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C-Reactive Protein Alterations in Bipolar Disorder: A Meta-Analysis
Abstract
OBJECTIVE: There is growing evidence that bipolar disorder (BD) is associated with inflammation, including abnormal levels of acute-phase C-reactive protein (CRP). Our meta-analysis was conducted to estimate the size of the association between CRP levels and BD, accounting also for subgroup differences (mood phases and treatment). DATA SOURCES: MEDLINE, EMBASE, PsycINFO, and ISI Web of Science and references of identified articles were searched up to June 2013 using the keywords (bipolar disorder) AND (C-reactive protein OR CRP). STUDY SELECTION: English language studies measuring blood levels of CRP in patients with BD and control subjects were selected, 136 abstracts were reviewed, 20 articles retrieved, and 11 studies included. DATA EXTRACTION: Two independent reviewers extracted data. All studies were included in the primary analyses, and between-group differences for subanalyses were also reported. This meta-analysis was performed using random-effects models. RESULTS: Eleven studies comprising 1,618 subjects were eligible for inclusion. Overall, CRP levels were significantly elevated in patients with BD versus controls (standardized mean difference [SMD] = 0.39; 95% CI, 0.24 to 0.55; P < .0001). CRP levels were significantly higher in manic (SMD = 0.73; 95% CI, 0.44 to 1.02; P < .001) and euthymic (SMD = 0.26; 95% CI, 0.01 to 0.51; P = .04), but not in depressed (SMD = 0.28; 95% CI, -0.17 to 0.73; P = .22) patients with BD compared to controls. CRP levels were unrelated to use of lithium or antipsychotic medication. CONCLUSIONS: This meta-analysis supports an association between increased CRP levels and BD. Given that an elevated level of CRP is a marker of low-grade inflammation and a risk factor for cardiovascular and malignant diseases, measurement of CRP level might be relevant to the clinical care of bipolar patients.
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“In addition to a host of physical health consequences, these inflammatory processes have been linked to psychopathology as shown in meta-analyses of depression (Howren et al. 2009), BPD (Dargél et al. 2015), psychosis (Miller et al. 2011), and PTSD (Passos et al. 2015).”
From Child Sexual Abuse as a Unique Risk Factor for the Development of Psychopathology: The Compounded Convergence of Mechanisms (2021) · cites this paper as Dargél et al. 2015
In the citing paper
“But the depression state has conflicting results43,44.”
From Inflammation-related biomarkers in major psychiatric disorders: a cross-disorder assessment of reproducibility and specificity in 43 meta-analyses (2019) · cites this paper as [44]
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Items 101–155 of 155
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Zhang, X., Li, X., Tong, J., Li, N., & Zhang, F. (2022) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001487 · Cited by 9
“This finding is consistent with those of previous studies (Dargél et al., 2015; Evers et al., 2019).”
BackgroundResultC-reactive protein as a biomarker for unipolar versus bipolar depression: a cross-sectional study
Dessoki, H. H., Khattab, R., Moris, W., Abdelhakim, A. A. E., Lotfy, A. M. M., & Salah, H. (2023) · Middle East Current Psychiatry · doi:10.1186/s43045-023-00342-0 · Cited by 7
“This means that CRP may be a biological marker for BD, associated with inflammation and mood states [34].”
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Association between CRP genetic diversity and bipolar disorder comorbid complications
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“Also, elevated CRP levels were found to be associated with schizophrenia (33,34), autism (35), and bipolar disorder (36).”
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“Introduction Increasing evidence suggests that immune system alterations are involved in the aetiology (Cassidy et al., 2002; Drexhage et al., 2010; Bai et al., 2014; Dargel et al., 2015; Dickerson et al., 2015) and treatment response of bipolar disorder (Li et al., 2015).”
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“High-sensitive C-reactive protein The replicated finding of elevated hs-CRP in samples of adults with BD [3,36] largely represents individuals with multiepisode and/or later stage BD, with a paucity of studies conducted in persons early in the illness trajectory.”
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Metadata
- Authors
- Dargél, A. A., Godin, O., Kapczinski, F., Kupfer, D. J., & Leboyer, M.
- Affiliations
- Hôpital Albert-Chenevier (FR)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2015-02-25
- Volume
- 76
- Issue
- 02
- Pages
- 142-150
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W1974846472
- Cited by
- 155
- References
- 0
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 6 · 2023: 14 · 2022: 13 · 2021: 18 · 2020: 14 · 2019: 13 · 2018: 14 · 2017: 17 · 2016: 29 · 2015: 6
- FWCI
- 17.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agence Nationale de la Recherche (ANR-11-IDEX-0004)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- bipolar disorder, C-reactive protein, inflammation, acute phase proteins, manic episodes, euthymic state, depressive episodes, lithium, antipsychotic drugs, cardiovascular risk
- MeSH terms
- Affect, Bipolar Disorder, C-Reactive Protein, Humans, Predictive Value of Tests, Biomarkers
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