Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Department of Mental Health, Innlandet Hospital Trust, Ottestad, Norway.
Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Acta Neuropsychiatr. 2020 Feb;32(1):23-31. doi: 10.1017/neu.2019.36. Epub 2019 Oct 30.
Cross-sectional data show elevated levels of circulating cytokines in psychiatric patients. The literature is divided concerning anti-inflammatory drugs' ability to relieve symptoms, questioning a causal link between inflammatory pathways and psychiatric conditions. We hypothesised that the development of circulating cytokine levels is related to mental distress, and that this relationship is affected by the use of anti-inflammatory drugs.
The study was a longitudinal assessment of 12-week inpatient treatment at Modum Bad Psychiatric Center, Norway. Sera and self-reported Global Severity Index (GSI) scores, which measure psychological distress, were collected at admission (T0), halfway (T1) and before discharge (T2). Other variables known to distort the neuroimmune interplay were included. These were age, gender, diagnosis of PTSD, antidepressants and anti-inflammatory drugs. A total of 128 patients (92 women and 36 men) were included, and 28 were using anti-inflammatory medication. Multilevel modelling was used for data analysis.
Patients with higher levels of IL-1RA and MCP-1 had higher GSI scores (p = 0.005 and p = 0.020). PTSD patients scored higher on GSI than non-PTSD patients (p = 0.002). These relationships were mostly present among those not using anti-inflammatory drugs (n = 99), with higher levels of IL-1RA and MCP-1 being related to higher GSI score (p = 0.023 and 0.018, respectively). Again, PTSD patients showed higher GSI levels than non-PTSD patients (p = 0.014).
Cytokine levels were associated with level of mental distress as measured by the GSI scores, but this relationship was not present among those using anti-inflammatory drugs. We found no association between cytokine levels and development of GSI score over time.
横断面数据显示精神科患者循环细胞因子水平升高。文献对于抗炎药物缓解症状的能力存在分歧，质疑炎症途径与精神疾病之间存在因果关系。我们假设循环细胞因子水平的发展与精神困扰有关，并且这种关系受抗炎药物的影响。
本研究是对挪威莫德姆巴德精神病中心 12 周住院治疗的纵向评估。在入院时（T0）、中途（T1）和出院前（T2）采集血清和自我报告的心理困扰全球严重程度指数（GSI）评分。还包括已知会扭曲神经免疫相互作用的其他变量。这些变量包括年龄、性别、创伤后应激障碍诊断、抗抑郁药和抗炎药。共纳入 128 例患者（92 名女性和 36 名男性），其中 28 例使用抗炎药物。使用多层次模型进行数据分析。
IL-1RA 和 MCP-1 水平较高的患者 GSI 评分较高（p = 0.005 和 p = 0.020）。创伤后应激障碍患者的 GSI 评分高于非创伤后应激障碍患者（p = 0.002）。这些关系主要存在于未使用抗炎药物的患者（n = 99）中，较高的 IL-1RA 和 MCP-1 水平与较高的 GSI 评分相关（p = 0.023 和 0.018）。同样，创伤后应激障碍患者的 GSI 评分高于非创伤后应激障碍患者（p = 0.014）。
细胞因子水平与 GSI 评分所衡量的心理困扰程度相关，但在使用抗炎药物的患者中不存在这种关系。我们没有发现细胞因子水平与 GSI 评分随时间的变化之间存在关联。
