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炎症增加预示着九年内重度抑郁障碍诊断状况的变化。

Increased inflammation predicts nine-year change in major depressive disorder diagnostic status.

机构信息

Department of Psychology.

出版信息

J Abnorm Psychol. 2021 Nov;130(8):829-840. doi: 10.1037/abn0000716. Epub 2021 Oct 7.

Abstract

proposes that increased baseline inflammatory activity may accumulate over time and lead to future major depressive disorder (MDD). However, most research conducted on this topic has been cross-sectional and examined between- (vs. within-) persons and symptom severity (vs. diagnosis). Therefore, we tested if elevated inflammatory activity at Time 1 (T1) would predict future within-person 9-year change in MDD diagnosis. Community-dwelling adults (n = 945) participated in the Midlife Development in the United States (MIDUS) study. T1 and Time 2 (T2) MDD status was assessed using the Composite International Diagnostic Interview-Short Form, and markers of inflammatory activity at T1 were measured (e.g., levels of serum interleukin-6 [IL-6], C-reactive protein [CRP], fibrinogen). Latent change score modeling was conducted. Higher T1 IL-6, CRP, and fibrinogen levels of inflammatory activity predicted T1-T2 development/relapse of MDD within persons. This effect occurred more strongly among women (vs. men; d = .149 vs. .042), younger (vs. older) adults (d = .137 vs. .119), persons with more (vs. less) chronic health issues (d = .133 vs. .065), low- (vs. middle- or high-) income earners (d = .161 vs. .050), and persons with more (vs. less) frequent childhood trauma (d = .156 vs. .017). Findings aligned with expanded cytokine theories, which posit that the impact of increased T1 inflammatory activity on future change in MDD status will be larger for subgroups vulnerable to increased stress exposure. Cognitive-behavioral or pharmacological approaches to reduce markers of inflammatory activity may prevent development/relapse of MDD. General Scientific Summary: Increased C-reactive protein (CRP), fibrinogen, and interleukin-6 (IL-6) levels predicted 9-year major depressive disorder (MDD) diagnostic status change more strongly in younger than older adults, women but not men, those with low (vs. high) income, as well as persons with high (vs. low) childhood trauma frequency and number of chronic illnesses. Findings aligned with expanded cytokine theories (e.g., social signal transduction theory of depression), which posit that markers of inflammatory activity predict future change in MDD status especially for populations vulnerable to heightened, chronic, and long-term exposure to environmental stressors. Continued efforts to empirically test expanded cytokine theories of depression may improve delineation of patterns of health disparities and facilitate effective measures to prevent the onset or recurrence of MDD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

摘要

提出基线炎症活动的增加可能会随着时间的推移而积累,并导致未来发生重度抑郁症(MDD)。然而,大多数关于这个主题的研究都是横断面的,研究的是个体之间(而非个体内部)和症状严重程度(而非诊断)。因此,我们检验了 T1 时升高的炎症活性是否会预测未来 9 年内 MDD 诊断的个体内变化。945 名社区居住的成年人参加了美国中年发展研究(MIDUS)。使用复合国际诊断访谈-短表评估 T1 和 T2 的 MDD 状态,测量 T1 时的炎症活性标志物(例如,血清白细胞介素-6[IL-6]、C 反应蛋白[CRP]、纤维蛋白原)。进行潜在变化评分模型分析。T1 时较高的 IL-6、CRP 和纤维蛋白原炎症活性水平预示着个体内部 T1-T2 期间 MDD 的发展/复发。这种影响在女性(与男性相比;d =.149 与.042)、较年轻(与较年长)成年人(d =.137 与.119)、有较多(与较少)慢性健康问题(d =.133 与.065)、收入较低(与中等或较高收入者相比;d =.161 与.050)和童年创伤频率较高(与较低)的人群中更为强烈(d =.156 与.017)。研究结果与扩展的细胞因子理论一致,该理论假设,增加的 T1 炎症活性对未来 MDD 状态变化的影响,对于容易受到增加的应激暴露影响的亚组而言将更大。降低炎症活性标志物的认知行为或药物治疗方法可能会预防 MDD 的发展/复发。一般科学总结:在较年轻的成年人中,C 反应蛋白(CRP)、纤维蛋白原和白细胞介素-6(IL-6)水平升高预示着 9 年内重度抑郁症(MDD)诊断状态变化的可能性更大,而在女性(而非男性)、收入较低(而非较高)的成年人中,以及童年创伤频率较高(而非较低)和慢性疾病较多(而非较少)的成年人中。研究结果与扩展的细胞因子理论(例如,抑郁症的社会信号转导理论)一致,该理论假设,炎症活性标志物可预测 MDD 状态的未来变化,尤其是对那些容易受到增强、慢性和长期环境应激源影响的人群。继续努力从实证上检验抑郁症的扩展细胞因子理论,可能有助于更好地区分健康差异模式,并促进预防 MDD 发作或复发的有效措施。(PsycInfo 数据库记录(c)2021 APA,保留所有权利)。

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