Abstract
Objectives
The inflammatory biomarker C-reactive protein (CRP) measures systemic inflammation and has been shown to be increased in patients with mood disorders such as depression. The objective of this study was to determine the association between self-reported mood disorders with CRP levels in a representative sample of the Canadian population using the Canadian Health Measures Survey (CHMS) data 2013–2014.
Methods
The CHMS is an ongoing national cross-sectional survey of Canadians about their general health. The current study used the data collected from Cycle 3 (2012/13) and was limited to adults aged 18 and older. Survey weights were assigned to adjust for non-response and non-random sample selection of the responding sample.
Results
Data were analyzed from 5782 respondents (400 (6.9%) self-reported mood disorders and 5382 (93.1%) reported no mood disorders). The CRP level was significantly higher among those with mood disorders than among those without (3.22 (0.17) vs. 2.34 (0.04) mg/L, p = 0.003). Respondents with CRP levels > 10.00 mg/L had 2.69 greater odds of reporting a mood disorder compared with those with CRP levels ≤ 1.00 mg/L (p = 0.02). Higher proportions of respondents with mood disorders were older, had lower BMI, had secondary education, had weak sense of community, had higher proportion of asthma or arthritis, were current/past smokers, had daily consumption of 3+ drinks of alcohol, and used prescription drugs, cannabis/hashish, or other drugs compared with those without mood disorders (all p’s < 0.05).
Conclusion
This study supported the association of CRP and mood disorder, specifically in a representative sample of the Canadian population. Targeting inflammation in depression and mood disorder warrants further study.
Résumé
Objectifs
Il a été démontré que la protéine C-réactive (PCR), un marqueur biologique qui permet de mesurer l’inflammation systémique, est élevée chez les patients hospitalisés pour des troubles de l’humeur comme la dépression. Nous avons cherché à déterminer l’association entre les troubles de l’humeur autodéclarés et les niveaux de PCR dans un échantillon représentatif de la population canadienne à l’aide des données de l’Enquête canadienne sur les mesures de la santé (ECMS) de 2013-2014.
Méthode
L’ECMS est une enquête transversale nationale continue menée auprès des Canadiennes et des Canadiens au sujet de leur état de santé général. Nous avons utilisé les données du cycle 3 de l’ECMS (2012-2013) en nous limitant aux adultes (18 ans et plus). Les poids d’enquête étaient ajustés en fonction des non-réponses et de la sélection non aléatoire de l’échantillon de répondants.
Résultats
Nous avons analysé les données de 5 782 répondants (400 [6,9%] ayant déclaré des troubles de l’humeur et 5 382 [93,1%] n’ayant déclaré aucun trouble de l’humeur). Le niveau de PCR était sensiblement plus élevé chez les répondants ayant des troubles de l’humeur que chez ceux n’ayant pas de trouble de l’humeur, soit 3,22 (0,17) c. 2,34 (0,04) mg/L, p = 0,003. Les répondants ayant des niveaux de PCR > 10,00 mg/L présentaient une probabilité 2,69 fois plus grande de déclarer un trouble de l’humeur que ceux dont les niveaux de PCR étaient ≤ 1,00 mg/L (p = 0,02). Des proportions plus élevées de répondants ayant des troubles de l’humeur étaient plus âgés et avaient un indice de masse corporelle inférieur, un diplôme d’études secondaires, un faible sentiment d’appartenance à la communauté, une proportion plus élevée d’asthme ou d’arthrite, étaient des fumeurs actuels ou passés, consommaient 3 verres d’alcool ou plus par jour et prenaient des médicaments sur ordonnance ou consommaient du cannabis/haschisch ou d’autres drogues comparativement aux répondants sans trouble de l’humeur (tous p < 0,05).
Conclusion
L’étude confirme l’association de la PCR et des troubles de l’humeur spécifiquement dans un échantillon représentatif de la population canadienne. Il serait justifié de pousser la recherche en ciblant l’inflammation dans la dépression et les troubles de l’humeur.
This is a preview of subscription content, access via your institution.
References
Allen, J., Sun, Y., & Woods, J. A. (2015). Exercise and the regulation of inflammatory responses. Progress in Molecular Biology and Translational Science, 135, 337–354. https://doi.org/10.1016/bs.pmbts.2015.07.003.
Archer, T., Josefsson, T., & Lindwall, M. (2014). Effects of physical exercise on depressive symptoms and biomarkers in depression. CNS & Neurological Disorders Drug Targets, 13(10), 1640–1653.
Au, B., Smith, K. J., Gariepy, G., & Schmitz, N. (2015). The longitudinal associations between C-reactive protein and depressive symptoms: evidence from the English Longitudinal Study of Ageing (ELSA). International Journal of Geriatric Psychiatry, 30(9), 976–984. https://doi.org/10.1002/gps.4250.
Cepeda, M. S., Stang, P., & Makadia, R. (2016). Depression is associated with high levels of C-reactive protein and low levels of fractional exhaled nitric oxide: results from the 2007-2012 National Health and Nutrition Examination Surveys. The Journal of Clinical Psychiatry, 77(12), 1666–1671. https://doi.org/10.4088/JCP.15m10267.
Cipriani, A., Furukawa, T. A., Salanti, G., Chaimani, A., Atkinson, L. Z., Ogawa, Y., et al. (2018). Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet, 391(10128), 1357–1366. https://doi.org/10.1016/s0140-6736(17)32802-7.
Cooney, G. M., Dwan, K., Greig, C. A., Lawlor, D. A., Rimer, J., Waugh, F. R., et al. (2013). Exercise for depression. Cochrane Database of Systematic Reviews (9), Cd004366, doi:https://doi.org/10.1002/14651858.CD004366.pub6.
Danner, M., Kasl, S. V., Abramson, J. L., & Vaccarino, V. (2003). Association between depression and elevated C-reactive protein. Psychosomatic Medicine, 65(3), 347–356. https://doi.org/10.1097/01.psy.0000041542.29808.01.
Elovainio, M., Aalto, A. M., Kivimaki, M., Pirkola, S., Sundvall, J., Lonnqvist, J., et al. (2009). Depression and C-reactive protein: population-based health 2000 study. Psychosomatic Medicine, 71(4), 423–430. https://doi.org/10.1097/PSY.0b013e31819e333a.
Felger, J. C., Haroon, E., Patel, T. A., Goldsmith, D. R., Wommack, E. C., Woolwine, B. J., et al. (2018). What does plasma CRP tell us about peripheral and central inflammation in depression? Molecular Psychiatry. https://doi.org/10.1038/s41380-018-0096-3.
Hastings, C. N., Sheridan, H., Pariante, C. M., & Mondelli, V. (2017). Does diet matter? The use of polyunsaturated fatty acids (PUFAs) and other dietary supplements in inflammation-associated depression. Current Topics in Behavioral Neurosciences, 31, 321–338. https://doi.org/10.1007/7854_2016_31.
Husain, M. I., Strawbridge, R., Stokes, P. R., & Young, A. H. (2017). Anti-inflammatory treatments for mood disorders: systematic review and meta-analysis. Journal of Psychopharmacology, 31(9), 1137–1148. https://doi.org/10.1177/0269881117725711.
Ji, L. L., & Zhang, Y. (2014). Antioxidant and anti-inflammatory effects of exercise: role of redox signaling. Free Radical Research, 48(1), 3–11. https://doi.org/10.3109/10715762.2013.844341.
Kewalramani, A., Bollinger, M. E., & Postolache, T. T. (2008). Asthma and mood disorders. International Journal of Child Health and Human Development, 1(2), 115–123.
Kohler, O., Benros, M. E., Nordentoft, M., Farkouh, M. E., Iyengar, R. L., Mors, O., et al. (2014). Effect of anti-inflammatory treatment on depression, depressive symptoms, and adverse effects: a systematic review and meta-analysis of randomized clinical trials. JAMA Psychiatry, 71(12), 1381–1391. https://doi.org/10.1001/jamapsychiatry.2014.1611.
Kohler, O., Krogh, J., Mors, O., & Benros, M. E. (2016). Inflammation in depression and the potential for anti-inflammatory treatment. Current Neuropharmacology, 14(7), 732–742.
Kohler-Forsberg, O., Buttenschon, H. N., Tansey, K. E., Maier, W., Hauser, J., Dernovsek, M. Z., et al. (2017). Association between C-reactive protein (CRP) with depression symptom severity and specific depressive symptoms in major depression. Brain, Behavior, and Immunity, 62, 344–350. https://doi.org/10.1016/j.bbi.2017.02.020.
Koopman, M., & El Aidy, S. (2017). Depressed gut? The microbiota-diet-inflammation trialogue in depression. Current Opinion in Psychiatry, 30(5), 369–377. https://doi.org/10.1097/yco.0000000000000350.
Marrie, R. A., Hitchon, C. A., Walld, R., Patten, S. B., Bolton, J. M., Sareen, J., et al. (2018). Increased burden of psychiatric disorders in rheumatoid arthritis. Arthritis Care & Research (Hoboken), 70(7), 970–978. https://doi.org/10.1002/acr.23539.
Marshe, V. S., Pira, S., Mantere, O., Bosche, B., Looper, K. J., Herrmann, N., et al. (2017). C-reactive protein and cardiovascular risk in bipolar disorder patients: a systematic review. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 79(Pt B), 442–451. https://doi.org/10.1016/j.pnpbp.2017.07.026.
Matcham, F., Rayner, L., Steer, S., & Hotopf, M. (2013). The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford), 52(12), 2136–2148. https://doi.org/10.1093/rheumatology/ket169.
McCormack, J., & Korownyk, C. (2018). Effectiveness of antidepressants. BMJ, 360, k1073. https://doi.org/10.1136/bmj.k1073.
Miller, A. H., & Raison, C. L. (2016). The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nature Reviews. Immunology, 16(1), 22–34. https://doi.org/10.1038/nri.2015.5.
Mojtabai, R. (2011). The public health impact of antidepressants: an instrumental variable analysis. Journal of Affective Disorders, 134(1–3), 188–197. https://doi.org/10.1016/j.jad.2011.05.037.
Molendijk, M., Molero, P., Ortuno Sanchez-Pedreno, F., Van der Does, W., & Angel Martinez-Gonzalez, M. (2018). Diet quality and depression risk: a systematic review and dose-response meta-analysis of prospective studies. Journal of Affective Disorders, 226, 346–354. https://doi.org/10.1016/j.jad.2017.09.022.
Morris, A. A., Zhao, L., Ahmed, Y., Stoyanova, N., De Staercke, C., Hooper, W. C., et al. (2011). Association between depression and inflammation--differences by race and sex: the META-Health study. Psychosomatic Medicine, 73(6), 462–468. https://doi.org/10.1097/PSY.0b013e318222379c.
Netz, Y. (2017). Is the comparison between exercise and pharmacologic treatment of depression in the clinical practice guideline of the American College of Physicians evidence-based? Frontiers in Pharmacology, 8, 257–257. https://doi.org/10.3389/fphar.2017.00257.
Nimmo, M. A., Leggate, M., Viana, J. L., & King, J. A. (2013). The effect of physical activity on mediators of inflammation. Diabetes, Obesity & Metabolism, 15(Suppl 3), 51–60. https://doi.org/10.1111/dom.12156.
Pearson, C., Janz, T., & Ali, J. (2015). Mental and substance use disorders in Canada. https://www150.statcan.gc.ca/n1/pub/82-624-x/2013001/article/11855-eng.htm. Accessed Aug 10 2019.
Read, J., & Williams, J. (2018). Adverse effects of antidepressants reported by a large international cohort: emotional blunting, suicidality, and withdrawal effects. Current Drug Safety, 13(3), 176–186. https://doi.org/10.2174/1574886313666180605095130.
Rosenblat, J. D., Kakar, R., Berk, M., Kessing, L. V., Vinberg, M., Baune, B. T., et al. (2016). Anti-inflammatory agents in the treatment of bipolar depression: a systematic review and meta-analysis. Bipolar Disorders, 18(2), 89–101. https://doi.org/10.1111/bdi.12373.
Turner, S., Mota, N., Bolton, J., & Sareen, J. (2018). Self-medication with alcohol or drugs for mood and anxiety disorders: a narrative review of the epidemiological literature. Depression and Anxiety, 35(9), 851–860. https://doi.org/10.1002/da.22771.
Valkanova, V., Ebmeier, K. P., & Allan, C. L. (2013). CRP, IL-6 and depression: a systematic review and meta-analysis of longitudinal studies. Journal of Affective Disorders, 150(3), 736–744. https://doi.org/10.1016/j.jad.2013.06.004.
White, D. J., Cox, K. H., Peters, R., Pipingas, A., & Scholey, A. B. (2015). Effects of four-week supplementation with a multi-vitamin/mineral preparation on mood and blood biomarkers in young adults: a randomised, double-blind, placebo-controlled trial. Nutrients, 7(11), 9005–9017. https://doi.org/10.3390/nu7115451.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
The Canadian Health Measures Survey (CHMS) has been approved by the Health Canada Research Ethics Board.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Leung, B.M.Y., Nwoke, C. Association between C-reactive protein and mood disorder in a representative sample of the Canadian population: analysis of CHMS data 2013–2014. Can J Public Health 111, 743–751 (2020). https://doi.org/10.17269/s41997-020-00297-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.17269/s41997-020-00297-3
Keywords
- Mood disorder
- Depression
- CRP
- Biomarker
- Inflammation
Mots-clés
- Troubles de l’humeur
- Dépression
- Protéine C-réactive
- Biomarqueur
- Inflammation