Hostname: page-component-76fb5796d-2lccl Total loading time: 0 Render date: 2024-04-25T11:10:38.731Z Has data issue: false hasContentIssue false

Psychological distress and circulating inflammatory markers in healthy young adults

Published online by Cambridge University Press:  11 March 2010

S. Goldman-Mellor*
Affiliation:
Division of Epidemiology, School of Public Health, University of California–Berkeley, Berkeley, CA, USA
L. Brydon
Affiliation:
Department of Epidemiology and Public Health, University College London, London, UK
A. Steptoe
Affiliation:
Department of Epidemiology and Public Health, University College London, London, UK
*
*Address for correspondence: S. Goldman-Mellor, U.C. Berkeley School of Public Health, Division of Epidemiology, 101 Haviland Hall, Berkeley, CA94720-7358, USA. (Email: sidragoldman@berkeley.edu)

Abstract

Background

Although a substantial body of research points to a link between psychological distress and inflammatory responses in middle-aged and older adults, particularly those with cardiovascular disease, the relationship between inflammation and distress in young, healthy individuals has not been established. This study was designed to investigate the cross-sectional association between psychological distress and inflammatory proteins in a young, healthy representative population of English adults.

Method

Participants were 1338 individuals aged 16–34 years from the 2006 Health Survey for England (HSE). Blood samples to measure plasma fibrinogen and high sensitivity C-reactive protein (hsCRP), as well as measures of psychological distress (using the General Health Questionnaire 12-item scale, GHQ-12) and covariates, were collected during home visits. Linear regression was used to assess the relationship between psychological distress and fibrinogen and hsCRP.

Results

Higher self-rated distress was positively associated with fibrinogen level in this young population, independently of age, sex, ethnicity, body mass index (BMI), high density lipoprotein (HDL) cholesterol, smoking, and alcohol and medication use (β=0.024, p<0.01). Psychological distress was not related to hsCRP.

Conclusions

Psychological distress may negatively impact inflammatory processes in young adulthood before the onset of chronic health problems such as hypertension and cardiovascular disease. Longitudinal research is needed to elucidate the relationship between distress and inflammation in young adults and its significance for later disease states.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barth, J, Schumacher, M, Herrmann-Lingen, C (2004). Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis. Psychosomatic Medicine 66, 802813.CrossRefGoogle ScholarPubMed
Black, P, Garbutt, L (2002). Stress, inflammation and cardiovascular disease. Journal of Psychosomatic Research 52, 123.CrossRefGoogle ScholarPubMed
Carney, RM, Freedland, KE, Stein, PK, Miller, GE, Steinmeyer, B, Rich, MW, Duntley, SP (2007). Heart rate variability and markers of inflammation and coagulation in depressed patients with coronary heart disease. Journal of Psychosomatic Research 62, 463467.CrossRefGoogle Scholar
Castell, JV, Gómez-Lechón, MJ, David, M, Fabra, R, Trullenque, R, Heinrich, PC (1990). Acute-phase response of human hepatocytes: regulation of acute-phase protein synthesis by interleukin-6. Hepatology 12, 11791186.CrossRefGoogle ScholarPubMed
Cook, DG, Cappuccio, FP, Atkinson, RW, Wicks, PD, Chitolie, A, Nakandakare, ER, Sagnella, GA, Humphries, SE (2001). Ethnic differences in fibrinogen levels: the role of environmental factors and the β-fibrinogen gene. American Journal of Epidemiology 153, 799806.CrossRefGoogle ScholarPubMed
Craig, R, Mindell, J (ed.) (2007). Health Survey for England 2006. Volume 3: Methodology and Documentation. The Information Centre: Leeds, UK.Google Scholar
Danese, A, Moffitt, T, Pariante, C, Ambler, A, Poulton, R, Caspi, A (2008). Elevated inflammation levels in depressed adults with a history of childhood maltreatment. Archives of General Psychiatry 65, 409416.CrossRefGoogle ScholarPubMed
Danner, M, Kasl, S, Abramson, J, Vaccarino, V (2003). Association between depression and elevated C-reactive protein. Psychosomatic Medicine 65, 347356.CrossRefGoogle ScholarPubMed
Davidson, KW, Schwartz, JE, Kirkland, SA, Mostofsky, E, Fink, D, Guernsey, D, Shimbo, D (2009). Relation of inflammation to depression and incident coronary heart disease (from the Canadian Nova Scotia Health Survey (NSHS95) Prospective Population Study). American Journal of Cardiology 103, 755761.CrossRefGoogle Scholar
Department of Health (2004). Health Survey for England (HSE) 2003. Methodology and documentation report (www.archive2.officialdocuments.co.uk/document/deps/doh/survey03/md/md.htm). Accessed 15 June 2008.Google Scholar
Doulalas, A, Rallidis, L, Gialernios, T, Moschonas, DN, Kougioulis, MN, Rizos, I, Tselegaridis, TS, Kremastinos, DT (2006). Association of depressive symptoms with coagulation factors in young healthy individuals. Atherosclerosis 186, 121125.CrossRefGoogle ScholarPubMed
Elovainio, M, Keltikangas-Järvinen, L, Pulkki-Råback, L, Kivimäki, M, Puttonen, S, Viikari, L, Raitakari, O (2006). Depressive symptoms and C-reactive protein: the Cardiovascular Risk in Young Finns Study. Psychological Medicine 36, 797805.CrossRefGoogle ScholarPubMed
Fibrinogen Studies Collaboration (2005). Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis. Journal of the American Medical Association 294, 17991809.Google Scholar
Fibrinogen Studies Collaboration (2007). Associations of plasma fibrinogen levels with established cardiovascular disease risk factors, inflammatory markers, and other characteristics: individual participant meta-analysis of 154,211 adults in 31 prospective studies. American Journal of Epidemiology 166, 867879.CrossRefGoogle Scholar
Ford, D, Erlinger, T (2004). Depression and C-reactive protein in US adults: data from the Third National Health and Nutrition Examination Survey. Archives of Internal Medicine 164, 10101014.CrossRefGoogle ScholarPubMed
Furukawa, TA, Kessler, RC, Slade, T, Andrews, G (2003). The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well-Being. Psychological Medicine 33, 357362.CrossRefGoogle ScholarPubMed
Gimeno, D, Kivimäki, M, Brunner, EJ, Elovainio, M, De Vogli, R, Steptoe, A, Kumari, M, Lowe, GD, Rumley, A, Marmot, MG, Ferrie, JE (2008). Associations of C-reactive protein and interleukin-6 with cognitive symptoms of depression: 12-year follow-up of the Whitehall II study. Psychological Medicine 4, 111.Google Scholar
Goldberg, D, Williams, P (1988). A User's Guide to the GHQ. NFER-Nelson: Windsor, UK.Google Scholar
Goldberg, DP, Gater, R, Sartorius, N, Ustun, TB, Piccinelli, M, Gureje, O, Rutter, C (1997). The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological Medicine 27, 191197.CrossRefGoogle ScholarPubMed
Gorman, JM, Sloan, RP (2000). Heart rate variability in depressive and anxiety disorders. American Heart Journal 140, 7783.CrossRefGoogle ScholarPubMed
Grano, N, Keltikangas-Jarvinen, L, Kouvonen, A, Virtanen, M, Elovainio, M, Vahtera, J, Kivimaki, M (2007). Impulsivity as a predictor of newly diagnosed depression. Scandinavian Journal of Psychology 48, 173179.CrossRefGoogle ScholarPubMed
Hayley, S, Poulter, MO, Merali, Z, Anisman, H (2005). The pathogenesis of clinical depression: stressor- and cytokine-induced alterations of neuroplasticity. Neuroscience 135, 659678.CrossRefGoogle ScholarPubMed
Hirokawa, K, Tsutsumi, A, Kayaba, K (2008). Psychosocial job characteristics and plasma fibrinogen in Japanese male and female workers: the Jichi Medical School cohort study. Atherosclerosis 198, 468476.CrossRefGoogle ScholarPubMed
Howren, MB, Lamkin, DM, Suls, J (2009). Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosomatic Medicine 71, 171186.CrossRefGoogle ScholarPubMed
Irwin, M, Miller, A (2007). Depressive disorders and immunity: 20 years of progress and discovery. Brain Behavior and Immunity 21, 374383.CrossRefGoogle ScholarPubMed
Koenig, W (2003). Fibrin(ogen) in cardiovascular disease: an update. Journal of Thrombosis and Haemostasis 89, 601609.Google ScholarPubMed
Kubzansky, LD, Cole, SR, Kawachi, I, Vokonas, P, Sparrow, D (2006). Shared and unique contributions of anger, anxiety, and depression to coronary heart disease: a prospective study in the Normative Aging Study. Annals of Behavioral Medicine 31, 2129.CrossRefGoogle ScholarPubMed
Kudielka, BM, Bellingrath, S, von Känel, R (2008). Circulating fibrinogen but not d-dimer level is associated with vital exhaustion in school teachers. Stress 11, 250258.CrossRefGoogle Scholar
Liukkonen, T, Silvennoinen-Kassinen, S, Jokelainen, J, Räsänen, JP, Leinonen, M, Meyer-Rochow, VB, Timonen, M (2006). The association between C-reactive protein levels and depression: results from the northern Finland 1966 birth cohort study. Biological Psychiatry 60, 825830.CrossRefGoogle ScholarPubMed
Matthews, KA, Schott, LL, Bromberger, J, Cyranowski, J, Everson-Rose, SA, Sowers, MF (2007). Associations between depressive symptoms and inflammatory/hemostatic markers in women during the menopausal transition. Psychosomatic Medicine 69, 124130.CrossRefGoogle ScholarPubMed
Miller, GE, Stetler, CA, Carney, RM, Freedland, KE, Banks, WA (2002). Clinical depression and inflammatory risk markers for coronary heart disease. American Journal of Cardiology 90, 12791283.CrossRefGoogle ScholarPubMed
Nabi, H, Singh-Manoux, A, Shipley, M, Gimeno, D, Marmot, MG, Kivimaki, M (2008). Do psychological factors affect inflammation and incident coronary heart disease: the Whitehall II Study. Arteriosclerosis, Thrombosis, and Vascular Biology 28, 13981406.CrossRefGoogle ScholarPubMed
Nazmi, A, Oliveira, IO, Victora, CG (2008). Correlates of C-reactive protein levels in young adults: a population-based cohort study of 3827 subjects in Brazil. Brazilian Journal of Medical and Biological Research 41, 357367.CrossRefGoogle ScholarPubMed
O'Loughlin, J, Lambert, M, Karp, I, McGrath, J, Gray-Donald, K, Barnett, TA, Delvin, EE, Levy, E, Paradis, G (2008). Association between cigarette smoking and C-reactive protein in a representative, population-based sample of adolescents. Nicotine and Tobacco Research 10, 525532.CrossRefGoogle Scholar
Pan, A, Ye, X, Franco, OH, Li, H, Yu, Z, Wang, J, Qi, Q, Gu, W, Pang, X, Liu, H, Lin, X (2008). The association of depressive symptoms with inflammatory factors and adipokines in middle-aged and older Chinese. PLoS ONE 3, e1392.CrossRefGoogle ScholarPubMed
Panagiotakos, DB, Pitsavos, C, Chrysohoou, C, Tsetsekou, E, Papageorgiou, C, Christodoulou, G, Stefanadis, C; ATTICA study (2004). Inflammation, coagulation, and depressive symptomatology in cardiovascular disease-free people; the ATTICA study. European Heart Journal 25, 492499.CrossRefGoogle ScholarPubMed
Pitsavos, C, Panagiotakos, DB, Papageorgiou, C, Tsetsekou, E, Soldatos, C, Stefanadis, C (2006). Anxiety in relation to inflammation and coagulation markers, among healthy adults: The ATTICA Study. Atherosclerosis 185, 320326.CrossRefGoogle ScholarPubMed
Raison, CL, Capuron, L, Miller, AH (2006). Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends in Immunology 27, 2431.CrossRefGoogle ScholarPubMed
Ranjit, N, Diez-Roux, AV, Shea, S, Cushman, M, Seeman, T, Jackson, SA, Ni, H (2007). Psychosocial factors and inflammation in the multi-ethnic study of atherosclerosis. Archives of Internal Medicine 167, 174181.CrossRefGoogle ScholarPubMed
Rugulies, R (2002). Depression as a predictor for coronary heart disease: a review and meta-analysis. American Journal of Preventive Medicine 23, 5161.CrossRefGoogle ScholarPubMed
Schroeder, V, Borner, U, Gutknecht, S, Schmid, JP, Saner, H, Kohler, HP (2007). Relation of depression to various markers of coagulation and fibrinolysis in patients with and without coronary artery disease. European Journal of Cardiovascular Prevention and Rehabilitation 14, 782787.CrossRefGoogle ScholarPubMed
Steptoe, A (2006). Depression and the development of coronary heart disease. In Depression and Physical Illness (ed. Steptoe, A.), pp. 5386. Cambridge University Press: Cambridge.CrossRefGoogle Scholar
Steptoe, A, Brydon, L (2007). Psychosocial factors and coronary heart disease: the role of psychoneuroimmunological processes. In Psychoneuroimmunology, 4th edn (ed. Ader, R.), pp. 945974. Elsevier: San Diego.CrossRefGoogle Scholar
Steptoe, A, Kunz-Ebrecht, SR, Owen, N (2003). Lack of association between depressive symptoms and markers of immune and vascular inflammation in middle-aged men and women. Psychological Medicine 33, 667674.CrossRefGoogle ScholarPubMed
Suarez, EC (2004). C-reactive protein is associated with psychological risk factors of cardiovascular disease in apparently healthy adults. Psychosomatic Medicine 66, 684691.CrossRefGoogle ScholarPubMed
Tracy, RP, Psaty, BM, Macy, E, Bovill, EG, Cushman, M, Cornell, ES, Kuller, LH (1997). Lifetime smoking exposure affects the association of C-reactive protein with cardiovascular disease risk factors and subclinical disease in healthy elderly subjects. Arteriosclerosis, Thrombosis, and Vascular Biology 17, 21672176.CrossRefGoogle ScholarPubMed
von Känel, R, Hepp, U, Buddeberg, C, Keel, M, Mica, L, Aschbacher, K, Schnyder, U (2006). Altered blood coagulation in patients with posttraumatic stress disorder. Psychosomatic Medicine 68, 598604.CrossRefGoogle ScholarPubMed
von Känel, R, Mausbach, BT, Kudielka, BM, Orth-Gomér, K (2008). Relation of morning serum cortisol to prothrombotic activity in women with stable coronary artery disease. Journal of Thrombosis and Thrombolysis 25, 165172.CrossRefGoogle ScholarPubMed
von Känel, R, Mills, PJ, Fainman, C, Dimsdale, JE (2001). Effects of psychological stress and psychiatric disorders on blood coagulation and fibrinolysis: a biobehavioral pathway to coronary artery disease? Psychosomatic Medicine 63, 531544.CrossRefGoogle ScholarPubMed
Whooley, M, Caska, C, Hendrickson, B, Rourke, M, Ho, J, Ali, S (2007). Depression and inflammation in patients with coronary heart disease: findings from the Heart and Soul Study. Biological Psychiatry 62, 314320.CrossRefGoogle ScholarPubMed