Study on the Role of Inflammatory Markers and Type D Personality on Symptom Profiles and Severity in Patients with Major Depressive Disorder

I Enatescu ,Roxana Oancea,Oana Neda-Stepan,Raul Patrascu,Mihaela Simu,Ioan Sorin Stratulat,Gabriela Vlad,Vladimir Poroch,Cãtãlina Giurgi-Oncu ,R Kalinovic ,I Papavă ,V.r Enatescu

doi:10.3390/app10165615

Abstract

The high rates of chronicity and recurrences account for the limited efficacy of current antidepressants, conceived based on the current neurobiological hypotheses, in reaching the full clinical and functional remission of major depressed (MDD) patients. We aimed to analyze the role of pro-inflammatory markers, C-reactive protein (CRP) and interleukin-6 (IL-6), respectively, and type D personality (TDP) on the depressive symptoms measured by the 17-item Hamilton Depression Rating Scale (HAM-D). The processed data are part of a prospective 8-weeks follow-up study conducted in 50 subjects with MDD referred to ‘Eduard Pamfil’ Psychiatric Clinic Timisoara. The presence of elevated pro-inflammatory markers in MDD patients with TDP has been significantly associated with higher somatic anxiety (p = 0.005) and somatic symptoms-general (p = 0.016) mean rank scores compared to their counterparts without significant inflammation. The combination of increased CRP and IL-6 levels were significantly correlated with higher impaired insight (p = 0.026) mean rank scores, additionally. The presence of a significant level of IL-6 has shown a significant effect of size (p = 0.023) on the severity of major depression at baseline. On the contrary, type D personality has not influenced the severity of depressive symptoms (p > 0.05). Inflammatory markers significantly impact the clinical profiles and symptoms severity of MDD patients.

Highlights

Major depressive disorder (MDD) is among the most prevalent psychiatric disorders in the general population, having a high rate of psychiatric comorbidities [1,2]
The current study aimed to investigate the hypothesis that pro-inflammatory markers (CRP and IL-6) and type D personality could shape the symptomatic profile and alter the severity of depressive symptoms in major depressed (MDD) patients
Demographic Data and Type D Personality Stratified by the Presence Inflammatory Markers

Summary

Introduction

Major depressive disorder (MDD) is among the most prevalent psychiatric disorders in the general population, having a high rate of psychiatric comorbidities [1,2]. Studies have found notable frequencies of depressive symptoms in distinct clinical subpopulations [3,4]. Albeit the most treatable psychiatric condition, only about one-third of MDD patients achieve remission in the first treatment step of antidepressant therapy [5]. There is a growing body of evidence suggesting that many other underlying biological mechanisms should be considered to develop new classes of antidepressant drugs [6]. Research data has evidenced that the neurotransmitters’ imbalances result in an overactivated response of immune systems through the HPA (hypothalamic-pituitary-adrenal) and sympathoadrenal medullary (SAM) axes dysfunction [7].

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