Abstract
BackgroundAlthough, the relation between inflammation and major depressive disorder (MDD) looks like firm, it may not exist in all patients with depression. Therefore, the main aim of this study was to compare serum C-reactive protein (CRP) level among clinical subtypes of MDD and its relation with suicidality.ResultsAccording to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for MDD, 98 patients included and categorized into five clinical subtypes groups: atypical, anxious, melancholic, psychotic, and unspecified depression with percent (11.2%, 31.6%, 19.4%, 15.3%, and 22.4%) respectively. Twenty-four (24.5%) of all patients had suicidal thoughts using Beck Scale for Suicidal Ideation (BSS) with statistically significant increase (P < 0.05*) in suicidality among atypical group. On assessing CRP level, there was highly statistical significant increase (P < 0.001**) among cases with atypical type and also cases with suicidal ideation. Also, logistic regression analysis found that the significant predictors for high CRP among the studied cases were smoking, suicidality, atypical depression, and suicide depression.ConclusionsHigher level of CRP was found among patients with atypical MDD, and there was significant relationship between CRP and suicidality.
Highlights
The relation between inflammation and major depressive disorder (MDD) looks like firm, it may not exist in all patients with depression
Demographic and clinical assessment The study at hand included 98 patients with MDD who were divided into five groups: atypical, anxious, melancholic, psychotic, and unspecified MDD
After performing logistic regression analysis for significant factors of high Creactive protein (CRP) among the studied cases, we found that the significant predictors for high CRP were smoking, suicidality, atypical depression, and suicide depression (Table 6)
Summary
The relation between inflammation and major depressive disorder (MDD) looks like firm, it may not exist in all patients with depression. Patients with neuropsychiatric disorders hold cardinal features of inflammation, involving raised inflammatory mediators targeting all tissues, which may contribute to the pathophysiology and clinical progression of these disorders. C-reactive protein (CRP) that is plasma protein and synthesized by hepatocytes increases due to infection or tissue injury. It is a suitable marker for systemic inflammation. The inflammatory hypothesis role in major depressive disorder (MDD) has been stated many times and evidenced by elevated levels of acute phase reactants and pro-inflammatory cytokines [4]. Even though the relation between inflammation and MDD looks like firm, they may not exist in all depression cases. It is recognized that the heterogeneity of depression is impeding the identification of depression biomarkers, as different subtypes may be the result of several pathophysiological mechanisms [5]
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