title: Associations between mood, anxiety or substance use disorders and inflammatory markers after adjustment for multiple covariates in a population-based study.
abstract: Inflammation is one possible mechanism underlying the associations between mental disorders and cardiovascular diseases (CVD). However, studies on mental disorders and inflammation have yielded inconsistent results and the majority did not adjust for potential confounding factors. We examined the associations of several pro-inflammatory cytokines (IL-1β, IL-6 and TNF-α) and high sensitive C-reactive protein (hsCRP) with lifetime and current mood, anxiety and substance use disorders (SUD), while adjusting for multiple covariates. The sample included 3719 subjects, randomly selected from the general population, who underwent thorough somatic and psychiatric evaluations. Psychiatric diagnoses were made with a semi-structured interview. Major depressive disorder was subtyped into "atypical", "melancholic", "combined atypical-melancholic" and "unspecified". Associations between inflammatory markers and psychiatric diagnoses were assessed using multiple linear and logistic regression models. Lifetime bipolar disorders and atypical depression were associated with increased levels of hsCRP, but not after multivariate adjustment. After multivariate adjustment, SUD remained associated with increased hsCRP levels in men (β = 0.13 (95% CI: 0.03,0.23)) but not in women. After multivariate adjustment, lifetime combined and unspecified depression were associated with decreased levels of IL-6 (β = -0.27 (-0.51,-0.02); β = -0.19 (-0.34,-0.05), respectively) and TNF-α (β = -0.16 (-0.30,-0.01); β = -0.10 (-0.19,-0.02), respectively), whereas current combined and unspecified depression were associated with decreased levels of hsCRP (β = -0.20 (-0.39,-0.02); β = -0.12 (-0.24,-0.01), respectively). Our data suggest that the significant associations between increased hsCRP levels and mood disorders are mainly attributable to the effects of comorbid disorders, medication as well as behavioral and physical CVRFs.
authors.affiliation: Department of Psychiatry, Lausanne University Hospital, Switzerland; Department of Mental Health and Psychiatry, Geneva University, Switzerland. Electronic address: Jennifer.Glaus@chuv.ch.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Glaus
authors.affiliation: Department of Psychiatry, Lausanne University Hospital, Switzerland.
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Vandeleur
authors.affiliation: Division of Psychosomatic Medicine, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
authors.affiliation: Department of Psychiatry, Lausanne University Hospital, Switzerland.
authors.forename: Aurélie M
authors.initials: AM
authors.lastname: Lasserre
authors.affiliation: Department of Psychiatry, Lausanne University Hospital, Switzerland.
authors.forename: Marie-Pierre F
authors.initials: MP
authors.lastname: Strippoli
authors.affiliation: Department of Psychiatry, Lausanne University Hospital, Switzerland.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Gholam-Rezaee
authors.affiliation: Department of Psychiatry, Lausanne University Hospital, Switzerland.
authors.forename: Enrique
authors.initials: E
authors.lastname: Castelao
authors.affiliation: Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland.
authors.forename: Pedro
authors.initials: P
authors.lastname: Marques-Vidal
authors.affiliation: Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland.
authors.forename: Pascal
authors.initials: P
authors.lastname: Bovet
authors.affiliation: Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Merikangas
authors.affiliation: Faculty of Biology and Medicine, University of Lausanne, Switzerland.
authors.forename: Vincent
authors.initials: V
authors.lastname: Mooser
authors.affiliation: Department of Internal Medicine, Lausanne University Hospital, Switzerland.
authors.forename: Gérard
authors.initials: G
authors.lastname: Waeber
authors.affiliation: Department of Internal Medicine, Lausanne University Hospital, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Vollenweider
authors.affiliation: Department of Mental Health and Psychiatry, Geneva University, Switzerland.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Aubry
authors.affiliation: Department of Psychiatry, Lausanne University Hospital, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Preisig
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000886:Anthropometry; D001008:Anxiety Disorders / Q000453:epidemiology*; D002097:C-Reactive Protein / Q000378:metabolism; D018672:Community Health Planning; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D019964:Mood Disorders / Q000453:epidemiology*; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*
chemical_list: D016207:Cytokines; D002097:C-Reactive Protein
keywords: Anxiety disorders; C-Reactive protein; Depression subtypes; Mood disorders; Pro-inflammatory cytokines; Substance use disorders