Elevated C-Reactive Protein Levels, Psychological Distress, and Depression in 73 131 Individuals.

Chronic inflammation is increasingly thought to underly many disease processes. This large study examined levela of C-reactive protein, a marker of systemic inflammation, and found clear and significant associations to the risk of depression.

Authors MK Wium-Andersen , DD Orsted, SF Nielsen, BG Nordestgaard
Institution Department of Clinical Biochemistry and Copenhagen General Population Study, Herlev Hospital
Publication Name Archives of General Psychiatry
Publication Date December 2012

CONTEXT The pathogenesis of depression is not fully understood, but studies suggest that low-grade systemic inflammation contributes to the development of depression.
OBJECTIVE To test whether elevated plasma levels of C-reactive protein (CRP) are associated with psychological distress and depression.
DESIGN We performed cross-sectional and prospective analyses of CRP levels in 4 clinically relevant categories using data from 2 general population studies.
SETTING The Copenhagen General Population and the Copenhagen City Heart studies.
PARTICIPANTS We examined 73 131 men and women aged 20 to 100 years.
MAIN OUTCOME MEASURES We ascertained psychological distress with 2 single-item self-reports and depression using self-reported antidepressant use, register-based prescription of antidepressants, and register-based hospitalization with depression. RESULTS In cross-sectional analyses, increasing CRP levels were associated with increasing risk for psychological distress and depression (P = 3 × 10-8 to P = 4 × 10-105 for trend). For self-reported use of antidepressants, the odds ratio was 1.38 (95% CI, 1.23-1.55) for CRP levels of 1.01 to 3.00 mg/L, 2.02 (1.77-2.30) for 3.01 to 10.00 mg/L, and 2.70 (2.25-3.25) for greater than 10.00 mg/L compared with 0.01 to 1.00 mg/L. For prescription of antidepressants, the corresponding odds ratios were 1.08 (95% CI, 0.99-1.17), 1.47 (1.33-1.62), and 1.77 (1.52-2.05), respectively; for hospitalization with depression, 1.30 (1.01-1.67), 1.84 (1.39-2.43), and 2.27 (1.54-3.32), respectively. In prospective analyses, increasing CRP levels were also associated with increasing risk for hospitalization with depression (P = 4 × 10-8 for trend).
CONCLUSIONS Elevated levels of CRP are associated with increased risk for psychological distress and depression in the general population.

Drew Ramsey, MD

Drew Ramsey, M.D. is a psychiatrist, author, and farmer. He is a clear voice in the mental health conversation and one of psychiatry’s leading proponents of using nutritional interventions. He is an assistant clinical professor of psychiatry at Columbia University College of Physicians and Surgeons.

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