Inflammatory phenotype of depression symptom structure: A network perspective
Open accessAbstract
Background There has been increasing interest in classifying inflammatory phenotypes of depression. Most investigations into inflammatory phenotypes only have tested whether elevated inflammation is associated with elevated levels of depression symptoms, or risk for a diagnosis. This study expanded the definition of phenotype to include the structure of depression symptoms as a function of inflammation.Methods Network models of depression symptoms were estimated in a sample of 4157 adults (mean age = 47.6, 51% female) from the 2015-2016 National Health and Nutrition Examination Survey (NHANES). Analyses included comparisons of networks between those with elevated (C-reactive protein (CRP) values ≥ 3.0 mg/L; N = 1696) and non-elevated CRP (N = 2841) as well as moderated network models with CRP group status and raw CRP values moderating the associations between depression symptoms.Results Differences emerged at all levels of analysis (global, symptom-specific, symptom-symptom associations). Specifically, the elevated CRP group had greater symptom connectivity (stronger total associations between symptoms). Further, difficulty concentrating and psychomotor difficulties had higher expected influence (concordance with other symptoms) in the elevated CRP group. Finally, there was evidence that several symptom-symptom associations were moderated by CRP.Conclusions This study provides consistent evidence that the structure of depression symptoms varies as a function of CRP levels. Greater symptom connectivity might contribute to why elevated CRP is associated with treatment-resistant depression. Additionally, differences in symptom structure might highlight different maintenance mechanisms and treatment targets for individuals with compared to those without elevated CRP. Finally, differences in symptom structure as a function of CRP highlight a potential misalignment of standard depression measures (the structure of which are evaluated on groups unselected for CRP levels) and the presentation of depression symptoms in those with elevated CRP.
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In 4157 adults, the elevated CRP group (>3 mg/L) showed greater symptom connectivity, concentration, psychomotor difficulties, and treatment-resistant depression.
“A recent network analysis investigated the association between inflammation and a specific depression phenotype [69]. PHQ-9 was administered to a sample of 4157 adults from the NHANES while hs-CRP levels were measured to identify possible inflammatory phenotypes of depression [69]. The elevated CRP group (>3 mg/L) showed greater symptom connectivity, concentration, psychomotor difficulties, and”
From C-Reactive protein as a biomarker for major depressive disorder? (2022) · cites this paper as [69]
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C-Reactive protein as a biomarker for major depressive disorder?
Orsolini, L., Pompili, S., Tempia Valenta, S., Salvi, V., & Volpe, U. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23031616 · Cited by 171 · see citing works
- Authors
- Moriarity, D. P., van Borkulo, C., & Alloy, L. B.
- Affiliations
- Temple University (US)
- Corresponding author
- Moriarity, Daniel P.
- Venue
- Brain Behavior and Immunity
- Publisher
- Elsevier BV
- Published
- 2021-03
- Volume
- 93
- Pages
- 35-42
- ISSN
- 0889-1591 (ISSN-L)
- PMC
- PMC7979456
- OpenAlex
- W3111616629
- Cited by
- 45
- References
- 56
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 7 · 2023: 4 · 2022: 11 · 2021: 10
- FWCI
- 1.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Brain Behavior and Immunity (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- UvA-DARE (University of Amsterdam) (submittedVersion, other-oa)
- TUScholarShare (Temple University) (submittedVersion, cc-by-nc-nd)
- PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
- PsyArXiv (OSF Preprints) (submittedVersion)
- Funders
- National Institute of Mental Health (F31MH122116, R01 MH101168)
- Topics
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- depression, inflammatory phenotype, C-reactive protein, symptom networks, concentration difficulties, psychomotor symptoms, treatment-resistant depression, inflammation, NHANES
- MeSH terms
- Adult, C-Reactive Protein, Depression, Female, Humans, Inflammation, Male, Middle Aged, Nutrition Surveys, Phenotype, Biomarkers
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