Assessing the links between childhood trauma, C-reactive protein and response to antidepressant treatment in patients with affective disorders

Eur Arch Psychiatry Clin Neurosci. 2021 Oct;271(7):1331-1341. doi: 10.1007/s00406-021-01245-z. Epub 2021 Mar 17.

Abstract

Adverse Childhood Experiences (ACE) are a well-known risk-factor for depression. Additionally, (high-sensitive) C-reactive Protein (hsCRP) is elevated in subgroups of depressed patients and high following ACE. In this context the literature considers hsCRP and ACE to be associated with treatment resistant depression. With the data being heterogenous, this study aimed to explore the associations of ACE, hsCRP levels and response to antidepressant treatment in uni- and bipolar depression. N = 76 patients diagnosed with uni- or bipolar depression and N = 53 healthy controls were included. Treatment was over 6 weeks in an inpatient psychiatric setting within an observatory study design. Depressive symptoms were assessed by the Montgomery-Asberg Depression Rating Scale (MADRS), ACE were assessed by the Childhood Trauma Questionnaire (CTQ); the body-mass-index (BMI) and hsCRP were measured. HsCRP levels did not differ between the study population and the healthy controls. While the depressive symptoms decreased, the hsCRP levels increased. Sexual abuse was associated with significant higher and emotional abuse with lower levels of hsCRP after 6 weeks. The baseline hsCRP levels and the ACE subgroups did not show significant associations with the treatment response in unipolar depressed patients. The long-lasting effects of specific forms of ACE may have relevant impact on inflammation, supporting hsCRP to be a suitable biomarker. With ACE and hsCRP not showing any significant associations with treatment response in the unipolar depressed subgroup, a more differentiate research concerning biomarkers and treatment regimens is needed when talking about treatment response.

Keywords: CRP; Childhood trauma; Depressive disorder; Inflammation; Treatment resistance.

MeSH terms

  • Adverse Childhood Experiences*
  • Antidepressive Agents* / therapeutic use
  • Biomarkers / blood
  • Bipolar Disorder* / blood
  • Bipolar Disorder* / drug therapy
  • C-Reactive Protein* / analysis
  • Case-Control Studies
  • Depressive Disorder* / blood
  • Depressive Disorder* / drug therapy
  • Depressive Disorder, Treatment-Resistant
  • Humans
  • Treatment Outcome

Substances

  • Antidepressive Agents
  • Biomarkers
  • C-Reactive Protein