Abstract

Although growing evidence supports an association between allergy, allergens and depression, it remains unknown if this relationship is between “states” (possible triggers) or “traits” (possible vulnerabilities). We hypothesized that patients with recurrent mood disorders who are sensitized to tree pollen (as determined by allergen specific IgE antibodies), in comparison to those who are not sensitized, would report larger negative changes in mood during exposure to tree pollen in spring. We also hypothesized that differences between high and low tree pollen periods in self reported allergy symptoms would correlate positively with differences in self reported depression scores. We present 1-year preliminary data on the first 51 patients with unipolar or bipolar disorder (age: 19-63 years, 65% female, twelve patients were tree-pollen IgE positive). Ratings of mood and allergic disease status were performed once during the peak airborne pollen counts and once during the period of low airborne pollen counts, as reported by two local pollen counting stations. Linear regression models were developed to examine associations of changes in depression scores (dependent variable) with tree pollen sensitization, changes in the allergy symptom severity score, adjusted for gender and order of testing. We did not confirm the hypothesized relationship between a specific tree pollen sensitization and changes in mood during tree pollen exposure. We did confirm the hypothesized positive relationship between the changes in allergy symptoms and changes in subjects' depression scores (adjusted p<0.05). This result is consistent with previous epidemiological evidence connecting allergy with depression, as well as our recent reports of increased expression of cytokines in the prefrontal cortex in victims of suicide and in experimental animals sensitized and exposed to tree pollen. A relationship between changes in allergy symptom scores and changes in depression scores supports a state-level rather than only trait-level relationship, and thus lends optimism to future causality-testing interventional studies, which might then lead to novel preventative environmental interventions in mood disorders.

Highlights

  • Major depression and bipolar disorder represent key public health issues due to their substantial prevalence, recurrence, and devastating effects in middle adulthood[1]

  • There was no significant difference in depression scores observed between subjects who were sensitized to pollen versus those who were Phadiatop negative for any of the variables evaluated except for the “order of visit” variable. 90% of subjects who were tree pollen specific IgE antibody negative made their low pollen visit before the high pollen period, while this was the case for only 42% of tree pollen sensitive subjects

  • We report a statistically significant positive relationship between the changes in upper respiratory allergy symptoms and changes in the subject’s depression scores over the spring from the low to high pollen periods

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Summary

Introduction

Major depression and bipolar disorder represent key public health issues due to their substantial prevalence, recurrence, and devastating effects in middle adulthood[1]. We reported that mood worsening occurs when atmospheric pollen is high and it is associated with a greater seasonality of mood and with seasonal affective disorder (SAD) of non-winter type[11]. Cohort studies have found a greater association between depression and allergy in women as compared to men[12,13]. It is unknown if this association is true or spurious, and if true, if it represents trait (vulnerability)- level relationship or if mood-states are involved, i.e. if there is adequate evidence to suggest that exposure to allergens might trigger mood changes in vulnerable individuals. A study relating change in allergen exposure, to changes in allergy scores, and to changes in depression scores, has no precedent to our knowledge, and would be important to direct our future investigation of a possible allergy-depression link

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