Basal and LPS-stimulated inflammatory markers and the course of anxiety symptoms

Wessel A. van Eeden*, Ebtisam El Filali, Albert M. van Hemert, Ingrid V. E. Carlier, Brenda W. J. H. Penninx, Femke Lamers, Robert Schoevers, Erik J. Giltay

*Corresponding author for this work

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Abstract

A cross-sectional relationship between low-grade inflammation -characterized by increased blood levels of Creactive protein (CRP) and pro-inflammatory cytokines- and anxiety has been reported, but the potential longitudinal relationship has been less well studied. We aimed to examine whether basal and lipopolysaccharide (LPS-)induced levels of inflammatory markers are associated with anxiety symptom severity over the course of nine years.

We tested the association between basal and LPS-induced inflammatory markers with anxiety symptoms (measured with the Beck's Anxiety Inventory; BAI, Fear Questionnaire; FQ and Penn's State Worry Questionnaire; PSWQ) at 5 assessment waves over a period up nine years. We used multivariate-adjusted mixed models in up to 2867 participants of the Netherlands Study of Depression and Anxiety (NESDA).

At baseline, 43.6% of the participants had a current anxiety disorder, of which social phobia (18.5%) was most prevalent. Our results demonstrated that baseline inflammatory markers were significantly associated with several outcomes of anxiety at baseline over nine subsequent years. BAI subscale of somatic (arousal) symptoms of anxiety, and FQ subscale of agoraphobia demonstrated the strongest effects with standardized betacoefficients of up to 0.14. The associations were attenuated by 25%-30% after adjusting for the presence of (comorbid) major depressive disorder (MDD), but remained statistically significant.

In conclusion, we found that participants with high levels of inflammatory markers have on average high levels of anxiety consisting of physical arousal and agoraphobia, which tended to persist over a period of nine years, albeit with small effect sizes. These associations were partly driven by co-morbid depression.

Original languageEnglish
Pages (from-to)378-387
Number of pages10
JournalBrain behavior and immunity
Volume98
DOIs
Publication statusPublished - Nov-2021

Keywords

  • Anxiety severity
  • Anxiety severity Anxiety disorder
  • Epidemiology
  • Inflammation
  • Longitudinal
  • STATE WORRY QUESTIONNAIRE
  • C-REACTIVE PROTEIN
  • POSTTRAUMATIC-STRESS-DISORDER
  • PSYCHOMETRIC PROPERTIES
  • DEPRESSIVE SYMPTOMS
  • GENERALIZED ANXIETY
  • FEAR QUESTIONNAIRE
  • INVENTORY
  • ASSOCIATION
  • RELIABILITY

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