Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-21T04:00:43.545Z Has data issue: false hasContentIssue false
  • English
  • Français

Inflammation, cognitive dysfunction, and suicidal ideation among patients with major depression

Published online by Cambridge University Press:  23 August 2021

Mao-Hsuan Huang Open the ORCID record for Mao-Hsuan Huang [Opens in a new window] ,
Mu-Hong Chen Open the ORCID record for Mu-Hong Chen [Opens in a new window] ,
Ju-Wei Hsu ,
Kai-Lin Huang ,
Shih-Jen Tsai ,
Tung-Ping Su  and
Ya-Mei Bai
Mao-Hsuan Huang
Affiliation:
Department of Psychiatry, YuanShan and Suao Branches of Taipei Veterans General Hospital, Ilan, Taiwan Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
Mu-Hong Chen*
Affiliation:
Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
Ju-Wei Hsu
Affiliation:
Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
Kai-Lin Huang
Affiliation:
Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
Shih-Jen Tsai
Affiliation:
Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
Tung-Ping Su
Affiliation:
Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
Ya-Mei Bai*
Affiliation:
Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
*
* Authors for correspondence: Mu-Hong Chen, MD, PhD Email: kremer7119@gmail.com Ya-Mei Bai, MD, PhD Email: ymbi@mail2000.com.tw
* Authors for correspondence: Mu-Hong Chen, MD, PhD Email: kremer7119@gmail.com Ya-Mei Bai, MD, PhD Email: ymbi@mail2000.com.tw
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Dysregulated proinflammatory cytokines have been shown to be associated with suicidal behavior. Cognitive deficits in working memory and inhibitory control have been demonstrated in depressed patients and people with suicidal ideation (SI). However, the association between proinflammatory cytokines, SI, and cognitive deficits in patients with major depressive disorder (MDD) remains unclear.

Methods

A total of 77 patients with MDD and age-/sex-matched 60 healthy individuals were recruited. MDD patients were divided into two groups: with SI (n = 36) and no SI (n = 41). SI was defined by a score of ≥2 in item 3 of the 17-item Hamilton Rating Scale for Depression. Levels of proinflammatory cytokines, including soluble interleukin-6 receptor, soluble tumor necrosis factor-α receptor type 1, and C-reactive protein (CRP), were measured, and cognitive function was assessed using 2-back task and Go/No-Go task.

Results

Patients with SI had higher levels of CRP than those without SI and controls (P = .007). CRP was positively associated with SI (β = 0.21, P = .037), independent of cognitive function and depressive symptoms. Furthermore, SI was associated with cognitive deficits in working memory and inhibitory control after adjusting for confounding factors (P < .05).

Conclusion

Our findings suggest that higher levels of serum CRP and deficits in working memory and inhibitory control may be associated with higher SI among patients with MDD.

Keywords

C-reactive proteincytokinesmajor depressive disordersuicidesuicidal ideation
Type
Original Research
Information
CNS Spectrums , Volume 27 , Issue 6 , December 2022 , pp. 724 - 730
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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

1. Turecki, G, Brent, DA. Suicide and suicidal behaviour. Lancet. 2016;387(10024):1227–1239.CrossRefGoogle ScholarPubMed
2. Garcia de la Garza A, Blanco, C, Olfson, M, et al. Identification of suicide attempt risk factors in a national US survey using machine learning. JAMA Psychiatry. 2021;78(4):398–406.Google Scholar
3. Niculescu, AB, Le-Niculescu, H, Levey, DF, et al. Precision medicine for suicidality: from universality to subtypes and personalization. Mol Psychiatry. 2017;22(9):1250–1273.CrossRefGoogle ScholarPubMed
4. Serafini, G, Canepa, G, Adavastro, G, et al. The relationship between childhood maltreatment and non-suicidal self-injury: a systematic review. Front Psychiatry. 2017;8:149.CrossRefGoogle ScholarPubMed
5. Nock, MK, Hwang, I, Sampson, NA, et al. Mental disorders, comorbidity and suicidal behavior: results from the national comorbidity survey replication. Mol Psychiatry. 2010;15(8):868–876.CrossRefGoogle ScholarPubMed
6. Rock, PL, Roiser, JP, Riedel, WJ, et al. Cognitive impairment in depression: a systematic review and meta-analysis. Psychological Med. 2014;44(10):2029–2040.CrossRefGoogle ScholarPubMed
7. Keilp, JG, Gorlyn, M, Russell, M, et al. Neuropsychological function and suicidal behavior: attention control, memory and executive dysfunction in suicide attempt. Psychological Med. 2013;43(3):539–551.CrossRefGoogle ScholarPubMed
8. Marzuk, PM, Hartwell, N, Leon, AC, et al. Executive functioning in depressed patients with suicidal ideation. Acta Psychiatr Scand. 2005;112(4):294–301.CrossRefGoogle ScholarPubMed
9. Westheide, J, Quednow, BB, Kuhn, KU, et al. Executive performance of depressed suicide attempters: the role of suicidal ideation. European Arch Psychiatry Clin Neurosci. 2008;258(7):414–421.CrossRefGoogle ScholarPubMed
10. Richard-Devantoy, S, Gorwood, P, Annweiler, C, et al. Suicidal behaviours in affective disorders: a deficit of cognitive inhibition? Can J Psychiatry. 2012;57(4):254–262.CrossRefGoogle ScholarPubMed
11. Brundin, L, Bryleva, EY, Thirtamara Rajamani, K. Role of inflammation in suicide: from mechanisms to treatment. Neuropsychopharmacology. 2017;42(1):271–283.CrossRefGoogle Scholar
12. Courtet, P, Giner, L, Seneque, M, et al. Neuroinflammation in suicide: toward a comprehensive model. World J Biol Psychiatry. 2016;17(8):564–586.CrossRefGoogle ScholarPubMed
13. Dowlati, Y, Herrmann, N, Swardfager, W, et al. A meta-analysis of cytokines in major depression. Biological Psychiatry. 2010;67(5):446–457.CrossRefGoogle ScholarPubMed
14. Goldsmith, DR, Rapaport, MH, Miller, BJ. A meta-analysis of blood cytokine network alterations in psychiatric patients: comparisons between schizophrenia, bipolar disorder and depression. Mol Psychiatry. 2016;21(12):1696–1709.CrossRefGoogle ScholarPubMed
15. Howren, MB, Lamkin, DM, Suls, J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med. 2009;71(2):171–186.CrossRefGoogle ScholarPubMed
16. Scheller, J, Chalaris, A, Schmidt-Arras, D, et al. The pro- and anti-inflammatory properties of the cytokine interleukin-6. Biochim Biophys Acta. 2011;1813(5):878–888.CrossRefGoogle ScholarPubMed
17. Bai, YM, Su, TP, Li, CT, et al. Comparison of pro-inflammatory cytokines among patients with bipolar disorder and unipolar depression and normal controls. Bipolar Disord. 2015;17(3):269–277.CrossRefGoogle ScholarPubMed
18. Chen, G, Goeddel, DV. TNF-R1 signaling: a beautiful pathway. Science. 2002;296(5573):1634–1635.CrossRefGoogle ScholarPubMed
19. Huang, MH, Chen, MH, Tu, PC, et al. Elevated tumor necrosis factor-alpha receptor subtype 1 and the association with abnormal brain function in treatment-resistant depression. J Affect Disord. 2018;235:250–256.CrossRefGoogle ScholarPubMed
20. Ducasse, D, Olie, E, Guillaume, S, et al. A meta-analysis of cytokines in suicidal behavior. Brain Behav Immun. 2015;46:203–211.CrossRefGoogle ScholarPubMed
21. Black, C, Miller, BJ. Meta-analysis of cytokines and chemokines in suicidality: distinguishing suicidal versus nonsuicidal patients. Biological Psychiatry. 2015;78(1):28–37.CrossRefGoogle ScholarPubMed
22. Serafini, G, Parisi, VM, Aguglia, A, et al. A specific inflammatory profile underlying suicide risk? Systematic review of the main literature findings. Int J Environ Res Public Health. 2020;17(7):2393.CrossRefGoogle ScholarPubMed
23. Gananca, L, Oquendo, MA, Tyrka, AR, et al. The role of cytokines in the pathophysiology of suicidal behavior. Psychoneuroendocrinology. 2016;63:296–310.CrossRefGoogle ScholarPubMed
24. O’Donovan, A, Rush, G, Hoatam, G, et al. Suicidal ideation is associated with elevated inflammation in patients with major depressive disorder. Depress Anxiety. 2013;30(4):307–314.CrossRefGoogle ScholarPubMed
25. Gibbs, HM, Davis, L, Han, X, et al. Association between C-reactive protein and suicidal behavior in an adult inpatient population. J Psychiatr Res. 2016;79:28–33.CrossRefGoogle Scholar
26. Park, RJ, Kim, YH. Association between high sensitivity CRP and suicidal ideation in the Korean general population. European Neuropsychopharmacol. 2017;27(9):885–891.CrossRefGoogle ScholarPubMed
27. Courtet, P, Jaussent, I, Genty, C, et al. Increased CRP levels may be a trait marker of suicidal attempt. European Neuropsychopharmacol. 2015;25(10):1824–1831.CrossRefGoogle ScholarPubMed
28. Raison, CL, Capuron, L, Miller, AH. Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends Immunol. 2006;27(1):24–31.CrossRefGoogle ScholarPubMed
29. Bradley, KA, Case, JA, Khan, O, et al. The role of the kynurenine pathway in suicidality in adolescent major depressive disorder. Psychiatry Res. 2015;227(2–3):206–212.CrossRefGoogle ScholarPubMed
30. Pompili, M, Lionetto, L, Curto, M, et al. Tryptophan and kynurenine metabolites: are they related to depression? Neuropsychobiology. 2019;77(1):23–28.CrossRefGoogle ScholarPubMed
31. Bauer, BW, Gustafsson, HC, Nigg, J, et al. Working memory mediates increased negative affect and suicidal ideation in childhood attention-deficit/hyperactivity disorder. J Psychopathol Behav Assess. 2018;40(2):180–193.CrossRefGoogle ScholarPubMed
32. Lindqvist, D, Janelidze, S, Hagell, P, et al. Interleukin-6 is elevated in the cerebrospinal fluid of suicide attempters and related to symptom severity. Biological Psychiatry. 2009;66(3):287–292.CrossRefGoogle ScholarPubMed
33. Isung, J, Mobarrez, F, Nordstrom, P, et al. Low plasma vascular endothelial growth factor (VEGF) associated with completed suicide. World J Biol Psychiatry. 2012;13(6):468–473.CrossRefGoogle ScholarPubMed
34. Vargas, HO, Nunes, SO, Pizzo de Castro, M, et al. Oxidative stress and lowered total antioxidant status are associated with a history of suicide attempts. J Affect Disord. 2013;150(3):923–930.CrossRefGoogle ScholarPubMed
35. Kim, YK, Lee, SW, Kim, SH, et al. Differences in cytokines between non-suicidal patients and suicidal patients in major depression. Prog Neuropsychopharmacol Biol Psychiatry. 2008;32(2):356–361.CrossRefGoogle ScholarPubMed
36. Kim, YK, Hong, JP, Hwang, JA, et al. TNF-alpha -308G>A polymorphism is associated with suicide attempts in major depressive disorder. J Affect Disord. 2013;150(2):668–672.CrossRefGoogle ScholarPubMed
37. Li, Z, Qi, D, Chen, J, et al. Venlafaxine inhibits the upregulation of plasma tumor necrosis factor-alpha (TNF-alpha) in the Chinese patients with major depressive disorder: a prospective longitudinal study. Psychoneuroendocrinology. 2013;38(1):107–114.CrossRefGoogle ScholarPubMed
38. Kim, SJ, Kang, SG, Cho, IH, et al. The relationship between poor performance on attention tasks and increased suicidal ideation in adolescents. Eur Child Adolesc Psychiatry. 2015;24(11):1361–1368.CrossRefGoogle ScholarPubMed
39. Kasckow, J, Youk, A, Anderson, SJ, et al. Trajectories of suicidal ideation in depressed older adults undergoing antidepressant treatment. J Psychiatric Res. 2016;73:96–101.CrossRefGoogle ScholarPubMed
40. Schmeichel, BJ, Volokhov, RN, Demaree, HA. Working memory capacity and the self-regulation of emotional expression and experience. J Pers Soc Psychol. 2008;95(6):1526–1540.CrossRefGoogle ScholarPubMed
41. Huber, RS, Hodgson, R, Yurgelun-Todd, DA. A qualitative systematic review of suicide behavior using the cognitive systems domain of the research domain criteria (RDoC) framework. Psychiatry Res. 2019;282:112589.CrossRefGoogle ScholarPubMed
42. Hopko, DR, Funderburk, JS, Shorey, RC, et al. Behavioral activation and problem-solving therapy for depressed breast cancer patients: preliminary support for decreased suicidal ideation. Behav Modif. 2013;37(6):747–767.CrossRefGoogle ScholarPubMed
43. Hiles, SA, Baker, AL, de Malmanche, T, et al. Interleukin-6, C-reactive protein and interleukin-10 after antidepressant treatment in people with depression: a meta-analysis. Psychological Med. 2012;42(10):2015–2026.CrossRefGoogle ScholarPubMed
44. Serafini, G, Gonda, X, Pompili, M, et al. The relationship between sensory processing patterns, alexithymia, traumatic childhood experiences, and quality of life among patients with unipolar and bipolar disorders. Child Abuse Negl. 2016;62:39–50.CrossRefGoogle ScholarPubMed
45. Naidu, KS, Morgan, LW, Bailey, MJ. Inflammation in the avian spleen: timing is everything. BMC Mol Biol. 2010;11:104.CrossRefGoogle ScholarPubMed
46. Beck, AT, Kovacs, M, Weissman, A. Assessment of suicidal intention: the scale for suicide ideation. J Consult Clin Psychol. 1979;47(2):343–352.CrossRefGoogle ScholarPubMed
47. Beck, AT, Steer, RA, Ranieri, WF. Scale for suicide ideation: psychometric properties of a self-report version. J Clin Psychol. 1988;44(4):499–505.3.0.CO;2-6>CrossRefGoogle ScholarPubMed
48. Saffer, BY, Klonsky, ED. The relationship of self-reported executive functioning to suicide ideation and attempts: findings from a large U.S.-based online sample. Arch Suicide Res. 2017;21(4):577–594.CrossRefGoogle ScholarPubMed
49. Rosenberg, HJ, Jankowski, MK, Sengupta, A, et al. Single and multiple suicide attempts and associated health risk factors in New Hampshire adolescents. Suicide Life-Threat Behav. 2005;35(5):547–557.CrossRefGoogle ScholarPubMed