Treatment-resistant depression and peripheral C-reactive protein

Dr Sam Chamberlain

Samuel R. Chamberlain, Jonathan Cavanagh, Peter de Boer, Valeria Mondelli, Declan N.C. Jones, Wayne C. Drevets, Philip J. Cowen, Neil A. Harrison, Linda Pointon, Carmine M. Pariante and Edward T. Bullmore

Background

C-reactive protein (CRP) is a candidate biomarker for major depressive disorder (MDD), but it is unclear how peripheral CRP levels relate to the heterogeneous clinical phenotypes of the disorder.

Aim

To explore CRP in MDD and its phenotypic associations.

Method

We recruited 102 treatment-resistant patients with MDD currently experiencing depression, 48 treatment-responsive patients with MDD not currently experiencing depression, 48 patients with depression who were not receiving medication and 54 healthy volunteers. High-sensitivity CRP in peripheral venous blood, body mass index (BMI) and questionnaire assessments of depression, anxiety and childhood trauma were measured. Group differences in CRP were estimated, and partial least squares (PLS) analysis explored the relationships between CRP and specific clinical phenotypes.

Results

Compared with healthy volunteers, BMI-corrected CRP was significantly elevated in the treatment-resistant group (P = 0.007; Cohen’s d = 0.47); but not significantly so in the treatment-responsive (d = 0.29) and untreated (d = 0.18) groups. PLS yielded an optimal two-factor solution that accounted for 34.7% of variation in clinical measures and for 36.0% of variation in CRP. Clinical phenotypes most strongly associated with CRP and heavily weighted on the first PLS component were vegetative depressive symptoms, BMI, state anxiety and feeling unloved as a child or wishing for a different childhood.

Conclusions

CRP was elevated in patients with MDD, and more so in treatment-resistant patients. Other phenotypes associated with elevated CRP included childhood adversity and specific depressive and anxious symptoms. We suggest that patients with MDD stratified for proinflammatory biomarkers, like CRP, have a distinctive clinical profile that might be responsive to second-line treatment with anti-inflammatory drugs.

Link

https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/treatmentresistant-depression-and-peripheral-creactive-protein/D23E125023396A714C7AAB8372FA3155

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Around one in 13 people in Britain suffers from anxiety or depression and last year the NHS issued 64.7 million prescriptions for antidepressants, double the amount given out a decade ago.

A raft of recent papers, and unexpected results from clinical trials, have shown that treating inflammation seems to alleviate depression.

Source: http://www.telegraph.co.uk/science/2017/09/08/depression-physical-illness-could-treated-anti-inflammatory/?WT.mc_id=tmg_share_tw

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More and more research is pointing towards the impact that our immune system has on our likelihood to develop depression. And understanding this could have huge impacts on how we treat it. We speak to Professor Carmine Pariante, who’s been investigating this fascinating area of research for the last 20 years to find out more.

Source: https://www.mqmentalhealth.org/posts/could-depression-be-caused-by-our-immune-system

Depression, a disease of the mind? Actually our immune system could be the culprit | Spectator Health

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Source: Depression, a disease of the mind? Actually our immune system could be the culprit | Spectator Health

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Source: Major step towards Alzheimer’s blood test – News – Cardiff University

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Source: We may be able to treat depression with anti-inflammatory drugs – here’s why