Evaluating the Inflammatory Status of Patients

December 5, 2017
Rakesh Jain

In this occasional feature on Psych Congress Network, members of the Psych Congress Steering Committee answer questions asked by audience members at Psych Congress meetings.

QUESTION: How do we evaluate a patient’s inflammatory status? Check C-reactive protein? Interleukin-6? Other signs or symptoms?

Your Questions AnsweredANSWER: This is a very good and pertinent question for the clinician who wants to be on the cutting edge of mental health care delivery. It is indeed true that inflammation plays a significant role in the pathogenesis of major depression. Multiple studies point to its importance in many, but not all, patients who suffer from major depression. And in particular, C-reactive protein and interleukin-6 (IL-6) have been implicated. At the moment, the data for both of these inflammatory markers is at group level, and not at individual patient level. They are not yet ready for "prime time" utilization in clinical practice.

The other part of your question is intriguing. Here are a few pointers. Obesity can be a marker for heightened inflammatory status, as can multiple failures on antidepressants. And needless to say, the presence of inflammatory disorders such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, etc. can be a clear marker for the presence of heightened inflammation.

There is emerging evidence that 3 things in particular can be helpful as anti-inflammatory interventions—physical exercise, regular mindfulness practice, and optimizing sleep. So as you can see, while evaluating individual patients’ inflammatory status may not yet be ready for utilization, it is perfectly reasonable to start recommending these nonpharmacological interventions that serve a double purpose—that being to help with mood, and to serve as anti-inflammatory interventions.

— Psych Congress cochair Rakesh Jain, MD, MPH, Clinical Professor, Department of Psychiatry, Texas Tech Health Sciences Center School of Medicine, Midland


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