The Association Between First-episode,drug-naive Anxious Major Depressive Disorder And Immune-inflammation

Background:Major depressive disorder(MDD)is a common mental disorder,the main clinical performance were depression,decreased interest and lack of pleasure,with high recurrence rate,which is a severe burden to the family and society.Investigation found that MDD with anxious with high prevalence,with severe social damage,and more difficult to treat.Research found that MDD with anxious have different neurobiological characteristics and therapeutic responses from MDD without anxious.Now MDD pathogenesis remains unclear,except for the monoamine transmitter hypothesis,immune inflammation,hypothalamus-pituitary-adrenal axis(HPA)and hypothalamic-pituitary-thyroid axis(HPT)are involved in MDD etiological processes.The purpose of this study was to investigate the immune inflammatory features associated with first-episode treatment-naive MDD with anxious.Methods:1.Recruited 54 inpatients with first episode treatment-naive major depressive disorder during May 2017-January 2020 from the first people’s Hospital of Guangzhou City Psychiatric Department.Collected the general demographic data of patients,and the patient’s depressive symptoms were assessed by using 17 items of the hamilton depression scale(HAMD17).The hamilton anxiety scale(HAMA)was used to assess the anxious system.Serum cytokine levels were measured by ELSIA methods,which including IL-2,IL-4,IL-6,IL-10,TNF-α and IFN-γ.Hs-CRP was measured by transmission immune-enhanced turbidimetry.The blood routine was examined by using the automatic blood cell analyzer,which including WBC,Neut#,Lymph#,Mono#,Baso#,Eos#.2.All subjects was divided into two groups according to the type of MDD.MDD with and without anxious characteristics,then the difference analysis between groups was compared.Anxiety-depression symptoms and blood indexes were studied in MDD group with anxiety-pain characteristics.Finally,statistically significant results were analyzed.3.logistic regression analysis was performed with age,sex and blood index as independent variables in MDD patients with anxious and MDD patients with non-anxious.Results:1.Of the 41 MDD patients,a total of 32 were MDD with anxious,accounting for78.05%,including 7 male(21.88%)and 25 female(78.12%).The age and education level of the two groups with and without anxious were statistically different(p<0,05),the patients with anxious characteristics was older,the education level was mostly junior middle school and university,and the gender was no statistical difference between the two groups.2.The difference between the two groups showed that MDD patients with anxious and without anxious had statistical differences in HAMA、HAMD17 and its factors scores,MDD patients with anxious had higher scores of HAMA、HAMD17 and its factors than those without anxious.MDD patients with anxious and without anxious have significant differences in IL-2、IL-4、TNF-α,MDD patients with anxious have higher IL-2、IL-4、TNF-α levels than patients without anxious.3.The results of correlation analysis in MDD patients with anxious showed that there was a positive correlation between Neut# and HAMA factors.4.Logistic regression analysis showed that age had a positive effect on MDD with anxious.Conclusions:Among MDD patients,most are with anxious.The clinical symptoms of patients with anxious are more severe and older and the IL-2,IL-4,TNF-α level are higher.The Neut# level isassociated with the anxious systoms.