The association of anxiety and stress-related disorders with C-reactive protein (CRP) within UK Biobank

Kennedy, E. and Niedzwiedz, C. L. (2022) The association of anxiety and stress-related disorders with C-reactive protein (CRP) within UK Biobank. Brain, Behavior, and Immunity, 19, 100410. (doi: 10.1016/j.bbih.2021.100410) (PMID:35028602) (PMCID:PMC8741412)

Abstract

Anxiety and stress-related disorders are both common and disabling psychiatric conditions. There are a number of hypotheses suggesting the underlying pathophysiology of these disorders, however, the exact mechanism is unknown. Inflammation has previously been linked with depression and has more recently been suggested as a possible link to anxiety aetiology. The objectives of this study are to assess the relationship between different anxiety/stress-related disorders and inflammation (measured by C-reactive protein) using the UK Biobank, and also determine whether any relationship between anxiety/stress disorders and inflammation is explained by depressive symptoms and other social and health-related factors. We utilised the UK Biobank for the sample of this study. Our sample included 353,136 participants of which 12,759 (3.61%) had a history of an anxiety (phobic, obsessive-compulsive, or other anxiety disorder including generalised anxiety and panic disorders) or stress-related disorder (including acute stress reaction, post-traumatic stress disorder and adjustment disorders). Four logistic regression models were calculated in which we tested the association between anxiety/stress disorders and C-reactive protein (CRP) >3 ​mg/L, adjusting for covariates (including age, sex, ethnicity, education level, socioeconomic deprivation, depressive symptoms, body mass index (BMI) and multimorbidity). An association was observed between other anxiety disorders (including panic and generalised anxiety disorders) and CRP (OR: 1.164 [95% CI: 1.096–1.236]). This was attenuated in models after the addition of BMI, multimorbidity and depressive symptoms. Stress/adjustment disorders followed a similar pattern of results (OR: 1.107 [95% CI: 1.040, 1.178]), with the association attenuated with the addition of BMI and multimorbidity). Phobic anxiety disorders (OR: 1.059 [95% CI: 0.896, 1.251]) and obsessive-compulsive disorders (OR: 1.299 [95% CI: 0.973, 1.733]) both showed no statistically significant results in any of the models. Our results support the hypothesis that some anxiety and stress-related disorders may be associated with high levels of inflammatory markers, as measured by CRP. Further studies are required to untangle the potential causal relationships involved.

• Item Type: Articles
• Additional Information: CLN acknowledges funding from the Medical Research Council (MR/ R024774/1) and a Lord Kelvin/Adam Smith Fellowship.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Niedzwiedz, Dr Claire
• Authors: Kennedy, E., and Niedzwiedz, C. L.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: Brain, Behavior, and Immunity
• Publisher: Elsevier
• ISSN: 0889-1591
• ISSN (Online): 1090-2139
• Published Online: 27 December 2021
• Copyright Holders: Copyright © 2021 The Author(s)
• First Published: First published in Brain, Behavior, and Immunity 19: 100410
• Publisher Policy: Reproduced under a Creative Commons licence

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
302182		A machine learning approach to understanding comorbidity between mental and physical health conditions	Claire Niedzwiedz	Medical Research Council (MRC)	MR/R024774/1	HW - Public Health