Association between depression or anxiety symptoms and immune-inflammatory characteristics in in-patients with tuberculosis: A cross-sectional study

Abstract

BackgroundDepression and anxiety are major psychological issues among patients with tuberculosis (TB) owing to chronic and complex treatments, have been reported to be closely correlated with immune and inflammation. However, the association of peripheral immune-inflammatory characteristics with depression/anxiety symptoms in in-patients with TB has rarely been reported.MethodsA cross-sectional study of 338 in-patients with TB from 3 hospitals in China were enrolled to investigate their depression and anxiety status by using the nine-item Patient Health Questionnaire (PHQ-9) and seven-item Generalized Anxiety Disorder Scale (GAD-7). Participants were divided into groups based on their PHQ-9 and GAD-7 scores, and differences in demography and immune-inflammatory characteristics were studied. Logistic analysis was performed to explore factors related to depression and anxiety symptoms.ResultsDepression and anxiety prevalence among patients with TB was 47.9 and 42.6%, respectively. Furthermore, 38.5% of patients reported a comorbidity of depression and anxiety symptoms. The counts of CD3, CD4, CD8, and lymphocytes decreased, whereas those of neutrophils, platelets, and peripheral blood cells and their derived indices increased among TB patients with depression or anxiety in comparison with those without symptoms (p < 0.05). In addition, increasing age, lower income (monthly income ≤ 3,000 yuan), divorced or widowed, drug resistance, and higher systemic immune inflammation index (SII) were significantly associated with depression or anxiety symptoms (p < 0.05).ConclusionApproximately half of the patients with TB suffered from depression or/and anxiety symptoms. Patients with depression or anxiety present worse cell immune status and stronger inflammatory responses compared to those without symptoms. We emphasized the importance of paying attention to the dysfunction of immune-inflammation process of TB patients with depression or anxiety symptoms. Especially, SII has a potential application value in guiding the evaluation of TB-related depression or anxiety owing to its easily accessibility and being economical.

Integrating systemic immune-inflammation index, fibrinogen, and T-SPOT.TB for precision distinction of active pulmonary tuberculosis in the era of mycobacterial disease research

“…Our research results indicate that the levels of ESAT-6, CFP-10, Systemic Immune-Inflammation Index (SII), and Fibrinogen (FIB) in the APTB group are significantly higher than those in the non-TB group. This suggests that after tuberculosis infection, SII and FIB may experience varying degrees of elevation, consistent with some previous research findings ( Kager et al, 2015 ; Liu et al, 2022 ). Inflammatory and coagulation indices tend to increase to different extents after tuberculosis infection ( Ştefanescu et al, 2021 ; Mustafa et al, 2022 ).…”

“…It reflects the individual’s immune status against pathogen infections and the severity of the disease, with minimal influence from mixed conditions ( Li et al, 2023 ), rendering it a novel immune-inflammatory marker that has garnered considerable attention. Previous studies have indicated an association between elevated SII and tuberculosis, with a correlation observed with anxiety ( Liu et al, 2022 ). Fibrinogen, a coagulation system activator, shows heightened levels in tuberculosis infections ( Kager et al, 2015 ; Pinelo et al, 2023 ).…”

Systemic immune inflammation index is a valuable marker for predicting hemodialysis patients with depression: a cross-sectional study

“…The risk of depression in MHD patients with SII > 963.93 is 4.709 times that of those with SII ≤ 478.32, and SII > 685.11 is the cutoff for diagnosing depression in patients. Similar to the results of this study, SII has also been shown to be an independent risk factor for depression in other chronic in ammatory diseases, Liu et al [41]found through logistic regression analysis that SII is signi cantly correlated with anxiety and depression in pulmonary tuberculosis patients. Wang et al [42]showed that high SII level was an independent risk factor for depression in diabetes patients through multivariate logistic regression analysis.In ammation is an important pathogenesis of stroke, and its in ammatory storm is also involved in the onset of post-stroke depression.…”

Correlation of systemic immune-inflammation index and moderate/major depression in patients with depressive disorders: a large sample cross-sectional study

“…For example, among patients with ischemic stroke, SII, platelet/lymphocyte ratio (PLR), and neutrophil/lymphocyte ratio (NLR) increased at admission, in particular, increased SII was significantly associated with the occurrence of post-ischemic stroke depression one month later, which may provide some prognostic clues for early detection of post-ischemic stroke depression ( 14 ). In the tuberculosis population, patients with symptoms of depression or anxiety had poorer cellular immune status and stronger inflammatory response than patients without symptoms of anxiety or depression, and a higher SII was significantly associated with symptoms of depression or anxiety ( p < 0.05) ( 21 ). A study of 2,566 patients with diabetes (including 370 patients diagnosed with comorbidity depression) showed that high SII levels were an independent risk factor for diabetic depression (OR = 1.347, 95%CI: 1.031–1.760, p = 0.02).…”