The bidirectional relationship between anxiety disorders and circulating levels of inflammatory markers: Results from a large longitudinal population-based study
Corresponding Author
Jennifer Glaus PhD
Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Switzerland
Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
Correspondence
Jennifer Glaus, Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Covent Drive, MSC 3720, Bldg 35A, Room 2E422A, Bethesda, MD 20892.
Email: [email protected]
Search for more papers by this authorRoland von Känel MD
Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland
Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland
Search for more papers by this authorAurélie M. Lasserre MD, PhD
Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Switzerland
Search for more papers by this authorMarie-Pierre F. Strippoli MSc
Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Switzerland
Search for more papers by this authorCaroline L. Vandeleur PhD
Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Switzerland
Search for more papers by this authorEnrique Castelao MSc
Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Switzerland
Search for more papers by this authorMehdi Gholam-Rezaee PhD
Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Switzerland
Search for more papers by this authorCiro Marangoni MD
Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
Search for more papers by this authorEn-Young N Wagner MD, PhD
Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland
Search for more papers by this authorPedro Marques-Vidal MD, PhD
Department of Internal Medicine, Lausanne University Hospital, Switzerland
Search for more papers by this authorGérard Waeber MD
Department of Internal Medicine, Lausanne University Hospital, Switzerland
Search for more papers by this authorPeter Vollenweider MD
Department of Internal Medicine, Lausanne University Hospital, Switzerland
Search for more papers by this authorMartin Preisig MD, MPH
Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Switzerland
Search for more papers by this authorKathleen R Merikangas PhD
Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
Search for more papers by this authorCorresponding Author
Jennifer Glaus PhD
Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Switzerland
Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
Correspondence
Jennifer Glaus, Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Covent Drive, MSC 3720, Bldg 35A, Room 2E422A, Bethesda, MD 20892.
Email: [email protected]
Search for more papers by this authorRoland von Känel MD
Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland
Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland
Search for more papers by this authorAurélie M. Lasserre MD, PhD
Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Switzerland
Search for more papers by this authorMarie-Pierre F. Strippoli MSc
Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Switzerland
Search for more papers by this authorCaroline L. Vandeleur PhD
Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Switzerland
Search for more papers by this authorEnrique Castelao MSc
Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Switzerland
Search for more papers by this authorMehdi Gholam-Rezaee PhD
Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Switzerland
Search for more papers by this authorCiro Marangoni MD
Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
Search for more papers by this authorEn-Young N Wagner MD, PhD
Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland
Search for more papers by this authorPedro Marques-Vidal MD, PhD
Department of Internal Medicine, Lausanne University Hospital, Switzerland
Search for more papers by this authorGérard Waeber MD
Department of Internal Medicine, Lausanne University Hospital, Switzerland
Search for more papers by this authorPeter Vollenweider MD
Department of Internal Medicine, Lausanne University Hospital, Switzerland
Search for more papers by this authorMartin Preisig MD, MPH
Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Switzerland
Search for more papers by this authorKathleen R Merikangas PhD
Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
Search for more papers by this authorAbstract
Background
Although there has been abundant research on chronic low-grade inflammation as a potential mechanism underlying the link between mood disorders and cardiovascular risk, less is known about the role of inflammatory factors and anxiety disorders. The aim of this paper is to evaluate the bi-directional associations between inflammatory markers including interleukin (IL)-6, tumor necrosis factor (TNF)-α, and high sensitivity C-reactive protein (hsCRP) with anxiety disorders and its subgroups.
Methods
The sample consisted of 3,113 participants (53.7% women; mean age: 51.0, S.D. 8.8 years), randomly selected from the general population, who underwent comprehensive somatic and psychiatric evaluations at baseline and follow-up (mean follow-up duration = 5.5 years, S.D. 0.6). Anxiety disorders were assessed with semistructured diagnostic interviews. Inflammatory biomarkers were analyzed in fasting blood samples.
Results
After adjustment for potential confounders, current anxiety disorders (β = 0.09, 95% CI 0.00–0.17) and agoraphobia (β = 0.25, 95% CI: 0.07–0.43) at baseline were associated with a steeper increase of hsCRP levels over the follow-up period. Current posttraumatic stress disorder (PTSD) was associated with a lower increase of IL-6 levels over the follow-up period (β = −0.52, 95% CI: −1.00/−0.04). There was no evidence for an association between inflammation markers at baseline and anxiety disorders at follow-up.
Conclusions
The prospective association between agoraphobia at baseline and hsCRP levels over the follow-up period suggests that chronic low-grade inflammation may be a consequence of this condition. The decrease in IL-6 in PTSD also requires further investigation. No evidence was found for chronic low-grade inflammation as a predictor of future anxiety disorders.
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