Correlation of clinical features with hs‑CRP in TRD patients

Abstract

Correlation of clinical features with hypersensitive C-reactive protein (hs-CRP) in patients with treatment-resistant depression (TRD) was investigated. The severity of disease in 103 TRD patients and 103 non-TRD patients was evaluated using the Hamilton Depression Scale (HAMD)-17. The levels of hs-CRP in both groups were detected via immunofluorescence. Clinical features and differences in hs-CRP before and after treatment in both groups were analyzed, and correlation of baseline hs-CRP level with clinical features of TRD patients was also analyzed. Moreover, the relationship between hs-CRP and occurrence of TRD was analyzed using logistic regression analysis, and the diagnostic value of hs-CRP in TRD was evaluated using the receiver operating characteristic (ROC) curve. The onset age in the TRD group was lower than that in the non-TRD group, the education in the TRD group was shorter than that in the non-TRD group, the total course of disease in the TRD group was longer than that in the non-TRD group, and both baseline and post-treatment hs-CRP level in the TRD group (12.05±5.79 and 9.02±3.71 mg/l) were higher than those in the non-TRD group (7.85±2.85 and 6.10±2.74 mg/l) (p<0.05). The HAMD score (r=0.338, p=0.031), anxiety/somatization factor score (r=0.465, p=0.015) and sleep disorder (r=0.387, p=0.029) of TRD patients were positively correlated with the hs-CRP level, but the onset age (r=−0.59, p=0.009) was negatively correlated with the hs-CRP level. Logistic regression analysis revealed that the baseline hs-CRP was included into the TRD regression equation [odds ratio (OR) =2.834, 95% confidence interval (CI) =1.723–4.886], and the area under the ROC curve was 0.893 (p<0.05, 95% CI=0.852–0.933). In the TRD group, the course of TRD in patients was longer, the onset of disease was earlier and the educational level was lower than that in the non-TRD group. Therefore, the level of hs-CRP can serve as a reference for the diagnosis of TRD.

C-Reactive Protein as a Biomarker for Major Depressive Disorder?

“…Based on the abovementioned inflammatory theory of depression, several studies investigated the association between CRP levels and antidepressant treatment [123]. A wide range of studies reported that elevated levels of CRP were associated with TRD patients [50,60,78,84,95,97]. Conversely, other studies showed that lower levels of CRP were associated with a better and faster response to SSRI treatment [63,98].…”

“…In the TRD group, the disease course was longer, the onset was earlier, and the educational level was lower. The HAMD score (p = 0.031), anxiety/somatization factor score (p = 0.015), and sleep disorder (p = 0.029) of TRD patients were positively associated with hs-CRP level, while the onset age (p = 0.009) was negatively correlated with the hs-CRP level [84].…”

“…A case-control study evaluated the association between MDD clinical features and hs-CRP levels in a sample of 103 TRD patients and 103 non-TRD patients [84]. Depressive symptoms were investigated through HAMD-17.…”

“…Based on our judgment, 40 studies were rated as "good" studies [16,45,46,48,49,[51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66]68,[71][72][73]75,76,78,81,83,[88][89][90][92][93][94][96][97][98]100] and 16 as "satisfactory" studies [47,50,67,69,70,74,77,79,80,82,[84]…”

Altered Brain Function in Treatment-Resistant and Non-treatment-resistant Depression Patients: A Resting-State Functional Magnetic Resonance Imaging Study

“…Overall medical costs for TRD patients are almost twice or more than twice as high as those for nTRD patients (8,9). In terms of clinical symptoms, compared with nTRD patients, TRD patients had more severe depressive symptoms, cognitive impairment, anxiety and distress, longer onset period, and lower work productivity (7,(10)(11)(12). Therefore, it is necessary to explore the biomarkers of TRD, which in turn will facilitate the understanding of the differences in the pathogenesis of TRD and nTRD.…”