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J Psychiatr Res. 2014 Nov;58:36-45. doi: 10.1016/j.jpsychires.2014.07.012. Epub 2014 Jul 22.

Associations between mood, anxiety or substance use disorders and inflammatory markers after adjustment for multiple covariates in a population-based study.

Author information

  • 1Department of Psychiatry, Lausanne University Hospital, Switzerland; Department of Mental Health and Psychiatry, Geneva University, Switzerland. Electronic address: Jennifer.Glaus@chuv.ch.
  • 2Department of Psychiatry, Lausanne University Hospital, Switzerland.
  • 3Division of Psychosomatic Medicine, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
  • 4Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland.
  • 5Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA.
  • 6Faculty of Biology and Medicine, University of Lausanne, Switzerland.
  • 7Department of Internal Medicine, Lausanne University Hospital, Switzerland.
  • 8Department of Mental Health and Psychiatry, Geneva University, Switzerland.

Abstract

Inflammation is one possible mechanism underlying the associations between mental disorders and cardiovascular diseases (CVD). However, studies on mental disorders and inflammation have yielded inconsistent results and the majority did not adjust for potential confounding factors. We examined the associations of several pro-inflammatory cytokines (IL-1β, IL-6 and TNF-α) and high sensitive C-reactive protein (hsCRP) with lifetime and current mood, anxiety and substance use disorders (SUD), while adjusting for multiple covariates. The sample included 3719 subjects, randomly selected from the general population, who underwent thorough somatic and psychiatric evaluations. Psychiatric diagnoses were made with a semi-structured interview. Major depressive disorder was subtyped into "atypical", "melancholic", "combined atypical-melancholic" and "unspecified". Associations between inflammatory markers and psychiatric diagnoses were assessed using multiple linear and logistic regression models. Lifetime bipolar disorders and atypical depression were associated with increased levels of hsCRP, but not after multivariate adjustment. After multivariate adjustment, SUD remained associated with increased hsCRP levels in men (β = 0.13 (95% CI: 0.03,0.23)) but not in women. After multivariate adjustment, lifetime combined and unspecified depression were associated with decreased levels of IL-6 (β = -0.27 (-0.51,-0.02); β = -0.19 (-0.34,-0.05), respectively) and TNF-α (β = -0.16 (-0.30,-0.01); β = -0.10 (-0.19,-0.02), respectively), whereas current combined and unspecified depression were associated with decreased levels of hsCRP (β = -0.20 (-0.39,-0.02); β = -0.12 (-0.24,-0.01), respectively). Our data suggest that the significant associations between increased hsCRP levels and mood disorders are mainly attributable to the effects of comorbid disorders, medication as well as behavioral and physical CVRFs.

Copyright © 2014 Elsevier Ltd. All rights reserved.

KEYWORDS:

Anxiety disorders; C-Reactive protein; Depression subtypes; Mood disorders; Pro-inflammatory cytokines; Substance use disorders

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