Is anxious-depression an inflammatory state?

Abstract

For several years, the literature has examined the association of depression and anxiety with inflammatory states such as atherosclerosis and cardiovascular disease, yet this association remains inconclusive. Several possible immune and endocrinological pathways have been postulated that associate depression and anxiety with inflammation and immune dysregulation. Anxiety and depression have usually been envisioned as two separate psychiatric conditions yet they share similar symptoms and are frequently encountered together among individuals. Individuals suffering from anxious-depression are more refractory to treatment and have been reported to have greater disability compared to individuals with anxiety or depression alone. With the current changes in the diagnostic manual for psychiatric disorders placing more emphasis on a dimensional approach for the diagnosis of psychiatric illnesses, the hypothesis presented is that anxious-depression should be considered as a chronic inflammatory phenomenon since it shares common physiopathological pathways and pharmacological treatments with inflammatory states. This hypothesis might help to investigate how different levels of inflammatory biomarkers could be correlated with symptoms of anxious-depression.

Conflict of interest statement

Conflict of Interest: None

Copyright © 2013 Elsevier Ltd. All rights reserved.

Figures

Figure 1. Theoretical Model of the Anxious-Depression as an Inflammatory State

Inflammation is characterized by HPA hyperactivity, immune dysregulation, increased monoamine activity, increased pro-inflammatory cytokines, cardiovascular reactivity and altered coagulation factors. The different symptoms of anxious-depression share the same biological processes observed in inflammation. This theoretical model supports the hypothesis that anxious-depression is an inflammatory state.