Systematic Review of the Evidence of a Relationship Between Chronic Psychosocial Stress and C-Reactive Protein

Introduction C-reactive protein (CRP) is an acute-phase reactant with an increasing number of clinical functions. Studies in recent years have identified several social, economic, demographic, and psychological factors that contribute to baseline inflammation. Psychosocial stress represents a significant contributor to baseline inflammation. Given the importance of understanding background drivers of CRP levels, we conducted this review to assess the impact of chronic psychosocial stress on CRP levels. Methods Medline was searched through February 2013 for human studies examining CRP levels with respect to chronic psychosocial stress. Results The initial search identified 587 articles from which 129 potentially appropriate articles were reviewed. Of these 129 articles, 40 articles were included in the review. These studies were published between 2003 and 2013. Of these studies, 6 analyzed employment stress, 2 analyzed unemployment stress, 6 analyzed burnout and vital exhaustion, 6 analyzed caregiver stress, 3 analyzed interpersonal stress, 17 analyzed socioeconomic position, and 2 analyzed discrimination. Conclusion We conclude that psychosocial stress significantly impacts CRP and should be considered when interpreting the meaning of CRP elevations.