Assessing the links between childhood trauma, C-reactive protein and response to antidepressant treatment in patients with affective disorders

Kai F Fischer,Richard Musil,Johannes Dorr,Julie Elsner,Michael Obermeier,Leonie Blei,Johanna Dobmeier,Peter Zill,Maria S Simon

doi:10.1007/s00406-021-01245-z

Abstract

Adverse Childhood Experiences (ACE) are a well-known risk-factor for depression. Additionally, (high-sensitive) C-reactive Protein (hsCRP) is elevated in subgroups of depressed patients and high following ACE. In this context the literature considers hsCRP and ACE to be associated with treatment resistant depression. With the data being heterogenous, this study aimed to explore the associations of ACE, hsCRP levels and response to antidepressant treatment in uni- and bipolar depression. N = 76 patients diagnosed with uni- or bipolar depression and N = 53 healthy controls were included. Treatment was over 6 weeks in an inpatient psychiatric setting within an observatory study design. Depressive symptoms were assessed by the Montgomery-Asberg Depression Rating Scale (MADRS), ACE were assessed by the Childhood Trauma Questionnaire (CTQ); the body-mass-index (BMI) and hsCRP were measured. HsCRP levels did not differ between the study population and the healthy controls. While the depressive symptoms decreased, the hsCRP levels increased. Sexual abuse was associated with significant higher and emotional abuse with lower levels of hsCRP after 6 weeks. The baseline hsCRP levels and the ACE subgroups did not show significant associations with the treatment response in unipolar depressed patients. The long-lasting effects of specific forms of ACE may have relevant impact on inflammation, supporting hsCRP to be a suitable biomarker. With ACE and hsCRP not showing any significant associations with treatment response in the unipolar depressed subgroup, a more differentiate research concerning biomarkers and treatment regimens is needed when talking about treatment response.

Highlights

Life stress is among the most important risk factors for physical and mental health problems [2, 22, 24, 39, 53, 60]
The present study aims to explore first, whether different forms of Adverse Childhood Experiences (ACE) are associated with altered hsCRP levels, second, if specific forms of ACE are associated with the response to anti-depression treatment, third, whether the treatment response is associated with hsCRP levels, and fourth, whether the hsCRP levels vary during anti-depressant treatment
The most suitable parameters for showing chronic inflammation after ACE remain unclear hsCRP, IL-6 and TNFalpha are being discussed as potential candidates [7, 57]

Summary

Introduction

Life stress is among the most important risk factors for physical and mental health problems [2, 22, 24, 39, 53, 60]. Adverse Childhood Experiences (ACE), such as emotional abuse and neglect, physical abuse and neglect and sexual abuse, are more frequent in numerous psychiatric diseases [2, 3, 13, 26, 53]. Literature suggests ACE to be a risk factor themselves by causing structural and functional brain alterations (e.g., [62, 82]) as well as a chronic state of inflammation induced by long-lasting psychological stress [23]

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