Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 308, Issue -, Pages 166-171Publisher
ELSEVIER
DOI: 10.1016/j.jad.2022.04.048
Keywords
Depression; Remission; Interleukin-6; Anxiety; Antidepressant
Categories
Funding
- National Research Foundation of Korea [NRF-2019M3C7A1031345, NRF-2020R1A2C2003472]
- National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London
- National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust
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The baseline serum IL-6 level and severity of anxiety symptoms can predict the outcome of antidepressant treatment. Patients with low IL-6 levels and mild anxiety symptoms are more likely to experience remission of depression.
Background: Despite the pathogenic role played by interleukin-6 (IL-6) signaling in depression, the association between baseline peripheral IL-6 signaling and the antidepressant treatment responses noted in clinical studies remains controversial. We investigated the effects of the baseline serum IL-6 (sIL-6) level and anxiety symptoms on the 12-week remission rate of depressed outpatients who received stepwise antidepressant treatments. Methods: At baseline, sIL-6 levels were measured, and anxiety symptoms were evaluated using the Hospital Anxiety Depression Scale-Anxiety subscale (HADS-A), in 1094 patients. All received stepwise antidepressant treatment. Subsequently, 12-week remission, defined as a Hamilton Depression Rating Scale (HAMD) score <= 7, was assessed. Results: The individual and interaction effects of the sIL-6 level (as a binary [low vs. high, based on the median value of 1.65 pg/mL] or continuous variable) and the HADS-A score (as a binary [<12 vs. >= 12] or continuous variable) on the 12-week remission rate were analyzed using logistic regression models after adjusting for relevant covariates. Patients with both low sIL-6 levels (<1.65 pg/mL) and HADS-A scores <12 had the highest 12-week remission rate; a significant interaction effect was also apparent. This effect was significant even when the data were analyzed as continuous variables. Conclusions: Our study suggests that the sIL-6 level can serve as a biomarker predicting the outcome of antidepressant treatment according to the severity of anxiety symptoms.
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