19 Pro-inflammatory cytokines and childhood trauma in young people with emerging mental health difficulties

Abstract

Objectives/aimsElevated levels of pro-inflammatory cytokines are associated with a range of mental illnesses, and also with childhood trauma.1–4 Evidence suggests that inflammation occurring as a result of childhood trauma could play a role in the pathogenesis of psychiatric disorders.5 6 However, previous research does not account for confounders, including psychotropic medication and illness duration, that may affect inflammation levels.7 The aim of this study was to investigate the relationship between childhood trauma exposure and levels of inflammation in young people with emerging mental health disorders with confounding factors removed.Methods10 patients, aged 16–25, with a range of psychiatric disorders and no history of psychotropic medication were recruited from Birmingham mental health services, along with 16 healthy controls. Childhood trauma exposure was assessed with the Childhood Trauma Questionnaire (CTQ), and blood samples were analysed for serum concentrations of pro- inflammatory cytokines IL-6 and IL-1β.ResultsThere was no significant difference in serum cytokines between patients and healthy controls, or those with and without childhood trauma (p>0.05). Post-hoc sample size calculations estimated 197 patients with and 197 without childhood trauma would be needed to detect a significant 2 pg/ml difference in cytokine levels (80% power, 5% significance). There was a weak positive, but non-significant, correlation between both cytokines and CTQ score in the patient group (rS=0.1–0.3, p>0.05). Multiple linear regression of CTQ score, sex and BMI found that none of these variables significantly predicted cytokine concentration in our population.ConclusionsThere is preliminary evidence of an association between childhood trauma and inflammation in patients with mental illness, but due to small sample size no definitive conclusions can be drawn from this data. Future research with a larger sample size and longitudinal approach would be beneficial in establishing whether a relationship exists independent of confounders.ReferencesGoldsmith DR, Rapaport MH, Miller BJ. A meta-analysis of blood cytokine network alterations in psychiatric patients: comparisons between schizophrenia, bipolar disorder and depression. Mol Psychiatr. 2016; 21: 1696–1709.Upthegrove R, Manzanares-Teson N, Barnes NM. Cytokine function in medication-naive first episode psychosis: a systematic review and meta-analysis. Schizophr. Res 2014; 155: 101–108.Baumeister D, Akhtar R, Ciufolini S, Pariante CM, Mondelli V. Childhood trauma and adulthood inflammation: a meta-analysis of peripheral C-reactive protein, interleukin-6 and tumour necrosis factor-α. Mol Psychiatr 2016; 21: 642–649.Danese A, Baldwin JR. Hidden wounds? Inflammatory links between childhood trauma and psychopathology. Annu Rev of Psychol 2017; 68: 517–544.Upthegrove R, Barnes NM. The immune system and schizophrenia: an update for clinicians. BJPsych Adv 2014; 20: 83–91.Miller AH, Maletic V, Raison CL. Inflammation and its discontents: the role of cytokines in the pathophysiology of major depression. Biol Psychiat 2009: 65; 732–741.Danese A, Pariante CM, Caspi A, Taylor A, Poulton R. Childhood maltreatment predicts adult inflammation in a life-course study. P Natl Acad Sci USA 2007;104:1319–1324.