Abstract
ObjectiveThe scarcity of research on associations between inflammatory markers and symptoms of depression and anxiety during adolescence has yielded inconsistent results. Further, not all studies have controlled for potential confounders. We explored the associations between baseline inflammatory markers and psychological distress including moderators at follow-up in a Norwegian adolescent population sample.MethodsData was derived from 373 girls and 294 boys aged 15–18 years at baseline, in the Fit Futures Study, a large-scale 2-year follow-up study on adolescent health. Baseline data was gathered from 2010 to 2011 and follow-up data from 2012 to 2013. Psychological distress was measured with Hopkins Symptom Checklist (HSCL-10). Serum levels of the following inflammatory markers were measured: C-reactive protein (CRP), Interleukin 6 (IL-6), Transforming growth factor alpha (TGF-α), Tumor necrosis factor alpha variant 1 (TRANCE), and variant 2 (TWEAK). Independent associations between baseline inflammatory markers and HSCL-10 at follow-up were explored by linear regressions, in sex-stratified analyses.ResultsIn girls, analyses showed positive associations between all inflammatory markers and HSCL-10, except for TRANCE. However, all associations were non-significant in crude as well as in adjusted analyses. In boys, CRP (p = 0.03) and TGF-α (p < 0.01) showed significant associations with HSCL-10, that remained significant after adjustment. Additionally, moderators were found. In boys, CRP was associated with HSCL-10 in those with high body fat and those being physical inactive, and the association between TWEAK and HSCL-10 was dependent upon sleep duration.ConclusionThere were significant prospective associations between CRP, TFG-α, and HSCL-10 in boys aged 15–18 years at baseline.
Highlights
Adolescents who experience psychological distress have increased risk of developing mental disorders later in life (Silva et al, 2020)
We explored the associations between baseline inflammatory markers and psychological distress including moderators at follow-up in a Norwegian adolescent population sample
C-reactive protein (CRP) (p = 0.03) and TGF-α (p < 0.01) showed significant associations with HSCL-10, that remained significant after adjustment
Summary
Adolescents who experience psychological distress have increased risk of developing mental disorders later in life (Silva et al, 2020). One in three adults with major depressive disorder (MDD) have elevated levels of inflammatory markers (Leighton et al, 2018), and the average levels of inflammatory markers in MDD patients are higher than in controls (Raison et al, 2006; Howren et al, 2009; Dowlati et al, 2010; Liu et al, 2012; Osimo et al, 2020). Patients with inflammatory conditions have higher risk for MDD compared to controls (Leighton et al, 2018), and up to 50% of patients receiving therapeutic administration of the cytokine interferon-α develop MDD (Raison et al, 2006). There is preliminary evidence suggesting that patients with general anxiety disorders show increased levels of inflammatory markers compared to controls (Vogelzangs et al, 2013; Michopoulos et al, 2017; Costello et al, 2019). With respect to psychological distress, studies have investigated associations between inflammatory markers and psychological distress in adults, and reported cross-sectional associations with C-reactive protein (CRP), in large population studies (WiumAndersen et al, 2013; Baek et al, 2019), and prospective associations with Interleukin 6 (IL-6; Virtanen et al, 2015)
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