Association of high-sensitivity C-reactive protein with de novo major depression

Pasco, Julie A., Nicholson, Geoffrey C., Williams, Lana J., Jacka, Felice N., Henry, Margaret J., Kotowicz, Mark A., Schneider, Hans G., Leonard, Brian E. and Berk, Michael 2010, Association of high-sensitivity C-reactive protein with de novo major depression, British journal of psychiatry, vol. 197, no. 5, pp. 372-377, doi: 10.1192/bjp.bp.109.076430.

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Title Association of high-sensitivity C-reactive protein with de novo major depression
Author(s) Pasco, Julie A.ORCID iD for Pasco, Julie A.
Nicholson, Geoffrey C.
Williams, Lana J.ORCID iD for Williams, Lana J.
Jacka, Felice N.ORCID iD for Jacka, Felice N.
Henry, Margaret J.
Kotowicz, Mark A.ORCID iD for Kotowicz, Mark A.
Schneider, Hans G.
Leonard, Brian E.
Berk, MichaelORCID iD for Berk, Michael
Journal name British journal of psychiatry
Volume number 197
Issue number 5
Start page 372
End page 377
Total pages 6
Publisher Royal College of Psychiatrists
Place of publication London, England
Publication date 2010-11
ISSN 0007-1250
Keyword(s) depression
Summary Background: Although there is cross-sectional evidence that changes in the immune system contribute to the pathophysiology of depression, longitudinal data capable of elucidating cause and effect relationships are lacking.

Aims: We aimed to determine whether subclinical systemic inflammation, as measured by serum high-sensitivity C-reactive protein (hsCRP) concentration, is associated with an increased risk of de novo major depressive disorder.

Method: Major depressive disorder was diagnosed using a clinical interview (SCID-I/NP). This is a retrospective cohort study; from a population-based sample of 1494 randomly selected women recruited at baseline during the period 1994-7, 822 were followed for a decade and provided measures of both exposure and outcome. Of these women, 644 (aged 20-84 years) had no prior history of depression at baseline and were eligible for analysis.

Results: During 5827 person-years of follow-up, 48 cases of de novo major depressive disorder were identified. The hazard ratio (HR) for depression increased by 44% for each standard deviation increase in log-transformed hsCRP (ln-hsCRP) (HR = 1.44, 95% CI 1.04-1.99), after adjusting for weight, smoking and use of non-steroidal anti-inflammatory drugs. Further adjustment for other lifestyle factors, medications and comorbidity failed to explain the observed increased risk for depression.

Conclusions: Serum hsCRP is an independent risk marker for de novo major depressive disorder in women. This supports an aetiological role for inflammatory activity in the pathophysiology of depression.
Notes This is an author-produced electronic version of an article accepted for publication in the British Journal of Psychiatry. The definitive publisher-authenticated version is available online at
Language eng
DOI 10.1192/bjp.bp.109.076430
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Related work DU:30042980
Copyright notice ©2010, Royal College of Psychiatrists
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