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The bidirectional relationship between anxiety disorders and circulating levels of inflammatory markers: Results from a large longitudinal population-based study


Glaus, Jennifer; von Känel, Roland; Lasserre, Aurélie M; Strippoli, Marie-Pierre F; Vandeleur, Caroline L; Castelao, Enrique; Gholam-Rezaee, Mehdi; Marangoni, Ciro; Wagner, En-Young N; Marques-Vidal, Pedro; Waeber, Gérard; Vollenweider, Peter; Preisig, Martin; Merikangas, Kathleen R (2018). The bidirectional relationship between anxiety disorders and circulating levels of inflammatory markers: Results from a large longitudinal population-based study. Depression and Anxiety, 35(4):360-371.

Abstract

BACKGROUND: Although there has been abundant research on chronic low-grade inflammation as a potential mechanism underlying the link between mood disorders and cardiovascular risk, less is known about the role of inflammatory factors and anxiety disorders. The aim of this paper is to evaluate the bi-directional associations between inflammatory markers including interleukin (IL)-6, tumor necrosis factor (TNF)-α, and high sensitivity C-reactive protein (hsCRP) with anxiety disorders and its subgroups.
METHODS: The sample consisted of 3,113 participants (53.7% women; mean age: 51.0, S.D. 8.8 years), randomly selected from the general population, who underwent comprehensive somatic and psychiatric evaluations at baseline and follow-up (mean follow-up duration = 5.5 years, S.D. 0.6). Anxiety disorders were assessed with semistructured diagnostic interviews. Inflammatory biomarkers were analyzed in fasting blood samples.
RESULTS: After adjustment for potential confounders, current anxiety disorders (β = 0.09, 95% CI 0.00-0.17) and agoraphobia (β = 0.25, 95% CI: 0.07-0.43) at baseline were associated with a steeper increase of hsCRP levels over the follow-up period. Current posttraumatic stress disorder (PTSD) was associated with a lower increase of IL-6 levels over the follow-up period (β = -0.52, 95% CI: -1.00/-0.04). There was no evidence for an association between inflammation markers at baseline and anxiety disorders at follow-up.
CONCLUSIONS: The prospective association between agoraphobia at baseline and hsCRP levels over the follow-up period suggests that chronic low-grade inflammation may be a consequence of this condition. The decrease in IL-6 in PTSD also requires further investigation. No evidence was found for chronic low-grade inflammation as a predictor of future anxiety disorders.

Abstract

BACKGROUND: Although there has been abundant research on chronic low-grade inflammation as a potential mechanism underlying the link between mood disorders and cardiovascular risk, less is known about the role of inflammatory factors and anxiety disorders. The aim of this paper is to evaluate the bi-directional associations between inflammatory markers including interleukin (IL)-6, tumor necrosis factor (TNF)-α, and high sensitivity C-reactive protein (hsCRP) with anxiety disorders and its subgroups.
METHODS: The sample consisted of 3,113 participants (53.7% women; mean age: 51.0, S.D. 8.8 years), randomly selected from the general population, who underwent comprehensive somatic and psychiatric evaluations at baseline and follow-up (mean follow-up duration = 5.5 years, S.D. 0.6). Anxiety disorders were assessed with semistructured diagnostic interviews. Inflammatory biomarkers were analyzed in fasting blood samples.
RESULTS: After adjustment for potential confounders, current anxiety disorders (β = 0.09, 95% CI 0.00-0.17) and agoraphobia (β = 0.25, 95% CI: 0.07-0.43) at baseline were associated with a steeper increase of hsCRP levels over the follow-up period. Current posttraumatic stress disorder (PTSD) was associated with a lower increase of IL-6 levels over the follow-up period (β = -0.52, 95% CI: -1.00/-0.04). There was no evidence for an association between inflammation markers at baseline and anxiety disorders at follow-up.
CONCLUSIONS: The prospective association between agoraphobia at baseline and hsCRP levels over the follow-up period suggests that chronic low-grade inflammation may be a consequence of this condition. The decrease in IL-6 in PTSD also requires further investigation. No evidence was found for chronic low-grade inflammation as a predictor of future anxiety disorders.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Klinik für Konsiliarpsychiatrie und Psychosomatik
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Clinical Psychology, Psychiatry and Mental health
Language:English
Date:1 April 2018
Deposited On:07 Mar 2019 15:24
Last Modified:07 Mar 2019 15:24
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:1091-4269
OA Status:Closed
Publisher DOI:https://doi.org/10.1002/da.22710
PubMed ID:29244900
Project Information:
  • : FunderSNSF
  • : Grant ID33CS30_134267
  • : Project TitleSchweizerische Transplantationskohorte
  • : FunderSNSF
  • : Grant ID323530_151479
  • : Project TitleProspective associations between depression subtypes and cardiovascular risk factors and diseases in a population-based cohort
  • : FunderSNSF
  • : Grant IDP2LAP3_161895
  • : Project TitleMechanisms underlying the associations between psychiatric disorders and cardiovascular diseases: prospective community and family study data

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