Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2024; 12(19): 3824-3836
Published online Jul 6, 2024. doi: 10.12998/wjcc.v12.i19.3824
Better understanding of c-reactive protein and leukocytes in psychiatric inpatients with affective disorders: A biopsychosocial approach
Felix Kölblinger, Elena MD Schönthaler, Andreas Baranyi, Tatjana Stross, Frederike T Fellendorf, Dirk von Lewinski, Robert Queissner, Eva Z Reininghaus, Nina Dalkner
Felix Kölblinger, Elena MD Schönthaler, Andreas Baranyi, Tatjana Stross, Frederike T Fellendorf, Robert Queissner, Eva Z Reininghaus, Nina Dalkner, Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
Dirk von Lewinski, Clinical Department of Cardiology, Medical University of Graz, Graz 8036, Austria
Author contributions: Kölblinger F was responsible for conceptualization, formal analysis, investigation, data curation, writing-original draft, writing-review and editing; Schönthaler E was responsible for conceptualization, methodology, software, validation, formal analysis, investigation, data curation, writing-original draft, writing-review, editing, visualization, supervision and project administration; Baranyi A was responsible for conceptualization, methodology, writing-review and editing; Stross T was responsible for software, formal analysis, data curation, writing-review and editing; Fellendorf F was responsible for writing-review and editing; von Lewinski D was responsible for conceptualization, methodology, writing-review and editing; Queissner R was responsible for methodology, writing-review and editing; Reininghaus E was responsible for resources, writing-review and editing; Dalkner N was responsible for conceptualization, methodology, validation, investigation, resources, writing-original draft, writing-review, editing, supervision, and project administration.
Institutional review board statement: This study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the Medical University of Graz (EK-number: 33-632 ex 20/21).
Informed consent statement: Informed consent was obtained from all participants prior to study inclusion.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: Data and analysis scripts can be accessed viahttps://doi.org/10.17605/OSF.IO/WGRXD.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Elena MD Schönthaler, MSc, Doctor, Researcher, Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, Graz 8036, Austria. elena.schoenthaler@medunigraz.at
Received: February 27, 2024
Revised: May 7, 2024
Accepted: May 27, 2024
Published online: July 6, 2024
Processing time: 122 Days and 20.2 Hours
Abstract
BACKGROUND

Affective disorders (AD) have been linked to inflammatory processes, although the underlying mechanisms of this relationship are still not fully elucidated. It is hypothesized that demographic, somatic, lifestyle, and personality variables predict inflammatory parameters in AD.

AIM

To identify biopsychosocial factors contributing to inflammation in AD measured with two parameters, C-reactive protein (CRP) and leukocytes.

METHODS

This observational study investigated 186 hospital inpatients diagnosed with AD using demographic parameters, serum inflammatory markers, somatic variables, psychological questionnaires, and lifestyle parameters. Hierarchical regression analyses were used to predict inflammatory markers from demographic, somatic, lifestyle, and personality variables.

RESULTS

Analyses showed that 33.8% of the variance of CRP was explained by body mass index and other somatic medication (e.g. anti-diabetics), age and education, and age of affective disorder diagnosis. For leukocytes, 20.1% of the variance was explained by smoking, diet, metabolic syndrome (MetS), and anti-inflammatory medication (e.g. non-steroidal anti-inflammatory drugs). Other psychiatric or behavioural variables did not reach significance.

CONCLUSION

Metabolic components seem important, with mounting evidence for a metabolic affective disorder subtype. Lifestyle modifications and psychoeducation should be employed to prevent or treat MetS in AD.

Keywords: Affective disorders; C-reactive protein; Leukocytes; Metabolic syndrome; Health behaviour; Personality

Core Tip: Somatic and psychological variables may affect inflammation in affective disorders (AD). In 186 inpatients with AD, C-reactive protein (CRP) and leukocytes were measured. CRP relates to somatic variables (e.g., body mass index), age, education, and age of diagnosis. Leukocytes relate to smoking, diet, and somatic variables (e.g., metabolic syndrome). Lifestyle modifications and psychoeducation on MetS is needed in individuals with AD to prevent symptom deterioration.