviolet light absorbed through the skin can affect mood; however, UVB exposure is known to increase the risk of cancer. In this study, we explored the effects of prolonged exposure to UVB on depression. Data were retrieved from the Taiwan National Health Insurance Research Database for 2008 to 2013. Each patient with depression was matched 1:4 with a comparison patient by sex and age (±5 years); thus, the study included 23,579 patients with depression and 94,316 healthy controls for comparison. The patients had been exposed to UVB for at least 1 year to observe the cumulative effect of UVB exposure. Based on the World Health Organization UV index, we divided the observation period data into five UV levels: low, moderate, high, very high, and extreme. A multivariate Poisson regression model was used to assess the risk of depression according to UVB exposure level, adjusting for sex, age, income, urbanization level, month, and comorbidities. The results revealed that the incidence rate ratio (IRR) for patients with depression was 0.889 for moderate levels (95% CI 0.835–0.947), 1.134 for high levels (95% CI: 1.022–1.260), 1.711 for very high levels (95% CI: 1.505–1.945), and 2.785 for extreme levels (95% CI: 2.439–3.180) when compared to low levels. Moderate levels of UVB lowered the risk of depression, while high levels of UVB gradually increased the risk. We propose that UVB at normal concentrations can effectively improve depression. However, exposure to high concentrations of UVB damage DNA results in physical diseases such as skin cancer, which increase the risk of depression.

Suggested Citation

  • Ci-Wen Luo & Shih-Pin Chen & Chen-Yu Chiang & Wen-Jun Wu & Chun-Jung Chen & Wen-Ying Chen & Yu-Hsiang Kuan, 2022. "Association between Ultraviolet B Exposure Levels and Depression in Taiwanese Adults: A Nested Case–Control Study," IJERPH, MDPI, vol. 19(11), pages 1-13, June.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:11:p:6846-:d:831126
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    References listed on IDEAS

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    1. Han-Yin Sun & Ci-Wen Luo & Yun-Wei Chiang & Kun-Lin Yeh Yi-Ching Li & Yung-Chung Ho & Shiuan-Shinn Lee & Wen-Ying Chen & Chun-Jung Chen & Yu-Hsiang Kuan, 2021. "Association Between PM 2.5 Exposure Level and Primary Open-Angle Glaucoma in Taiwanese Adults: A Nested Case–control Study," IJERPH, MDPI, vol. 18(4), pages 1-12, February.
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    Cited by:

    1. Hyo-Jeong Hwang & Yean-Jung Choi & Dongwan Hong, 2022. "The Association between Self-Rated Health Status, Psychosocial Stress, Eating Behaviors, and Food Intake According to the Level of Sunlight Exposure in Korean Adults," IJERPH, MDPI, vol. 20(1), pages 1-13, December.

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