Associations between C-reactive protein and individual symptoms of depression in a lower-middle income country.

IF 3.9 3区 医学 Q1 PSYCHIATRY
BJPsych Open Pub Date : 2024-10-03 DOI:10.1192/bjo.2024.735
Elise Fellows, Brett D M Jones, John Hodsoll, Nusrat Husain, Ameer B Khoso, Allan H Young, Imran B Chaudhry, M Ishrat Husain
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Abstract

Background: Data on associations between inflammation and depressive symptoms largely originate from high income population settings, despite the greatest disease burden in major depressive disorder being attributed to populations in lower-middle income countries (LMICs).

Aims: We assessed the prevalence of low-grade inflammation in adults with treatment-resistant depression (TRD) in Pakistan, an LMIC, and investigated associations between peripheral C-reactive protein (CRP) levels and depressive symptoms.

Method: This is a secondary analysis of two randomised controlled trials investigating adjunctive immunomodulatory agents (minocycline and simvastatin) for Pakistani adults with TRD (n = 191). Logistic regression models were built to assess the relationship between pre-treatment CRP (≥ or <3 mg/L) and individual depressive symptoms measured using the Hamilton Depression Rating Scale. Descriptive statistics and regression were used to assess treatment response for inflammation-associated symptoms.

Results: High plasma CRP (≥3 mg/L) was detected in 87% (n = 146) of participants. Early night insomnia (odds ratio 2.33, 95% CI 1.16-5.25), early morning waking (odds ratio 2.65, 95% CI 1.29-6.38) and psychic anxiety (odds ratio 3.79, 95% CI 1.39-21.7) were positively associated, while gastrointestinal (odds ratio 0.38, 95% CI 0.14-0.86) and general somatic symptoms (odds ratio 0.34, 95% CI 0.14-0.74) were negatively associated with inflammation. Minocycline, but not simvastatin, improved symptoms positively associated with inflammation.

Conclusions: The prevalence of inflammation in this LMIC sample with TRD was higher than that reported in high income countries. Insomnia and anxiety symptoms may represent possible targets for personalised treatment with immunomodulatory agents in people with elevated CRP. These findings require replication in independent clinical samples.

一个中低收入国家的 C 反应蛋白与个人抑郁症状之间的关系。
背景:目的:我们评估了巴基斯坦(一个中低收入国家)成人难治性抑郁症(TRD)患者中低度炎症的患病率,并研究了外周C反应蛋白(CRP)水平与抑郁症状之间的关联:本研究对两项随机对照试验进行了二次分析,这两项试验研究了针对巴基斯坦成年TRD患者(n = 191)的辅助免疫调节药物(米诺环素和辛伐他汀)。建立了逻辑回归模型,以评估治疗前 CRP(≥ 或 结果)之间的关系:87%的参与者(n = 146)检测到血浆 CRP 偏高(≥3 mg/L)。早夜失眠(几率比 2.33,95% CI 1.16-5.25)、早醒(几率比 2.65,95% CI 1.29-6.38)和精神焦虑(几率比 3.79,95% CI 1.39-21.7)与炎症呈正相关,而胃肠道症状(几率比 0.38,95% CI 0.14-0.86)和一般躯体症状(几率比 0.34,95% CI 0.14-0.74)与炎症呈负相关。米诺环素(而非辛伐他汀)可改善与炎症正相关的症状:结论:与高收入国家相比,低收入国家样本中的TRD患者炎症发生率更高。失眠和焦虑症状可能是CRP升高患者使用免疫调节剂进行个性化治疗的目标。这些发现需要在独立的临床样本中进行复制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BJPsych Open
BJPsych Open Medicine-Psychiatry and Mental Health
CiteScore
6.30
自引率
3.70%
发文量
610
审稿时长
16 weeks
期刊介绍: Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.
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