The association between anxiety, traumatic stress, and obsessive-compulsive disorders and chronic inflammation: A systematic review and meta-analysis

Renna, Megan E.; O’Toole, Mia Skytte; Spaeth, Phillip E.; Lekander, Mats; Mennin, Douglas S.

doi:10.1002/da.22790

Cited by 154 publications

(118 citation statements)

References 89 publications

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“…In finding that peripheral inflammation in RSDS was most tightly- linked with the EZM—a test of anxiety-like behavior—it is worth noting the DSM-IV originally characterized PTSD under the umbrella of anxiety disorders ( American Psychiatric Association, 2000 ). There is a breadth of clinical literature demonstrating differences in peripheral inflammation in patients with PTSD as well as other anxiety disorders ( O’Donovan, 2015 ; Neigh and Ali, 2016 ; Boscarino, 2004 ; Kim et al, 2020 ; Renna et al, 2018 ). Importantly, many of the cytokines we found to be differentially elevated in control versus RSDS have also been shown to be elevated in human plasma from patients with PTSD, such as IL-2, IL-6, IL-17, and TNFα (summarized well by Wang et al ) ( Wang et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Peripheral inflammation is strongly linked to elevated zero maze behavior in repeated social defeat stress

Elkhatib

Moshfegh

Watson

et al. 2020

Brain, Behavior, and Immunity

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Post-traumatic stress disorder (PTSD) is a psychiatric illness that results in an increased risk for a variety of inflammatory diseases. The exact etiology of this increased risk is unknown, and thus several animal models have been developed to investigate the neuroimmune interactions of PTSD. Repeated social defeat stress (RSDS) is an established preclinical model of psychological trauma that recapitulates certain behavioral and inflammatory aspects of human PTSD. Furthermore, RSDS has been utilized to subgroup animals into susceptible and resilient populations based on one specific behavioral phenotype ( i.e. , social interaction). Herein, we conducted an extensive investigation of circulating inflammatory proteins after RSDS and found significant elevations in various cytokines and chemokines after exposure to RSDS. When categorizing animals into either susceptible or resilient populations based on social interaction, we found no inflammatory or other behavioral differences between these subgroups. Furthermore, correlative analyses found no significant correlation between social interaction parameters and inflammation. In contrast, parameters from the elevated zero maze (EZM) demonstrated significant associations and clustering to five circulating cytokines. When animals were subdivided into susceptible and resilient populations solely based upon combined EZM performance, significant inflammatory differences were evident between these groups. Strikingly, these circulating inflammatory proteins displayed a stronger predictive ability of EZM performance compared to social interaction test performance. These findings provide new insights into inflammatory markers associated with RSDS, and the utility of EZM to effectively group RSDS-exposed mice into populations with differential levels of peripheral inflammation.

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Section: Discussionmentioning

confidence: 99%

Peripheral inflammation is strongly linked to elevated zero maze behavior in repeated social defeat stress

Elkhatib

Moshfegh

Watson

et al. 2020

Brain, Behavior, and Immunity

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“… 46 Mindfulness-based interventions, understood as an awareness of the experience of the present moment and emphasizing the attention paid to one’s thoughts, bodily sensations and emotions, have shown to be effective among patients with IBD. 47 They often combine meditation with contemporary cognitive–behavioral approaches, and several mechanisms behind their effectiveness have been identified. 48 In fact, their positive effects on various mental health conditions have been reported in diverse clinical and non-clinical populations.…”

Section: The Decaloguementioning

confidence: 99%

Covid-19 and the management of patients with inflammatory bowel disease: a practical decalogue for the post-pandemic phase

Papa

Lopetuso

et al. 2020

Therap Adv Gastroenterol

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The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised several concerns for patients with chronic immune-mediated diseases, including inflammatory bowel disease (IBD). As the outbreak appears to be in the descending phase, at least in some part of the world, as in most European countries, guidance is urgently needed to provide optimal care for our IBD patients in order to gradually and safely reduce the gap in care that has been accumulated in the months of lockdown and to face all the backlogs. Therefore, we have provided a decalogue of practical recommendations for gastroenterologists to manage patients with IBD in the post-peak phase of the COVID-19 pandemic. They include all the aspects of IBD care, not only pharmacological ones but also endoscopy, surgery, psychological treatment, telemedicine, diagnostics and educational tasks provided by doctors and patient associations.

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“…Sickness behavior symptoms show a considerable overlap with depressive symptoms like anhedonia, anorexia, low concentration, low energy, low libido, psychomotor slowness, irritability; and researchers have hypothesized that depression is a maladaptive or exacerbated form of sickness behavior in some patients with chronic low-grade inflammation 15 – 20 . Besides their reward-sensitivity related symptoms, recent studies suggest that also trauma- and anxiety-related symptoms are related to inflammatory markers, resulting in a mix of overlapping symptoms of mood, anxiety, and post-traumatic stress disorder 13 , 21 – 23 . A causal pathway in which inflammation causes symptoms of anxiety is less established as studies show that inflammatory levels increase when study participants became anxious 24 , 25 , and a large longitudinal study found that anxiety predicted inflammation in the future but not vice versa 26 .…”

Section: Introductionmentioning

confidence: 99%

Basal and LPS-stimulated inflammatory markers and the course of individual symptoms of depression

et al. 2020

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Multiple studies show an association between inflammatory markers and major depressive disorder (MDD). People with chronic low-grade inflammation may be at an increased risk of MDD, often in the form of sickness behaviors. We hypothesized that inflammation is predictive of the severity and the course of a subset of MDD symptoms, especially symptoms that overlap with sickness behavior, such as anhedonia, anorexia, low concentration, low energy, loss of libido, psychomotor slowness, irritability, and malaise. We tested the association between basal and lipopolysaccharide (LPS)-induced inflammatory markers with individual MDD symptoms (measured using the Inventory of Depressive Symptomatology Self-Report) over a period of up to 9 years using multivariate-adjusted mixed models in 1147-2872 Netherlands Study of Depression and Anxiety (NESDA) participants. At baseline, participants were on average 42.2 years old, 66.5% were women and 53.9% had a current mood or anxiety disorder. We found that basal and LPSstimulated inflammatory markers were more strongly associated with sickness behavior symptoms at up to 9-year follow-up compared with non-sickness behavior symptoms of depression. However, we also found significant associations with some symptoms that are not typical of sickness behavior (e.g., sympathetic arousal among others). Inflammation was not related to depression as a unified syndrome but rather to the presence and the course of specific MDD symptoms, of which the majority were related to sickness behavior. Anti-inflammatory strategies should be tested in the subgroup of MDD patients who report depressive symptoms related to sickness behavior.

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The association between anxiety, traumatic stress, and obsessive-compulsive disorders and chronic inflammation: A systematic review and meta-analysis

Cited by 154 publications

References 89 publications

Peripheral inflammation is strongly linked to elevated zero maze behavior in repeated social defeat stress

Peripheral inflammation is strongly linked to elevated zero maze behavior in repeated social defeat stress

Covid-19 and the management of patients with inflammatory bowel disease: a practical decalogue for the post-pandemic phase

Basal and LPS-stimulated inflammatory markers and the course of individual symptoms of depression

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