The effect of trauma and alcohol on the relationship between level of cytokines and depression among patients entering psychiatric treatment

Toft, Helge; Bramness, Jørgen G.; Tilden, Terje; Wampold, Bruce E.; Lien, Lars

doi:10.1186/s12888-018-1677-z

Cited by 21 publications

(12 citation statements)

References 48 publications

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“…The study is part of a larger research project and some methods have been presented elsewhere. 14 The patients were recruited from a high-threshold psychiatric center in Norway treating patients with depression, anxiety, and eating or trauma disorders. Enrolled patients have previously tried treatment elsewhere with no or little success, many of them for years.…”

Section: Methodsmentioning

confidence: 99%

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PTSD patients show increasing cytokine levels during treatment despite reduced psychological distress

Toft¹,

Bramness²,

Lien³

et al. 2018

NDT

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BackgroundA reciprocal relationship between activated innate immune system and changes in mood and behavior has been established. There is still a paucity of knowledge on how the immune system responds during psychiatric treatment. We aimed to explore circulating cytokines and assess psychiatric symptom severity scores during 12 weeks of inpatient psychiatric treatment.MethodsThe study was a longitudinal assessment of 124 patients (88 women and 36 men) in treatment at Modum Psychiatric Center, Norway. The patient sample comprised a mixed psychiatric population of whom 39 were diagnosed with posttraumatic stress disorder (PTSD). Serum blood samples for cytokine analysis and measures of mental distress using Global Severity Index were collected at admission (T0), halfway (T1), and before discharge (T2). Other factors assessed were age, gender, and the use of antidepressants and anti-inflammatory drugs. Multilevel modeling was used for longitudinal analyses to assess the repeated cytokine samples within each patient.ResultsOverall level of IL-1RA was higher in PTSD patients when compared to those without PTSD (P=0.021). The level of IL-1β, MCP-1, and TNF-α increased over time in PTSD compared to non-PTSD patients (P=0.025, P=0.011 and P=0.008, respectively). All patients experienced reduced mental distress as measured by self-reported Global Severity Index scores. Stratified analysis showed that PTSD patients who used anti-inflammatory drugs had higher levels of IL-1β (P=0.007) and TNF-α (P=0.049) than PTSD patients who did not use such drugs.ConclusionThe study indicates that traumatized patients may have a distinct neuroimmune development during recovery. Their activated immune system shows even further activation during their rehabilitation despite symptom reduction.

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Section: Methodsmentioning

confidence: 99%

“…We have earlier found bivariate associations between trauma and IL-1RA and TNF-α in a cross-sectional assessment, 14 and we decided to explore these relationships longitudinally. Research suggests that the immunological response in PTSD patients differs from the response in psychiatric patients without PTSD.…”

Section: Introductionmentioning

confidence: 99%

PTSD patients show increasing cytokine levels during treatment despite reduced psychological distress

Toft¹,

Bramness²,

Lien³

et al. 2018

NDT

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“…Biological Abnormalities Associated with Childhood Maltreatment-Several persistent biological alterations associated with childhood maltreatment may mediate the increased risk for development of mood and other disorders. Childhood maltreatment is associated with systemic inflammation [86,87] as assessed by measurements of C-reactive protein (CRP) and inflammatory cytokines including tumor necrosis factor-alpha (TNFα) and interleukin-6 (IL-6). Childhood maltreatment was found to be associated with increased plasma CRP levels and increased body mass index in 483 participants identified as being on the psychosis spectrum [88].…”

Section: Underlying Mechanisms By Which Childhood Maltreatment Increamentioning

confidence: 99%

The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders

Lippard

Nemeroff

2020

AJP

352

180

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A large body of evidence has demonstrated that exposure to childhood maltreatment at any stage of development can have long-lasting consequences. It is associated with a marked increase in risk for psychiatric and medical disorders. This review summarizes the literature investigating the effects of childhood maltreatment on disease vulnerability for mood disorders, specifically summarizing cross-sectional and more recent longitudinal studies that demonstrate childhood maltreatment is more prevalent and associated with increased risk for first mood episode, episode recurrence, greater comorbidities, and increased risk for suicidal ideation and attempts in individuals with mood disorders. It summarizes the persistent alterations associated with childhood maltreatment, including alterations in the HPA axis and inflammatory cytokines, which may contribute to disease vulnerability and a more pernicious disease course. We discuss several candidate genes and environmental factors, for example alcohol/substance use, that may alter disease vulnerability and illness course and neurobiological associations that may mediate these relationships following childhood maltreatment. Studies provide insight into modifiable mechanisms and provide direction to improve both treatment and prevention strategies. "It is not the bruises on the body that hurt. It is the wounds of the heart and the scars on the mind."

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“…The data collection was active from March 2015 through April 2016. Data were collected as part of a major study entitled DARCY (for details on DARCY, see Toft, Neupane, Bramness, Tilden, Wampold, & Lien, 2018).…”

Section: Brief Description Of the Clinical And The General Samplesmentioning

confidence: 99%

Young Adults in Nature-Based Services in Norway—In-Group and Between-Group Variations Related to Mental Health Problems

Steigen

Eriksson

Kogstad

et al. 2018

Nordic Journal of Social Research

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Young adults with mental health problems who do not attend school or work constitute a significant welfare challenge in Norway. The welfare services available to these individuals include nature-based services, which are primarily located on farms and integrate the natural and agricultural environment into their daily activities. The aim of this study is to examine young adults (16–30 years old) not attending school or work who participated in nature-based services in Norway. In particular, the study analyses mental health problems among the participants and in-group variations regarding their symptoms of mental health problems using the Hopkins Symptoms Checklist (HSCL-10). This paper compares symptoms of mental health problems among participants in nature-based services with those of a sample from the general population and a sample of those receiving clinical in-patient mental healthcare. A questionnaire was developed for the study and was completed by 93 participants in nature-based services. The majority of these participants were recruited from the Norwegian Labour and Welfare Administration (NAV), local mental health services, and school authorities. Results indicate that just more than half of the respondents exhibited symptoms of mental health problems based on their HSCL-10 scores. In general, they reported fewer symptoms than the clinical in-patient sample (18–30 years old) and more symptoms than the general population sample (18–19 years old). Among the participants in nature-based services, those recruited through NAV and local mental health services exhibited no differences in symptoms. Half of the participants older than 23 years in nature-based services had not completed upper secondary school. The participants, including those with symptoms of mental health problems and low expectations at the outset of their participation, generally expressed high satisfaction with the services.

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The effect of trauma and alcohol on the relationship between level of cytokines and depression among patients entering psychiatric treatment

Cited by 21 publications

References 48 publications

PTSD patients show increasing cytokine levels during treatment despite reduced psychological distress

PTSD patients show increasing cytokine levels during treatment despite reduced psychological distress

The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders

Young Adults in Nature-Based Services in Norway—In-Group and Between-Group Variations Related to Mental Health Problems

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