Treatment response and cognitive impairment in major depression: Association with C-reactive protein
Abstract
Levels of inflammatory markers have been found to be significantly associated with major depressive disorder (MDD) and cognitive impairment. The aim of this study was to investigate whether the level of C-reactive protein (CRP) is correlated with depressive mood and cognitive impairment in MDD patients. In 149 subjects with MDD, the 21-item Hamilton Rating Scale for Depression (HAM-D), Continuous Performance Test (CPT), Finger-Tapping Test (FTT), and Wisconsin Card-Sorting Test (WCST) were administered before and after antidepressant treatment. Besides, the level of CRP was measured. After 6weeks of treatment, the total HAM-D scores decreased significantly. In addition, the subjects' performance in the masked CPT and the WCST with completed categories significantly improved (p<0.001 and p=0.027, respectively) after the reliable change indices were corrected for practice effects. The CRP levels had increased significantly after six weeks of treatment after adjustment for age and gender (p<0.001). In addition, the CRP levels remained significantly high after six weeks of treatment in patients with a higher baseline level (r=0.657, p<0.001). Although the association between baseline CRP level and HAM-D score was not significant, the baseline CRP level was significantly correlated with treatment response at week 2 (r=0.327, p=0.020). The baseline CRP level was also negatively correlated with performance in the FTT before treatment (r=-0.580, p=0.006). Moreover, the baseline CRP level was significantly correlated with performance in the FTT (r=-0.501, p=0.021) and WCST with completed categories (r=-0.521, p=0.015) at week 6. The cognitive function of patients with high baseline CRP levels might remain impaired even if their mood symptoms improve after antidepressant treatment. Whether adjunctive anti-inflammatory medication may help to preserve cognitive function merits further investigation.
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Elevated serum C-reactive protein indicates poor response to psychological treatment such as cognitive behavioural therapy or interpersonal therapy but good response to antidepressants such as fluoxetine or nortriptyline.
“Studies have shown that elevated serum CRP indicates poor response to psychological treatment (such as cognitive behavioural therapy (CBT) or interpersonal therapy) but good response to antidepressant, such as fluoxetine or nortriptyline.17–20”
Among 149 recruited subjects, there was no association between CRP levels and HAM-D scores in the medication-free MDD subgroup.
“Chang et al. (2012) [50] evaluated whether CRP levels were associated with depressive symptoms and cognitive impairment in MDD patients. The authors found that among 149 recruited subjects, there was no association between CRP levels and HAM-D scores in the medication-free MDD subgroup.”
From C-Reactive protein as a biomarker for major depressive disorder? (2022) · cites this paper as [50]
After six weeks of treatment, patients with higher baseline CRP levels still exhibited poor psychomotor speed and poor executive functioning.
“After six weeks of treatment, patients with higher baseline CRP levels still exhibited poor psychomotor speed and poor executive functioning [50].”
From C-Reactive protein as a biomarker for major depressive disorder? (2022) · cites this paper as [50]
In 149 MDD patients treated with antidepressants for six weeks, baseline CRP levels were negatively and significantly associated with performance in the FTT and WCST after six weeks of treatment (respectively, p = 0.006 and p = 0.021), reporting a significant association between CRP levels and the domains of attention and executive cognitive function.
“A cross-sectional study evaluated the association between CRP levels, depressive symptoms, and cognitive impairment in 149 MDD patients treated with antidepressants for six weeks [50]. Scale for Depression (HAM-D), Continuous Performance Test (CPT), Finger-Tapping Test (FTT), and Wisconsin Card-Sorting Test (WCST) were administered to the sample. Baseline CRP levels were negatively and”
From C-Reactive protein as a biomarker for major depressive disorder? (2022) · cites this paper as [50]
Pro-inflammatory status may correlate with poor neurocognitive performance.
“there is evidence that pro-inflammatory status may also correlate with poor neurocognitive performance [102].”
From Cognitive remission: a novel objective for the treatment of major depression? (2016) · cites this paper as [102]
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- Authors
- Chang, H. H., Lee, I. H., Gean, P. W., Lee, S.-Y., Chi, M. H., Yang, Y. K., Lu, R.-B., & Chen, P. S.
- Affiliations
- National Cheng Kung University (TW)
- National Cheng Kung University Hospital (TW)
- Corresponding author
- Chen, Po See
- Venue
- Brain, Behavior, and Immunity
- Publisher
- Elsevier BV
- Published
- 2012-01
- Volume
- 26
- Issue
- 1
- Pages
- 90-95
- ISSN
- 0889-1591 (ISSN-L)
- OpenAlex
- W2090213741
- Cited by
- 120
- References
- 61
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 8 · 2023: 10 · 2022: 14 · 2021: 15 · 2020: 7 · 2019: 12 · 2018: 12 · 2017: 7 · 2016: 11 · 2015: 3 · 2014: 6 · 2013: 7
- FWCI
- 1.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Brain Behavior and Immunity (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cheng Kung University
- Topics
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- major depressive disorder, C-reactive protein, cognitive impairment, antidepressant response, inflammatory markers, depressive mood, executive function, finger tapping speed
- MeSH terms
- Adult, Antidepressive Agents, C-Reactive Protein, Cognition Disorders, Major Depressive Disorder, Female, Fingers, Humans, Male, Middle Aged, Neuropsychological Tests, Psychiatric Status Rating Scales, Psychomotor Performance, Treatment Outcome, Diagnostic and Statistical Manual of Mental Disorders
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