Department of Clinical Psychology, Changshu Third People's Hospital, Changshu Mental Health Center, Changshu, China, 215500.
Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China, 210009.
J Affect Disord. 2019 May 1;250:432-438. doi: 10.1016/j.jad.2019.03.001. Epub 2019 Mar 4.
Inflammation has been shown previously to predict antidepressant treatment response. This retrospective study was conducted to test if the baseline serum C-reactive protein (CRP) levels could predict antidepressant treatment responses in a Chinese sample.
75 adult inpatients (26 male, 49 female) with major depressive disorder (MDD) diagnosed according to DSM-5 were included in this study. Sociodemographic and clinical features, baseline CRP levels, 17-item Hamilton Depression Rating Scale (HDRS-17) and Hamilton Anxiety Rating Scale (HARS) scores assessed at baseline and weeks 1, 2, 3 and 4 were then collected. Afterwards patients were divided into two groups: the low CRP group (baseline CRP < 1 mg/L, n = 47) and the high CRP group (baseline CRP ≥ 1 mg/L, n = 28). Depression severity and treatment response were compared between the two groups.
Repeated-measures ANOVA showed a significant group * assessments interaction in HDRS-17 scores (F = 4.754; p = 0.005). Post-hoc test showed that the two groups differed in HDRS-17 scores at week 4 (F = 6.698; p = 0.012), with the low CRP group having lower HDRS-17 scores than the high CRP group. Moreover, the low CRP group exhibited higher percent reduction in HDRS-17 scores at week 3 (F = 5.016; p = 0.028) and week 4 (F = 9.865; p = 0.003) as compared to the high CRP group. Cox proportional hazard model showed that the remission rate was higher in the low CRP group (p = 0.010).
Patients received uncontrolled antidepressant therapy and the sample size was limited.
Baseline serum CRP levels may predict antidepressant treatment responses in patients with MDD and patients with higher levels of CRP were less likely to get remission.
炎症先前已被证明可预测抗抑郁治疗反应。本回顾性研究旨在检验基线血清 C 反应蛋白（CRP）水平是否可预测中国患者的抗抑郁治疗反应。
本研究纳入了 75 名符合 DSM-5 标准的成年住院患者（26 名男性，49 名女性），诊断为重度抑郁症（MDD）。收集了人口统计学和临床特征、基线 CRP 水平、基线和第 1、2、3 和 4 周的 17 项汉密尔顿抑郁量表（HDRS-17）和汉密尔顿焦虑量表（HARS）评分。随后将患者分为两组：低 CRP 组（基线 CRP<1mg/L，n=47）和高 CRP 组（基线 CRP≥1mg/L，n=28）。比较两组之间的抑郁严重程度和治疗反应。
重复测量方差分析显示 HDRS-17 评分的组*评估交互作用显著（F=4.754；p=0.005）。事后检验显示，两组在第 4 周的 HDRS-17 评分存在差异（F=6.698；p=0.012），低 CRP 组的 HDRS-17 评分低于高 CRP 组。此外，与高 CRP 组相比，低 CRP 组在第 3 周（F=5.016；p=0.028）和第 4 周（F=9.865；p=0.003）时 HDRS-17 评分的百分比降低更高。Cox 比例风险模型显示低 CRP 组的缓解率更高（p=0.010）。
患者接受了不受控制的抗抑郁治疗，且样本量有限。
基线血清 CRP 水平可能预测 MDD 患者的抗抑郁治疗反应，且 CRP 水平较高的患者缓解的可能性较小。
