Inflammatory and metabolic dysregulation and the 2-year course of depressive disorders in antidepressant users.
Scarce evidence suggests that inflammatory and metabolic dysregulation predicts poor response to antidepressants, which could result in worse depression outcome. This study prospectively examined whether inflammatory and metabolic dysregulation predicted the 2-year course of depressive disorders among antidepressant users. Data were from the Netherlands Study of Depression and Anxiety, including 315 persons (18-65 years) with a current depressive disorder (major depressive disorder, dysthymia) at baseline according to the DSM-IV criteria and using antidepressants. Inflammatory (C-reactive protein, interleukin-6 (IL-6), tumor-necrosis factor-α) and metabolic (waist circumference, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, fasting glucose) factors were measured at baseline. Primary outcome for course of depression was indicated by whether or not a DSM-IV depressive disorder diagnosis was still/again present at 2-year follow-up, indicating chronicity of depression. Elevated IL-6, low HDL cholesterol, hypertriglyceridemia, and hyperglycemia were associated with chronicity of depression in antidepressant users. Persons showing ⩾ 4 inflammatory or metabolic dysregulations had a 1.90 increased odds of depression chronicity (95% CI = 1.12-3.23). Among persons who recently (ie, at most 3 months) started antidepressant medication (N = 103), having ⩾ 4 dysregulations was associated with a 6.85 increased odds of depression chronicity (95% CI = 1.95-24.06). In conclusion, inflammatory and metabolic dysregulations were found to predict a more chronic course of depressive disorders among patients using antidepressants. This could suggest that inflammatory and metabolic dysregulation worsens depression course owing to reduced antidepressant treatment response and that alternative intervention treatments may be needed for depressed persons with inflammatory and metabolic dysregulation.
1] Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands [2] Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
Nicole
N
Vogelzangs
Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Aartjan T F
AT
Beekman
Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Arianne K B
AK
van Reedt Dortland
Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Robert A
RA
Schoevers
Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
Erik J
EJ
Giltay
Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Peter
P
de Jonge
1] Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands [2] Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
Brenda W J H
BW
Penninx
D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D016207:Cytokines / Q000097:blood; D003866:Depressive Disorder / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology*; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008659:Metabolic Diseases / Q000097:blood / Q000209:etiology*; D008875:Middle Aged; D009426:Netherlands; D055815:Young Adult
D000928:Antidepressive Agents; D016207:Cytokines; D008075:Lipoproteins, HDL; D002097:C-Reactive Protein