The association between immune activation and manic symptoms in patients with a depressive disorder
Open Access
- 22 October 2013
- journal article
- research article
- Published by Springer Science and Business Media LLC in Translational Psychiatry
- Vol. 3 (10), e314
- https://doi.org/10.1038/tp.2013.87
Abstract
Although recent studies have shown that immunological processes play an important role in the pathophysiology of mood disorders, immune activation may only be present in specific subgroups of patients. Our study aimed to examine whether immune activation was associated with (a) the presence of manic symptoms and (b) the onset of manic symptoms during 2 years of follow-up in depressed patients. Patients with a depressive disorder at baseline (N=957) and healthy controls (N=430) were selected from the Netherlands Study of Depression and Anxiety. Assessments included lifetime manic symptoms at baseline and two-year follow up, as well as C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) at baseline. Within depressed patients, immune activation was not related to the presence or absence of lifetime manic symptoms at baseline. However, CRP levels were strongly elevated in depressed men who developed manic symptoms compared with those who did not develop manic symptoms over 2 years (Pd=0.89). IL-6 and TNF-α were also higher in depressed men with an onset of manic symptoms, but this association was not significant. However, we found that the onset of manic symptoms was particularly high in men with multiple elevated levels of inflammatory markers. Depressed men who developed manic symptoms during follow-up had increased immunological activity (especially CRP) compared with depressed men who did not develop manic symptoms. Further research should explore whether a treatment approach focusing on inflammatory processes may be more effective in this specific subgroup of depressed patients.Keywords
This publication has 65 references indexed in Scilit:
- Understanding the somatic consequences of depression: biological mechanisms and the role of depression symptom profileBMC Medicine, 2013
- Can bipolar disorder be viewed as a multi-system inflammatory disease?Journal of Affective Disorders, 2012
- Association of depressive disorders, depression characteristics and antidepressant medication with inflammationTranslational Psychiatry, 2012
- Depression is an inflammatory disease, but cell-mediated immune activation is the key component of depressionProgress in Neuro-Psychopharmacology and Biological Psychiatry, 2011
- Cardiovascular disease in persons with depressive and anxiety disordersJournal of Affective Disorders, 2010
- A Meta-Analysis of Cytokines in Major DepressionBiological Psychiatry, 2010
- Cardiovascular, Inflammatory, and Metabolic Consequences of Sleep DeprivationProgress in Cardiovascular Diseases, 2009
- Depression and Inflammation in Patients With Coronary Heart Disease: Findings from the Heart and Soul StudyBiological Psychiatry, 2007
- Cytokine Production and Treatment Response in Major Depressive DisorderNeuropsychopharmacology, 2000
- Depression, immunocompetence, and prostaglandins of the E seriesPsychiatry Research, 1986