Differential association of somatic and cognitive symptoms of depression and anxiety with inflammation

Findings from the Netherlands Study of Depression and Anxiety (NESDA)

H.E. Duivis, N. Vogelzangs, N. Kupper, P. de Jonge, B.W.J.H. Penninx

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective
Depression and anxiety have been suggested to be associated with systemic inflammation upregulation. However, results are not always consistent, which may be due to symptom heterogeneity of depression and anxiety. There are some indications that associations with inflammation are mainly driven by somatic symptoms of depression and anxiety. We therefore set out to evaluate the differential association of somatic and cognitive symptoms of depression and anxiety with inflammation, while adjusting for demographic, health related, and lifestyle related variables.
Methods
We evaluated baseline data from 2861 participants from the Netherlands Study of Depression and Anxiety (NESDA). The Inventory of Depressive Symptomatology and the Beck Anxiety Inventory were used to assess depressive symptoms and anxiety symptoms. For both scales somatic and cognitive symptoms scales were calculated. Baseline blood samples were collected to determine high sensitivity C-Reactive Protein (CRP), interleukin (IL)-6, and Tumor Necrosis Factor (TNF)-α. We used linear regression to analyze the associations adjusting for demographics and health indicators and markers for an unhealthy lifestyle.
Results
After adjustment for sociodemographic and health indicators, depressive symptoms were associated with higher levels of CRP, IL-6 and TNF-α. This association was mainly driven by somatic symptoms. For anxiety, somatic symptoms were associated with higher levels of CRP, IL-6 and TNF-α, whereas cognitive anxiety symptoms were associated with CRP (men only). Markers of an unhealthy lifestyle explained the significant associations.
Conclusions
Especially somatic symptoms of depression and anxiety are associated with inflammation. However, this association was mostly mediated through unhealthy lifestyles among depressed and anxious individuals.
Keywords: Depressive symptoms, Anxiety symptoms, Somatic, Cognitive, Inflammation, hsCRP, IL-6, TNF-α, Cohort study
Original languageEnglish
Pages (from-to)1573-1585
JournalPsychoneuroendocrinology
Volume38
Issue number9
DOIs
Publication statusPublished - 2013

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Netherlands
Depression
Interleukin-6
Tumor Necrosis Factor-alpha
Medically Unexplained Symptoms
Equipment and Supplies
Linear Models
Up-Regulation

Cite this

@article{aa6817ee8f74460d84e7b6e90fc4c0e6,
title = "Differential association of somatic and cognitive symptoms of depression and anxiety with inflammation: Findings from the Netherlands Study of Depression and Anxiety (NESDA)",
abstract = "ObjectiveDepression and anxiety have been suggested to be associated with systemic inflammation upregulation. However, results are not always consistent, which may be due to symptom heterogeneity of depression and anxiety. There are some indications that associations with inflammation are mainly driven by somatic symptoms of depression and anxiety. We therefore set out to evaluate the differential association of somatic and cognitive symptoms of depression and anxiety with inflammation, while adjusting for demographic, health related, and lifestyle related variables.MethodsWe evaluated baseline data from 2861 participants from the Netherlands Study of Depression and Anxiety (NESDA). The Inventory of Depressive Symptomatology and the Beck Anxiety Inventory were used to assess depressive symptoms and anxiety symptoms. For both scales somatic and cognitive symptoms scales were calculated. Baseline blood samples were collected to determine high sensitivity C-Reactive Protein (CRP), interleukin (IL)-6, and Tumor Necrosis Factor (TNF)-α. We used linear regression to analyze the associations adjusting for demographics and health indicators and markers for an unhealthy lifestyle.ResultsAfter adjustment for sociodemographic and health indicators, depressive symptoms were associated with higher levels of CRP, IL-6 and TNF-α. This association was mainly driven by somatic symptoms. For anxiety, somatic symptoms were associated with higher levels of CRP, IL-6 and TNF-α, whereas cognitive anxiety symptoms were associated with CRP (men only). Markers of an unhealthy lifestyle explained the significant associations.ConclusionsEspecially somatic symptoms of depression and anxiety are associated with inflammation. However, this association was mostly mediated through unhealthy lifestyles among depressed and anxious individuals.Keywords: Depressive symptoms, Anxiety symptoms, Somatic, Cognitive, Inflammation, hsCRP, IL-6, TNF-α, Cohort study",
author = "H.E. Duivis and N. Vogelzangs and N. Kupper and {de Jonge}, P. and B.W.J.H. Penninx",
year = "2013",
doi = "10.1016/j.psyneuen.2013.01.002",
language = "English",
volume = "38",
pages = "1573--1585",
journal = "Psychoneuroendocrinology",
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number = "9",

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Differential association of somatic and cognitive symptoms of depression and anxiety with inflammation : Findings from the Netherlands Study of Depression and Anxiety (NESDA). / Duivis, H.E.; Vogelzangs, N.; Kupper, N.; de Jonge, P.; Penninx, B.W.J.H.

In: Psychoneuroendocrinology, Vol. 38, No. 9, 2013, p. 1573-1585.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Differential association of somatic and cognitive symptoms of depression and anxiety with inflammation

T2 - Findings from the Netherlands Study of Depression and Anxiety (NESDA)

AU - Duivis, H.E.

AU - Vogelzangs, N.

AU - Kupper, N.

AU - de Jonge, P.

AU - Penninx, B.W.J.H.

PY - 2013

Y1 - 2013

N2 - ObjectiveDepression and anxiety have been suggested to be associated with systemic inflammation upregulation. However, results are not always consistent, which may be due to symptom heterogeneity of depression and anxiety. There are some indications that associations with inflammation are mainly driven by somatic symptoms of depression and anxiety. We therefore set out to evaluate the differential association of somatic and cognitive symptoms of depression and anxiety with inflammation, while adjusting for demographic, health related, and lifestyle related variables.MethodsWe evaluated baseline data from 2861 participants from the Netherlands Study of Depression and Anxiety (NESDA). The Inventory of Depressive Symptomatology and the Beck Anxiety Inventory were used to assess depressive symptoms and anxiety symptoms. For both scales somatic and cognitive symptoms scales were calculated. Baseline blood samples were collected to determine high sensitivity C-Reactive Protein (CRP), interleukin (IL)-6, and Tumor Necrosis Factor (TNF)-α. We used linear regression to analyze the associations adjusting for demographics and health indicators and markers for an unhealthy lifestyle.ResultsAfter adjustment for sociodemographic and health indicators, depressive symptoms were associated with higher levels of CRP, IL-6 and TNF-α. This association was mainly driven by somatic symptoms. For anxiety, somatic symptoms were associated with higher levels of CRP, IL-6 and TNF-α, whereas cognitive anxiety symptoms were associated with CRP (men only). Markers of an unhealthy lifestyle explained the significant associations.ConclusionsEspecially somatic symptoms of depression and anxiety are associated with inflammation. However, this association was mostly mediated through unhealthy lifestyles among depressed and anxious individuals.Keywords: Depressive symptoms, Anxiety symptoms, Somatic, Cognitive, Inflammation, hsCRP, IL-6, TNF-α, Cohort study

AB - ObjectiveDepression and anxiety have been suggested to be associated with systemic inflammation upregulation. However, results are not always consistent, which may be due to symptom heterogeneity of depression and anxiety. There are some indications that associations with inflammation are mainly driven by somatic symptoms of depression and anxiety. We therefore set out to evaluate the differential association of somatic and cognitive symptoms of depression and anxiety with inflammation, while adjusting for demographic, health related, and lifestyle related variables.MethodsWe evaluated baseline data from 2861 participants from the Netherlands Study of Depression and Anxiety (NESDA). The Inventory of Depressive Symptomatology and the Beck Anxiety Inventory were used to assess depressive symptoms and anxiety symptoms. For both scales somatic and cognitive symptoms scales were calculated. Baseline blood samples were collected to determine high sensitivity C-Reactive Protein (CRP), interleukin (IL)-6, and Tumor Necrosis Factor (TNF)-α. We used linear regression to analyze the associations adjusting for demographics and health indicators and markers for an unhealthy lifestyle.ResultsAfter adjustment for sociodemographic and health indicators, depressive symptoms were associated with higher levels of CRP, IL-6 and TNF-α. This association was mainly driven by somatic symptoms. For anxiety, somatic symptoms were associated with higher levels of CRP, IL-6 and TNF-α, whereas cognitive anxiety symptoms were associated with CRP (men only). Markers of an unhealthy lifestyle explained the significant associations.ConclusionsEspecially somatic symptoms of depression and anxiety are associated with inflammation. However, this association was mostly mediated through unhealthy lifestyles among depressed and anxious individuals.Keywords: Depressive symptoms, Anxiety symptoms, Somatic, Cognitive, Inflammation, hsCRP, IL-6, TNF-α, Cohort study

U2 - 10.1016/j.psyneuen.2013.01.002

DO - 10.1016/j.psyneuen.2013.01.002

M3 - Article

VL - 38

SP - 1573

EP - 1585

JO - Psychoneuroendocrinology

JF - Psychoneuroendocrinology

SN - 0306-4530

IS - 9

ER -