UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

A systematic review and meta-analysis of the association between peripheral inflammatory cytokines and generalised anxiety disorder

Costello, H; Gould, R; Abrol, E; Howard, R; (2019) A systematic review and meta-analysis of the association between peripheral inflammatory cytokines and generalised anxiety disorder. BMJ Open , 9 (7) , Article e027925. 10.1136/bmjopen-2018-027925. Green open access

[thumbnail of Abrol_e027925.full.pdf]
Preview
Text
Abrol_e027925.full.pdf - Published Version

Download (1MB) | Preview

Abstract

Objective: Inflammation has been implicated in the aetiology of mental illness. We conducted the first systematic review and meta-analysis of the association between peripheral markers of inflammation and generalised anxiety disorder (GAD). Design: Systematic review and meta-analysis of studies measuring peripheral cytokine levels in people with GAD compared to controls. Data sources: MEDLINE(1950–), EMBASE(1947-), PsycINFO(1872–) and Web of Science(1945–) databases up until January 2018. Eligibility criteria: Primary, quantitative research studies of people with a diagnosis of GAD assessed using a standardised clinical interview that measured peripheral inflammatory markers. Data extraction and synthesis: Two independent reviewers extracted data and assessed study quality. Meta-analysis using a random-effects model was conducted for individual cytokines where data from three or more studies were available. Results: 14/1718 identified studies met inclusion criteria, comprising 1188 patients with GAD and 10,623 controls. In total 16 cytokines were evaluated. Significantly raised levels of CRP, IFN-γ and TNF-α were reported in GAD patients compared to controls in two or more studies. Ten further pro-inflammatory cytokines were reported to be significantly raised in GAD in at least one study. However, 5/14 studies found no difference in levels of at least one cytokine. Only CRP studies reported sufficient data for meta-analysis. CRP was significantly higher in people with GAD compared to controls, with a small effect size (Cohen’s d = 0.38, 0.06-0.69), comparable to that reported in schizophrenia. However, heterogeneity was high (I 2= 75%), in keeping with meta-analyses of inflammation in other psychiatric conditions and reflecting differences in participant medication use, co-morbid depression and cytokine sampling methodology. Conclusion: There is preliminary evidence to suggest an inflammatory response in GAD, but it remains unclear whether inflammatory cytokines play a role in aetiology. GAD remains a poorly studied area of neuroinflammation compared to other mental disorders and further longitudinal studies are required.

Type: Article
Title: A systematic review and meta-analysis of the association between peripheral inflammatory cytokines and generalised anxiety disorder
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjopen-2018-027925
Publisher version: https://doi.org/10.1136/bmjopen-2018-027925
Language: English
Additional information: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Institute of Cognitive Neuroscience
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10075207
Downloads since deposit
94Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item