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创伤后应激障碍、重度抑郁症和分离对创伤后女性 C 反应蛋白的影响差异。

The differential effects of PTSD, MDD, and dissociation on CRP in trauma-exposed women.

机构信息

Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States of America.

Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States of America.

出版信息

Compr Psychiatry. 2019 Aug;93:33-40. doi: 10.1016/j.comppsych.2019.06.007. Epub 2019 Jul 3.

Abstract

OBJECTIVE

C-reactive protein (CRP), a marker of systemic inflammation, has been associated with psychiatric disorders including major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). Some research suggests that exposure to trauma can trigger increased activity in the inflammatory system. Dissociation is associated with chronic trauma exposure and may be an important factor in understanding the risk for psychiatric outcomes associated with inflammation. The main objective of the current study was to understand how CRP was related to trauma, dissociation, PTSD and MDD in a sample of 55 traumatized African American women with type 2 diabetes mellitus recruited from an urban hospital.

METHOD

High sensitivity CRP (hsCRP) was assayed through blood samples; psychiatric disorders were assessed with structured clinical interviews, dissociation was assessed with the Multiscale Dissociation Inventory, and exposure to trauma in childhood and adulthood was assessed with the Childhood Trauma Questionnaire and the Traumatic Events Inventory, respectively.

RESULTS

Correlational results showed a significant association between higher concentrations of hsCRP and child abuse (p < 0.05), overall dissociation severity (p < 0.001), and PTSD symptoms (p < 0.01). ANOVA results showed significantly higher levels of hsCRP in those with current MDD, current PTSD, and remitted PTSD. A hierarchical linear regression model demonstrated a significant association between dissociation symptoms and greater hsCRP levels independent of childhood abuse, PTSD, and MDD (R∆ = 0.11, p = 0.001) and independent of emotion dysregulation (p < 0.05).

CONCLUSION

These findings suggest that dissociation symptoms among those with a history of trauma may be particularly associated with higher levels of inflammation.

摘要

目的

C 反应蛋白(CRP)是一种全身性炎症标志物,与包括重度抑郁症(MDD)和创伤后应激障碍(PTSD)在内的精神疾病有关。一些研究表明,创伤暴露会引发炎症系统的活性增加。解离与慢性创伤暴露有关,可能是理解与炎症相关的精神疾病结果的风险的一个重要因素。本研究的主要目的是了解 CRP 在一个由城市医院招募的 55 名患有 2 型糖尿病的非裔美国创伤女性样本中与创伤、解离、PTSD 和 MDD 的关系。

方法

通过血液样本检测高敏 CRP(hsCRP);使用结构临床访谈评估精神疾病,使用多维分离量表评估分离,使用儿童期创伤问卷和创伤事件清单评估儿童期和成年期的创伤暴露。

结果

相关结果表明,hsCRP 浓度与儿童期虐待(p<0.05)、整体解离严重程度(p<0.001)和 PTSD 症状(p<0.01)之间存在显著关联。方差分析结果表明,当前 MDD、当前 PTSD 和缓解 PTSD 患者的 hsCRP 水平显著较高。分层线性回归模型表明,在独立于儿童期虐待、PTSD 和 MDD(R∆=0.11,p=0.001)以及独立于情绪失调(p<0.05)的情况下,解离症状与更高的 hsCRP 水平之间存在显著关联。

结论

这些发现表明,有创伤史的个体中的解离症状可能与更高的炎症水平特别相关。

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