C-Reactive Protein Alterations in Bipolar Disorder
- 25 February 2015
- journal article
- research article
- Published by Physicians Postgraduate Press, Inc in British Journal of Psychology
- Vol. 76 (02), 142-150
- https://doi.org/10.4088/jcp.14r09007
Abstract
Objective: There is growing evidence that bipolar disorder (BD) is associated with inflammation, including abnormal levels of acute-phase C-reactive protein (CRP). Our meta-analysis was conducted to estimate the size of the association between CRP levels and BD, accounting also for subgroup differences (mood phases and treatment). Data Sources: MEDLINE, EMBASE, PsycINFO, and ISI Web of Science and references of identified articles were searched up to June 2013 using the keywords (bipolar disorder) AND (C-reactive protein OR CRP). Study Selection: English language studies measuring blood levels of CRP in patients with BD and control subjects were selected, 136 abstracts were reviewed, 20 articles retrieved, and 11 studies included. Data Extraction: Two independent reviewers extracted data. All studies were included in the primary analyses, and between-group differences for subanalyses were also reported. This meta-analysis was performed using random-effects models. Results: Eleven studies comprising 1,618 subjects were eligible for inclusion. Overall, CRP levels were significantly elevated in patients with BD versus controls (standardized mean difference [SMD] = 0.39; 95% CI, 0.24 to 0.55; P <. 0001). CRP levels were significantly higher in manic (SMD = 0.73; 95% CI, 0.44 to 1.02; P <. 001) and euthymic (SMD = 0.26; 95% CI, 0.01 to 0.51; P = .04), but not in depressed (SMD = 0.28; 95% CI, -0.17 to 0.73; P = .22) patients with BD compared to controls. CRP levels were unrelated to use of lithium or antipsychotic medication. Conclusions: This meta-analysis supports an association between increased CRP levels and BD. Given that an elevated level of CRP is a marker of low-grade inflammation and a risk factor for cardiovascular and malignant diseases, measurement of CRP level might be relevant to the clinical care of bipolar patients. (C) Copyright 2015 Physicians Postgraduate Press, Inc.This publication has 56 references indexed in Scilit:
- The association between immune activation and manic symptoms in patients with a depressive disorderTranslational Psychiatry, 2013
- Anxiety disorders and inflammation in a large adult cohortTranslational Psychiatry, 2013
- Can bipolar disorder be viewed as a multi-system inflammatory disease?Journal of Affective Disorders, 2012
- C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysisThe Lancet, 2010
- To assess, to control, to exclude: Effects of biobehavioral factors on circulating inflammatory markersBrain, Behavior, and Immunity, 2009
- Increased excitotoxicity and neuroinflammatory markers in postmortem frontal cortex from bipolar disorder patientsMolecular Psychiatry, 2009
- Cardiovascular, Inflammatory, and Metabolic Consequences of Sleep DeprivationProgress in Cardiovascular Diseases, 2009
- The use of high-sensitivity assays for C-reactive protein in clinical practiceNature Clinical Practice Cardiovascular Medicine, 2008
- From inflammation to sickness and depression: when the immune system subjugates the brainNature Reviews Neuroscience, 2008
- Measuring inconsistency in meta-analysesBMJ, 2003