Wiesław Jerzy Cubała1, Jerzy Landowski. 1. Department of Psychiatry, Medical University of Gdańsk, Gdańsk, Poland. Electronic address: cubala@gumed.edu.pl.
Abstract
BACKGROUND: Hypercortisolemia and low grade systemic inflammation are observed in major depressive disorder (MDD). Studies on markers of systematic inflammation and Hypothalamic-Pituitary-Adrenal (HPA) axis dysregulation in MDD produce confounded results due to heterogeneity of MDD patients related to illness stages and severity with a large proportion suffering from remitted-recurrent and treatment-resistant/chronic depression with first-episode major depression being underrepresented. This study was designed to examine whether and to what extent CRP is related to baseline cortisol concentrations in a well defined cohort of short-illness-duration first-episode, treatment-naïve MDD patients. METHODS: The levels of salivary C-reactive protein (CRP) and baseline plasma cortisol concentrations were studied in this cross-sectional case-control study on 20 non-late-life adult, treatment- naïve MDD patients with short-illness-duration first affective episode and in 20 age- and sex-matched healthy controls. Depressed patients showed a basal score in the Hamilton Rating Scale for Depression (HAMD-17) higher than 20. RESULTS: No significant difference in CRP concentration between MDD and control groups was found. Significantly higher baseline cortisol (p=0.01) concentration was observed in MDD as compared to controls. Significant positive correlation was found between cortisol and CRP levels both in MDD subjects (r=0.57; p=0.008) and controls (r=0.61; p=0.004). LIMITATIONS: The current study is limited by its cross-sectional design and small sample size. CONCLUSION: The study supports data on elevated cortisol concentration in MDD providing no evidence for elevated CRP levels at the early stage of the disease.
BACKGROUND: Hypercortisolemia and low grade systemic inflammation are observed in major depressive disorder (MDD). Studies on markers of systematic inflammation and Hypothalamic-Pituitary-Adrenal (HPA) axis dysregulation in MDD produce confounded results due to heterogeneity of MDDpatients related to illness stages and severity with a large proportion suffering from remitted-recurrent and treatment-resistant/chronic depression with first-episode major depression being underrepresented. This study was designed to examine whether and to what extent CRP is related to baseline cortisol concentrations in a well defined cohort of short-illness-duration first-episode, treatment-naïve MDDpatients. METHODS: The levels of salivary C-reactive protein (CRP) and baseline plasma cortisol concentrations were studied in this cross-sectional case-control study on 20 non-late-life adult, treatment- naïve MDDpatients with short-illness-duration first affective episode and in 20 age- and sex-matched healthy controls. Depressedpatients showed a basal score in the Hamilton Rating Scale for Depression (HAMD-17) higher than 20. RESULTS: No significant difference in CRP concentration between MDD and control groups was found. Significantly higher baseline cortisol (p=0.01) concentration was observed in MDD as compared to controls. Significant positive correlation was found between cortisol and CRP levels both in MDD subjects (r=0.57; p=0.008) and controls (r=0.61; p=0.004). LIMITATIONS: The current study is limited by its cross-sectional design and small sample size. CONCLUSION: The study supports data on elevated cortisol concentration in MDD providing no evidence for elevated CRP levels at the early stage of the disease.
Authors: Andrew J Perrin; Mark A Horowitz; Jacob Roelofs; Patricia A Zunszain; Carmine M Pariante Journal: Front Psychiatry Date: 2019-06-28 Impact factor: 4.157