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C-reactive protein level in late-onset depression: A case–control study
Open accessAbstract
Background: Late-onset depression (LOD) is less responsive to standard antidepressant medication compared to early-onset depressive disorder. A group of early-onset depressive episode is less responsive to antidepressant medication, and immune dysregulation is critically involved in it. LOD has been associated with increased vascular risk factor and atherosclerosis and immune dysregulation is critically involved in vascular disease. We hypothesized that increased inflammatory activity may be associated with late-onset depressive disorders. Aim: The aim of this study is to study the C-reactive protein (CRP) levels in LOD compared with age-matched controls and association between CRP levels and severity of depressive episode. Settings and Design: This was a case–control study at tertiary care psychiatry department. Materials and Methods: Depressed patients (as per International Classification of Disease 10 Diagnostic and Research Criteria) of age >55 years were recruited and age-matched control participant were recruited after informed consent. A complete clinical assessment, assessment of vascular risk factors, blood sample for the evaluation of serum CRP was obtained, and baseline depression severity was measured on Hamilton Depression Rating Scale (HDRS). Statistical Analysis: The quantitative and qualitative variables were described as means, standard deviation, and P value. The student's t-test for parametric data and the mann-whitney test for nonparametric data spearman correlation coefficient method were used. Results: The mean age of cases (n = 25) was 64.7 ± 5.8 years, and mean age of controls (n = 25) was 64.2 ± 3.7 years. Patients with current depressive disorders had 40% times higher levels of CRP than control. Baseline HDRS of cases was 18 ± 3. CRP level and depression severity shows strong positive (r = 0.935, P = <0.001) correlation between CRP level and depression severity. Conclusion: LOD was associated with higher level of CRP compared to age-matched nondepressed patients. Raised CRP was associated with severity of depressive episode of LOD.
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“The authors suggested that the late-onset depression was associated with higher CRP levels.”
From C-Reactive protein as a biomarker for major depressive disorder? (2022) · cites this paper as [81]
In the citing paper
“A case-control study comparing 25 patients aged ≥55 years at their first depressive episode, assessed through Hamilton Depression Rating Scale (HAMD), and 27 age-matched healthy controls, found that subjects with current depressive disorders showed 40-fold higher CRP levels compared to control group [81].”
From C-Reactive protein as a biomarker for major depressive disorder? (2022) · cites this paper as [81]
In the citing paper
“Moreover, CRP levels were strongly and positively associated with depression severity [81]”
From C-Reactive protein as a biomarker for major depressive disorder? (2022) · cites this paper as [81]
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Cites
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BackgroundAtherosclerosis--an inflammatory disease
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“Results of this study confirm previous findings of immune dysregulation in depressed persons.[10,18] Vogelzangs et al.”
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“Indian Journal of Psychiatry Volume 60, Issue 4, October-December 2018 468 disorder in general population.[1] Late-onset depression (LOD) constitutes about 2% of depressive disorders.”
BackgroundAssociations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis.
Howren, M. B., Lamkin, D. M., & Suls, J. (2009) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181907c1b · Cited by 2,766 · cited 1×
“Results of this study confirm previous findings of immune dysregulation in depressed persons.[10,18] Vogelzangs et al.”
ResultDepression in Late Life: Review and Commentary
Blazer, D. G. (2003) · The Journals of Gerontology Series A · doi:10.1093/gerona/58.3.m249 · Cited by 2,383 · cited 1×
“These are associated with increased mortality.[3,4]”
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Cited by
Sorted by citations
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
“Moreover, CRP levels were strongly and positively associated with depression severity [81] Another study proposed CRP as a biomarker to differentiate MDD and BD type 2 (BD-II), by recruiting 88 BD-II, 72 drug-naïve MDD and 96 healthy controls [79].”
BackgroundMethodSex differences in the inflammation-depression link: A systematic review and meta-analysis
Jarkas, D., Villeneuve, A. H., Daneshmend, A., Villeneuve, P. J., & McQuaid, R. J. (2024) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2024.07.037 · Cited by 84
“A number of investigations have reported that specific depression symptomatologies are related to high CRP levels (K ¨ ohler et al., 2018; Mishra et al., 2018; Osimo et al., 2019).”
BackgroundIslam, M. R., Sohan, M., Daria, S., Masud, A. A., Ahmed, M. U., Roy, A., & Shahriar, M. (2023) · International Journal of Immunopathology and Pharmacology · doi:10.1177/03946320231198828 · Cited by 41
Jones, C., & Nemeroff, C. B. (2021) · Advances in experimental medicine and biology · doi:10.1007/978-981-33-6044-0_27 · Cited by 23
Xia, J., Chen, M., Shao, H., Chen, H., Zhu, S., Zhao, M., Luo, W., Yang, J., & Wu, S. (2023) · Frontiers in Bioscience-Landmark · doi:10.31083/j.fbl2812356 · Cited by 17
“[34] found that CRP levels in patients with late-onset depression were 40% higher than in age-matched non-depressed individuals.”
BackgroundHuang, D., Wang, L., Wu, Y., Qin, X., Du, G., & Zhou, Y. (2022) · ACS Omega · doi:10.1021/acsomega.1c06046 · Cited by 16
Vascular depression and cognitive dysfunction
Bogolepova, A. N. (2019) · Neurology neuropsychiatry Psychosomatics · doi:10.14412/2074-2711-2019-3s-26-31 · Cited by 16
Yao, P., Sun, H., & Li, X. (2022) · Frontiers in Genetics · doi:10.3389/fgene.2022.1048761 · Cited by 9
Chen, B., Dong, J., Guo, W., & Li, T. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-06123-1 · Cited by 8
“Consistent with this hypothesis, some studies have linked elevated CRP levels to greater risk of depression [8–10] and to development of more severe depressive symptoms [9, 11, 12].”
BackgroundResultGulbaz, Z.-U.-A., Mirza, S., Naveed, S., Azeem, M. W., Husain, N., & Cheema, M. I. (2025) · Psychiatric Quarterly · doi:10.1007/s11126-025-10223-w · Cited by 2
Wang, X., Gao, Y., Wang, D., Du, X., & Liu, S. (2024) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s490717 · Cited by 2
The Neurobiology of Late-Life Depression
Lee, K. J., Kim, H. J., & Kim, Y. (2025) · 신경정신의학 · doi:10.4306/jknpa.2025.64.3.164
Complex Neurobiological Mechanisms and Risk Factors Underlying Late-Life Depression
Lee, K. J., & Kim, Y. (2026) · Advances in experimental medicine and biology · doi:10.1007/978-981-95-6872-7_16
Metadata
- Authors
- Mishra, D., Sardesai, U., & Razdan, R.
- Affiliations
- Shyam Shah Medical College (IN)
- Mahatma Gandhi Memorial Medical College (IN)
- Corresponding author
- Mishra, Dheerendra
- ORCID
- Mishra, Dheerendra
- Venue
- Indian Journal of Psychiatry
- Published
- 2018
- Volume
- 60
- Issue
- 4
- Pages
- 467
- ISSN
- 0019-5545 (ISSN-L)
- PMC
- PMC6278212
- OpenAlex
- W2926557421
- Cited by
- 13
- References
- 26
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 1 · 2019: 1
- FWCI
- 0.16
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Indian Journal of Psychiatry (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- late-onset depression, C-reactive protein, inflammation, immune dysregulation, depression severity, older adults, vascular risk factors, atherosclerosis, antidepressant resistance
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