Depression and Routine Biochemical Markers: A Cross Sectional Study
Background: Today, globally up to 6–12% of the adult population suffered mental disorder and recurrent depression. The prevalence of depression in India was reported as 4.5% by WHO. Currently the diagnosis of major depression is carried out through symptom-based assessment process, which has limitation of the development of personalised treatment plans. Objective: To determine the association between various biochemical markers of the inflammation, lipid profile, BMI, thyroid profile and depression among the patients attending department of psychiatry in a tertiary care centre. Methods: A cross-sectional study conducted among 50 patients attending the psychiatry department at S.N. Medical college, Agra and diagnosed as Depression disorder, during April 2012 to December 2012. Hamilton rating scale (HAM-D) was used to assess the severity of depression. The patients were also assessed for their vitals, lipid profile, thyroid profile, ESR, CRP and BMI. Results: 19 (38%) study subjects were in the age group of 18yrs to 30 yrs with mean age as 34.2 ±14.57 years. 36(72%) were of normal weight or under-weight and14 (28%) were pre-obese. Among 14 pre-obese and obese study subjects, 2(15.4%) had mild, 4(18.2%) had moderate and 8(53.3%) had severe type of depression(p=0.03). ESR is more in severe depression as compared to mild and moderate depression. (p=<0.001%). C-reactive protein is statistically more in severe depression (T =2.25; P= < 0.001). Conclusions: There is a positive and significant relationship between the severity of depression and ESR, CRP and BMI among the patients attending department of psychiatry.
2. Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-V). American Psychiatric Association.
3. Hilsenroth M. J, Baity M. W, Mooney, M. A, Meyer, G. J. DSM-IV Major Depressive Episode criteria: Anevaluation of reliability and validity across three different rating methods. Int J Psychiatr Clin Pract. 2004;8(1):3-10.
4. Stein D. J, Phillips K. A, Bolton D, Fulford K. W, Sadler J. Z, Kendler K. S. What is a mental/psychiatricdisorder? From DSM-IV to DSM-V. Psychol Med 2010;40(11):1759-65.
5. Phillips J, Frances A, Cerullo M. A, Chardavoyne J, Decker H. S, First M. B, Ghaemi N, Greenberg G, Hinderliter A. C, Kinghorn W. A, LoBello S. G, Martin E. B, Mishara A. L, Paris J, Pierre J. M, Pies R. W, Pincus H. A, Porter D, Pouncey C, Schwartz M. A, Szasz T, Wakefield J. C, Waterman G. S, Whooley O, ZacharP. The six most essential questions in psychiatric diagnosis: a pluralogue part 1:conceptual and definitional issues in psychiatric diagnosis. Philos Ethics Humanit Med 2012;7:3.
6. Biomarkers Definitions Working Group. Biomarkers and surrogate endpoints: preferred definitions andconceptual framework. Clin Pharmacol Ther 2001;69(3):89-95.
7. Boksa, P. A way forward for research on biomarkers for psychiatric disorders. J Psychiatry Neurosci. 2013;38(2):75- 7.
8. Kluge W, Alsaif M, Guest P. C, Schwarz E, Bahn S. Translating potential biomarker candidates forschizophrenia and depression to animal models of psychiatric disorders. Expert Rev Mol Diagn. 2011;11(7):721-33.
9. Schmidt H. D, Shelton R. C, Duman R. S. Functional biomarkers of depression: diagnosis, treatment, andpathophysiology. 2011;36(12):2375-2394.
10. Hamilton M. A rating scale for depression. J. Neurol. Neurosurg,Psychiat.1960; 23 : 56.
11. Howren M. B, Lamkin D. M, Suls. J. Associations of depression with C-reactive protein, IL-1, and IL-6: a metaanalysis. Psychosom Med. 2009;71(2):171-86.
12. Valkanova V, Ebmeier K. P, Allan C. L. CRP, IL-6 and depression: A systematic review and meta-analysis oflongitudinal studies. J Affect Disord. 2013;4(3): 212-216
13. Danner M, Kasl SV, Abramson JL, Vaccarino V.Psychosom Med. 2003;65(3):347-56
14. Ford D. E, Erlinger T. P. Depression and C-reactive protein in US adults: data from the Third National Healthand Nutrition Examination Survey. Arch Intern Med 2004;164(9):1010-4.
15. Wium-Andersen M. K, Orsted D. D, Nielsen S. F, Nordestgaard B. G. Elevated C-Reactive Protein Levels,Psychological Distress, and Depression in 131 Individuals. JAMA Psychiatry 2013;70(2):176-84.
16. Roberts LM, Pattison H, Roalfe A, Franklyn J, Wilson S, Hobbs FD, Parle JV. Is subclinical thyroid dysfunction in the elderly associated with depression or cognitive dysfunction? Ann Intern Med. 2006;145(8):573-81.
17. Almeida OP, Alfonso H, Flicker L, Hankey G, Chubb SA, Yeap BB, Thyroid hormones and depression: the Health in Men study.Am J Geriatr Psychiatry. 2011;19(9):763-70.
18. Chavda N, Kantharia ND, Jaykaran . Effects of fluoxetine and escitalopram on C-reactive protein in patients of depression.J Pharmacol Pharmacother. 2011; 2(1): 11–16.
19. Morgan RE. Plasma cholesterol and depressive symptoms in older men. Lancet; 341(8837):75-9.
20. Brown SL. Low cholesterol concentrations and severe depressive symptoms in elderly people, BMJ; 21; 308 (6940):1328-32.
21. S.Markowitz, M. A. Friedman, S. M. Arent. “Understanding the relation between obesity and depression: causal mechanisms and implications for treatment,” Clinical Psychology:Science and Practice.2008; 15(1):1–20.
22. A. M. Keddie, “Associations between severe obesity and depression: results from the national health and nutrition examination survey, 2005-2006.” Preventing Chronic Disease.2011; 8(3): A57.
23. C. Dong, L. E. Sanchez, R. A. Price. “Relationship of obesity to depression: a family-based study.” International Journal ofObesity.2004; 28(6): 790–795.
24. F. S. Luppino, L. M. De Wit, P. F. Bouvy. “Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies.” Archives of General Psychiatry. 2010; 67(3):220–229.
25. De Wit L, Luppino, F. van Straten, A. Penninx, B. Zitman, F. Cuijpers, P. Depression and obesity: A meta -analysis of community based studies. Psychiatry Research. 2010; 178: 230 235.