title: The predictive value of somatic and cognitive depressive symptoms for cytokine changes in patients with major depression.
abstract: BACKGROUND
  Elevated concentrations of proinflammatory cytokines have been hypothesized as an important factor in the pathophysiology of depression. Depression itself is considered to be a heterogeneous disorder. Current findings suggest that "cognitive" and "somatic" symptom dimensions are related to immune function in different ways. So far, little research has been done on the longitudinal aspects of inflammation in patients with major depression, especially with respect to different symptom dimensions of depression. Therefore, we investigated which aspects of depression may predict changes in tumor necrosis factor-alpha (TNF-alpha) and interleukin (IL)-6 over 4 weeks.
  
  
  METHODS
  Forty-one patients with major depression diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), and 45 healthy controls were enrolled. Serum measurements of TNF-alpha and IL-6 were conducted at baseline and 4 weeks later. Psychometric measures included the assessment of cognitive-affective depressive symptoms and somatic symptoms during the last 7 days as well as somatic symptoms during the last 2 years.
  
  
  RESULTS
  Patients with depression showed increased levels of TNF-alpha (P<0.05) compared to healthy controls. Hierarchical regression analyses indicated that neither depressive nor somatic symptoms predict changes in proinflammatory cytokines in the whole sample of depressed patients. Moderation analyses and subsequent sex-stratified regression analyses indicated that higher somatoform symptoms during the last 2 years significantly predict an increase in TNF-alpha in women with major depression (P<0.05) but not in men. Exploratory analyses indicated that the stability of TNF-alpha and IL-6 (as indicated by intraclass correlation coefficients) over 4 weeks was high for TNF-alpha but lower for IL-6.
  
  
  CONCLUSIONS
  The present study demonstrated that a history of somatoform symptoms may be important for predicting future changes in TNF-alpha in women with major depression.
authors: Division of Clinical Psychology and Psychotherapy, Philipps Universität Marburg, Marburg, Germany.
authors: Katharina
authors: K
authors: Dannehl
authors: Division of Clinical Psychology and Psychotherapy, Philipps Universität Marburg, Marburg, Germany.
authors: Winfried
authors: W
authors: Rief
authors: Institute for Laboratory Medicine, Ludwig-Maximilian Universität, Munich, Germany.
authors: Markus J
authors: MJ
authors: Schwarz
authors: Division of Clinical Psychology and Psychotherapy, Philipps Universität Marburg, Marburg, Germany.
authors: Annika
authors: A
authors: Hennings
authors: Division of Clinical Psychology and Psychotherapy, Philipps Universität Marburg, Marburg, Germany.
authors: Sabine
authors: S
authors: Riemer
authors: Department of Psychiatry, Ludwig-Maximilian Universität, Munich, Germany.
authors: Verena
authors: V
authors: Selberdinger
authors: Department of Psychiatry, Ludwig-Maximilian Universität, Munich, Germany.
authors: Theresa
authors: T
authors: Stapf
authors: Division of Clinical Psychology and Psychotherapy, Philipps Universität Marburg, Marburg, Germany.
authors: Frank
authors: F
authors: Euteneuer
keywords: interleukin-6; symptom dimension; tumor necrosis factor-alpha