Zainal Nur Hani
National University of Singapore, Department of Psychology, Kent Ridge Campus, Singapore.
Brain Behav Immun Health. 2025 Jul 4;48:101052. doi: 10.1016/j.bbih.2025.101052. eCollection 2025 Oct.
Major depressive disorder (MDD) is a prevalent mental disorder, and low social support and high strain could impact its long-term symptom severity. Increased inflammation, marked by C-reactive protein (CRP) and fibrinogen, has also been correlated with more MDD symptoms. However, the inflammation-MDD symptom association might vary by social support dimensions. The current study thus examined how social support dimensions moderated the inflammation-MDD severity correlation.
Community adults ( = 1,054) with and without MDD provided plasma samples to measure CRP and fibrinogen levels and completed self-reports of perceived support and strain from family, friends, and partners at Wave 1 (W1). MDD severity was assessed at W1 and Wave 2 (W2, nine-year follow-up). Multiple linear regressions and generalized additive modeling (GAM) assessed how W1 social support dimensions and inflammation levels interacted to predict W2 MDD severity, controlling for clinical and sociodemographic covariates.
Increased W1 fibrinogen predicted higher W2 MDD severity in participants with lower (vs. higher) W1 social support and higher (vs. lower) social strain (|standardized β| = 0.18-2.31 vs. 0.01-0.03). Further, increased CRP predicted more MDD symptoms in participants with higher (vs. lower) social strain (|β| = 0.24-0.26 vs. 0.15-0.16). These significant interaction findings were identical in linear and GAM models that accommodate non-linear associations. : Results suggested that increased proinflammatory activity indexed by CRP and fibrinogen levels could predict nine-year MDD severity under social strains, consistent with the social signal transduction theory. Improving social support and decreasing social strain might buffer inflammation-related depression.
重度抑郁症（MDD）是一种常见的精神障碍，社会支持低和压力大会影响其长期症状严重程度。以C反应蛋白（CRP）和纤维蛋白原标记的炎症增加也与更多的MDD症状相关。然而，炎症与MDD症状的关联可能因社会支持维度而异。因此，本研究探讨了社会支持维度如何调节炎症与MDD严重程度的相关性。
有或无MDD的社区成年人（n = 1054）提供血浆样本以测量CRP和纤维蛋白原水平，并在第1波（W1）完成关于来自家人、朋友和伴侣的感知支持和压力的自我报告。在W1和第2波（W2，九年随访）评估MDD严重程度。多元线性回归和广义相加模型（GAM）评估W1社会支持维度和炎症水平如何相互作用以预测W2 MDD严重程度，同时控制临床和社会人口统计学协变量。
在W1社会支持较低（vs较高）且社会压力较高（vs较低）的参与者中，W1纤维蛋白原增加预示着W2 MDD严重程度更高（标准化β绝对值= 0.18 - 2.31 vs 0.01 - 0.03）。此外，在社会压力较高（vs较低）的参与者中，CRP增加预示着更多的MDD症状（β绝对值= 0.24 - 0.26 vs 0.15 - 0.16）。这些显著的相互作用发现在适应非线性关联的线性和GAM模型中是相同的。结果表明，以CRP和纤维蛋白原水平为指标的促炎活性增加可以预测社会压力下九年的MDD严重程度，这与社会信号转导理论一致。改善社会支持和减轻社会压力可能缓冲与炎症相关的抑郁。
