Generalized anxiety and C-reactive protein levels: a prospective, longitudinal analysis.

Journal Article (Journal Article)

BACKGROUND: Generalized anxiety disorder (GAD) is highly co-morbid with depression. Depression is associated with elevated levels of the inflammation marker C-reactive protein (CRP), cross-sectionally and over time. To date, no studies have looked at the association between CRP and GAD. METHOD: A total of nine waves of data from the prospective population-based Great Smoky Mountains Study (n=1420) were used, covering children in the community aged 9-16, 19 and 21 years old. Structured interviews were used at each assessment to assess GAD symptoms, diagnosis and cumulative episodes. Blood spots were collected and assayed for high-sensitivity CRP levels. RESULTS: GAD was associated with increased levels of CRP in bivariate cross-sectional analyses. These bivariate associations, however, were attenuated after accounting for demographic, substance-use and health-related covariates. In longitudinal models, there was little evidence that CRP predicted later GAD. Associations from GAD to later CRP were attenuated in models adjusted for health-related coavariates and there was evidence that the GAD-CRP association was mediated by body mass index (BMI) and medication use. CONCLUSIONS: Similar to depression, GAD was associated with elevated levels of CRP, but the effect of GAD on CRP levels was explained by the effect of GAD on health-related behaviors such as BMI and medication use. This study suggests differences in the association between inflammation and depression and GAD.

Full Text

Duke Authors

Cited Authors

  • Copeland, WE; Shanahan, L; Worthman, C; Angold, A; Costello, EJ

Published Date

  • December 2012

Published In

Volume / Issue

  • 42 / 12

Start / End Page

  • 2641 - 2650

PubMed ID

  • 22716910

Pubmed Central ID

  • PMC3449031

Electronic International Standard Serial Number (EISSN)

  • 1469-8978

Digital Object Identifier (DOI)

  • 10.1017/S0033291712000554


  • eng

Conference Location

  • England