Association between C-reactive protein (CRP) with depression symptom severity and specific depressive symptoms in major depression

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  • Ole Köhler-Forsberg
  • Henriette N Buttenschøn
  • Katherine E Tansey, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom.
  • ,
  • Wolfgang Maier, Department of Psychiatry, University of Bonn, Germany.
  • ,
  • Joanna Hauser, Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
  • ,
  • Mojca Zvezdana Dernovsek, University Psychiatric Clinic and the Medical Faculty, University of Ljubljana, Kongresni trg 12, 1000, Ljubljana, Slovenia.
  • ,
  • Neven Henigsberg, Croatian Institute for Brain Research, Medical School, University of Zagreb, Salata 3, 10 000, Zagreb, Croatia.
  • ,
  • Daniel Souery, aa Laboratoire de Psychologie Medicale, Centre Européen de Psychologie Medicale , Université Libre de Bruxelles and Psy Pluriel , Brussels , Belgium.
  • ,
  • Anne Farmer, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom.
  • ,
  • Marcella Rietschel, Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany.
  • ,
  • Peter McGuffin, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom.
  • ,
  • Katherine J Aitchison, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK; Departments of Psychiatry and Medical Genetics, University of Alberta, Edmonton, AB, Canada.
  • ,
  • Rudolf Uher, Department of Psychiatry, Dalhousie University, Halifax, N.S., Canada.
  • ,
  • Ole Mors, iSEQ, Centre for Integrative Sequencing, Aarhus; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus; Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark.

INTRODUCTION: Population-based studies have associated inflammation, particularly higher C-reactive protein (CRP), with depressive severity, but clinical trials in major depressive disorder were rather non-specific without examining the role of gender. We aimed to investigate the association between CRP and overall depression severity including specific depressive symptoms and to examine potential gender differences.

METHODS: We included 231 individuals with major depressive disorder from the Genome-Based Therapeutics Drugs for Depression (GENDEP) study. At baseline, we assessed high-sensitivity CRP levels and psychopathology with the Montgomery Aasberg Depression Rating Scale (MADRS). We performed linear regression analyses to investigate the association between baseline CRP levels with overall MADRS severity and specific symptoms at baseline and adjusted for age, gender, anti-inflammatory and psychotropic drug treatment, body mass index, smoking, inflammatory diseases, and recruitment center.

RESULTS: Higher CRP levels were significantly associated with greater overall MADRS symptom severity (p=0.02), which was significant among women (p=0.02) but not among men (p=0.68). Among women, higher CRP was associated with increased severity on observed mood, cognitive symptoms, interest-activity, and suicidality, but we found no significant associations among men. Interaction analyses showed no significant gender differences on the overall MADRS score or specific symptoms.

DISCUSSION: Our results support the sickness syndrome theory suggesting that chronic low-grade inflammation may be associated with a subtype of depression. The potential gender differences in psychopathology may be explained by biological and/or psychosocial factors, e.g. differential modulation of immune responses by sex hormones. Clinical studies should investigate symptom-specific and/or gender-specific treatment guided by peripheral inflammatory markers.

Original languageEnglish
JournalBrain, Behavior, and Immunity
Volume62
Pages (from-to)344-350
Number of pages7
ISSN0889-1591
DOIs
Publication statusPublished - May 2017

    Research areas

  • Journal Article

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