title: C-reactive protein: A differential biomarker for major depressive disorder and bipolar II disorder.
abstract: Objectives We aimed to examine whether the C-reactive protein (CRP) level could be used to differentiate between major depressive disorder (MDD) and bipolar II disorder (BD II). Methods Ninety-six healthy controls, 88 BD II and 72 MDD drug-naïve patients in their major depressive episodes were enrolled. The fasting plasma level of high-sensitivity CRP was assessed at baseline and after treatment. Results The BD II patients presented significantly higher 17-item Hamilton Depression Rating Scale (HDRS) scores and CRP levels at baseline when adjustment for age, gender, and body mass index (P <  0.001 and P <  0.001, respectively). After treatment the CRP levels remained significantly different (P <  0.001), although the HDRS score was not significantly different between the BD II and MDD patients. A receiver-operating characteristic analysis showed that a baseline CRP level of 621.6 ng/mL could discriminate between BD II and MDD, with an area under the curve of 0.816 and a sensitivity and specificity of 0.699 and 0.882, respectively. Furthermore, the baseline CRP level greater than 621.6 ng/ml had 28.2 higher odds of a diagnosis of BD II (P <  0.001, 95% confidence interval: 10.96-72.35). Conclusions The level of CRP plays a role of biomarker to differentiate between MDD and BD II depression in both their depressed and euthymic state.
authors.affiliation: a Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University , Tainan , Taiwan.|b School of Pharmacy, College of Medicine , National Cheng Kung University , Tainan , Taiwan.
authors.forename: Hui Hua
authors.initials: HH
authors.lastname: Chang
authors.affiliation: c Department of Psychiatry , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan.
authors.forename: Tzu-Yun
authors.initials: TY
authors.lastname: Wang
authors.affiliation: c Department of Psychiatry , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan.|d Addiction Research Center, National Cheng Kung University , Tainan , Taiwan.|e Department of Psychiatry , National Cheng Kung University Hospital , Dou-Liou Branch , Yunlin, Taiwan.
authors.forename: I Hui
authors.initials: IH
authors.lastname: Lee
authors.affiliation: f Department of Psychiatry , Kaohsiung Veterans General Hospital , Kaohsiung , Taiwan.
authors.forename: Sheng-Yu
authors.initials: SY
authors.lastname: Lee
authors.affiliation: c Department of Psychiatry , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan.|d Addiction Research Center, National Cheng Kung University , Tainan , Taiwan.
authors.forename: Kao Chin
authors.initials: KC
authors.lastname: Chen
authors.affiliation: g Department of Psychiatry , Tri-Service General Hospital, National Defense Medical Center , Taipei , Taiwan.
authors.forename: San-Yuan
authors.initials: SY
authors.lastname: Huang
authors.affiliation: c Department of Psychiatry , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan.|d Addiction Research Center, National Cheng Kung University , Tainan , Taiwan.|e Department of Psychiatry , National Cheng Kung University Hospital , Dou-Liou Branch , Yunlin, Taiwan.|h Institute of Behavioral Medicine, College of Medicine , National Cheng Kung University , Tainan , Taiwan.
authors.forename: Yen Kuang
authors.initials: YK
authors.lastname: Yang
authors.affiliation: c Department of Psychiatry , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan.|d Addiction Research Center, National Cheng Kung University , Tainan , Taiwan.
authors.forename: Ru-Band
authors.initials: RB
authors.lastname: Lu
authors.affiliation: c Department of Psychiatry , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan.|d Addiction Research Center, National Cheng Kung University , Tainan , Taiwan.
authors.forename: Po See
authors.initials: PS
authors.lastname: Chen
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001714:Bipolar Disorder / Q000097:blood* / Q000175:diagnosis; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000097:blood* / Q000175:diagnosis; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013624:Taiwan; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: Biomarker; C-reactive protein; bipolar disorder; inflammation; major depressive disorder