Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 20
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Au, Bonnie Smith, Kimberley J. Gariépy, Geneviève and Schmitz, Norbert 2015. The longitudinal associations between C-reactive protein and depressive symptoms: evidence from the English Longitudinal Study of Ageing (ELSA). International Journal of Geriatric Psychiatry, Vol. 30, Issue. 9, p. 976.

    Courtet, Ph. Jaussent, I. Genty, C. Dupuy, A.M. Guillaume, S Ducasse, D. and Olié, E. 2015. Increased CRP levels may be a trait marker of suicidal attempt. European Neuropsychopharmacology, Vol. 25, Issue. 10, p. 1824.

    Maleki, Ali Samandari, Saeid Almeida, Osvaldo Jafarian Kerman, Scott Reza Abdolvand, Mahdi Aliyari, Farshid and Foroughi, Saeid 2014. Correlation Between Hypertension, C-Reactive Protein and Serum Uric Acid With Psychological Well-being. Iranian Red Crescent Medical Journal, Vol. 16, Issue. 7,

    Park, Soyeon Joo, Yeon Ho McIntyre, Roger S. and Kim, Byungsu 2014. Metabolic Syndrome and Elevated C-Reactive Protein Levels in Elderly Patients With Newly Diagnosed Depression. Psychosomatics, Vol. 55, Issue. 6, p. 640.

    Nunes, Sandra Odebrecht Vargas Vargas, Heber Odebrecht Prado, Eduardo Barbosa, Decio Sabbatini de Melo, Luiz Picoli Moylan, Steven Dodd, Seetal and Berk, Michael 2013. The shared role of oxidative stress and inflammation in major depressive disorder and nicotine dependence. Neuroscience & Biobehavioral Reviews, Vol. 37, Issue. 8, p. 1336.

    Odebrecht Vargas, Heber Vargas Nunes, Sandra Odebrecht Pizzo de Castro, Marcia Cristina Bortolasci, Chiara Sabbatini Barbosa, Décio Kaminami Morimoto, Helena Venugopal, Kamalesh Dodd, Seetal Maes, Michael and Berk, Michael 2013. Oxidative stress and lowered total antioxidant status are associated with a history of suicide attempts. Journal of Affective Disorders, Vol. 150, Issue. 3, p. 923.

    Wium-Andersen, M K Ørsted, D D and Nordestgaard, B G 2013. Association between elevated plasma fibrinogen and psychological distress, and depression in 73 367 individuals from the general population. Molecular Psychiatry, Vol. 18, Issue. 8, p. 854.

    Naismith, Sharon L. Norrie, Louisa M. Mowszowski, Loren and Hickie, Ian B. 2012. The neurobiology of depression in later-life: Clinical, neuropsychological, neuroimaging and pathophysiological features. Progress in Neurobiology, Vol. 98, Issue. 1, p. 99.

    Soberg, Helene L. Finset, Arnstein Roise, Olav and Bautz-Holter, Erik 2012. The Trajectory of Physical and Mental Health From Injury to 5 Years After Multiple Trauma: A Prospective, Longitudinal Cohort Study. Archives of Physical Medicine and Rehabilitation, Vol. 93, Issue. 5, p. 765.

    Almeida, Osvaldo P. 2011. Evolution, depression and the interplay between chance and choices. International Psychogeriatrics, Vol. 23, Issue. 07, p. 1021.

    Almeida, Osvaldo P. Alfonso, Helman Yeap, Bu B. Hankey, Graeme and Flicker, Leon 2011. Complaints of difficulty to fall asleep increase the risk of depression in later life: The health in men study. Journal of Affective Disorders, Vol. 134, Issue. 1-3, p. 208.

    Johansson, Peter Lesman-Leegte, Ivonne Svensson, Erland Voors, Adriaan van Veldhuisen, Dirk J. and Jaarsma, Tiny 2011. Depressive symptoms and inflammation in patients hospitalized for heart failure. American Heart Journal, Vol. 161, Issue. 6, p. 1053.

    Veen, Gerthe Giltay, Erik J. van Vliet, Irene M. DeRijk, Roel H. Klaassens, Ellen R. van Pelt, Johannes and Zitman, Frans G. 2011. C-reactive protein polymorphisms are associated with the cortisol awakening response in basal conditions in human subjects. Stress, Vol. 14, Issue. 2, p. 128.

    Almeida, O. P. Norman, P. E. Allcock, R. Bockxmeer, F. v. Hankey, G. J. Jamrozik, K. and Flicker, L. 2009. Polymorphisms of the CRP gene inhibit inflammatory response and increase susceptibility to depression: The Health in Men Study. International Journal of Epidemiology, Vol. 38, Issue. 4, p. 1049.

    Howren, M Bryant Lamkin, Donald M. and Suls, Jerry 2009. Associations of Depression With C-Reactive Protein, IL-1, and IL-6: A Meta-Analysis. Psychosomatic Medicine, Vol. 71, Issue. 2, p. 171.

    Maas, D. W. van der Mast, R. C. and de Craen, A. J. M. 2009. Increased C-reactive protein is not associated with apathy: the Leiden 85-Plus Study. International Journal of Geriatric Psychiatry, Vol. 24, Issue. 11, p. 1177.

    McNamara, Robert K. 2009. Membrane Omega-3 Fatty Acid Deficiency as a Preventable Risk Factor for Comorbid Coronary Heart Disease in Major Depressive Disorder. Cardiovascular Psychiatry and Neurology, Vol. 2009, p. 1.

    Norman, P. E Flicker, L. Almeida, O. P Hankey, G. J Hyde, Z. and Jamrozik, K. 2009. Cohort Profile: The Health In Men Study (HIMS). International Journal of Epidemiology, Vol. 38, Issue. 1, p. 48.

    Pikhart, Hynek Hubacek, Jaroslav A. Kubinova, Ruzena Nicholson, Amanda Peasey, Anne Capkova, Nada Poledne, Rudolf and Bobak, Martin 2009. Depressive symptoms and levels of C-reactive protein. Social Psychiatry and Psychiatric Epidemiology, Vol. 44, Issue. 3, p. 217.

    Kohn, Robert Gum, Amber M and King-Kallimanis, Bellinda 2008. Mood Disorders in Later Life.


The association between C-reactive protein concentration and depression in later life is due to poor physical health: results from the Health in Men Study (HIMS)

  • OSVALDO P. ALMEIDA (a1) (a2), PAUL NORMAN (a1) (a3), GRAEME J. HANKEY (a1) (a4), KONRAD JAMROZIK (a5) and LEON FLICKER (a1) (a4)
  • DOI:
  • Published online: 01 May 2007

C-reactive protein (CRP) is a non-specific marker of inflammation that has been associated with depression and vascular disease, particularly in men. This study aimed to investigate the association between high CRP concentration and depression while taking physical health into account.


A cross-sectional study of a community-dwelling sample of 5438 men aged 70+. Participants with scores ⩾7 on the 15-item Geriatric Depression Scale (GDS-15) were considered to display clinically significant depressive symptoms. We measured the serum concentration of CRP with a high-sensitivity assay. The assessment of physical co-morbidity included three components: the Charlson weighted index, self-report of major health events on a standardized questionnaire, and the physical component of the 36-item Short-Form Health Survey (SF-36). Other measured factors included age, native language, education, a standardized socio-economic index, smoking, prior or current history of depression treatment, cognitive impairment (Mini-Mental State Examination score <24) and body mass index (BMI).


Participants with depression (n=340) were older than their controls without depression (age in years: 76·6±4·4 v. 75·4±4·1). Men with CRP concentration >3 mg/l had an increased odds ratio (OR) [1·59, 95% confidence interval (CI) 1·20–2·11] of being depressed compared to men with CRP ⩽3 mg/l. This association became non-significant once we adjusted the analysis for the measures of physical co-morbidity and other confounding factors (OR 1·22, 95% CI 0·86–1·73).


The physiological mechanisms that lead to the onset and maintenance of depressive symptoms in older men remain to be determined, but CRP concentration is unlikely to play a significant role in that process.

Corresponding author
*Address for correspondence: Professor Osvaldo P. Almeida, WA Centre for Health and Ageing (M573), University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

G. S. Alexopoulos , B. S. Meyers , R. C. Young , S. Campbell , D. Silbersweig & M. Charlson (1997). ‘Vascular depression’ hypothesis. Archives of General Psychiatry 54, 915922.

O. P. Almeida & S. A. Almeida (1999). Short versions of the Geriatric Depression Scale: a study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV. International Journal of Geriatric Psychiatry 14, 858865.

O. P. Almeida , L. Flicker , P. N. Norman , G. J. Hankey , S. Vasikaran , F. van Bockxmeer & K. Jamrozik (2007). Association of ardiovascular risk factors and disease with depression in later life. American Journal of Geriatric Psychiatry. Published online: 8 December 2006. doi: 10.1097/01.JGP.0000246869.49892.77.

M. E. Charlson , P. Pompei , K. L. Ales & C. R. MacKenzie (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Diseases 40, 373383.

R. M. Crum , J. C. Anthony , S. S. Bassett & M. F. Folstein (1993). Population-based norms for the Mini-Mental State Examination by age and educational level. Journal of the American Medical Association 269, 23862391.

J. Danesh , J. G. Wheeler , G. M. Hirschfield , S. Eda , G. Eiriksdottir , A. Rumley , G. D. O. Lowe , M. B. Pepys & V. Gudnason (2004). C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. New England Journal of Medicine 350, 13871397.

M. Danner , S. V. Kasl , J. L. Abramson & V. Vaccarino (2003). Association between depression and elevated C-reactive protein. Psychosomatic Medicine 65, 347356.

K. M. Douglas , A. J. Taylor & P. G. O'Malley (2004). Relationship between depression and C-reactive protein in a screening population. Psychosomatic Medicine 66, 679683.

M. F. Folstein , S. E. Folstein & P. R. McHugh (1975). Mini-mental State: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189198.

D. E. Ford & T. P. Erlinger (2004). Depression and C-reactive protein in US adults: data from the Third National Health and Nutrition Examination Study. Archives of Internal Medicine 164, 10101014.

T. L. Gruenewald , T. E. Seeman , C. D. Ryff , A. S. Karlamangla & B. H. Singer (2006). Combinations of biomarkers predictive of later life mortality. Proceedings of the National Academy of Sciences USA 103, 1415814163.

C. D. Holman , A. J. Bass , I. L. Rouse & M. S. Hobbs (1999). Population-based linkage of health records in Western Australia: development of a health services research linked database. Australian and New Zealand Journal of Public Health 23, 453459.

W. J. Kop , J. S. Gottdiener , C. M. Tangen , L. P. Fried , M. A. McBurnie , J. Walston , A. Newman , C. Hirsch & R. P. Tracy (2002). Inflammation and coagulation factors in persons >65 years of age with symptoms of depression but without evidence of myocardial ischemia. American Journal of Cardiology 89, 419424.

H. K. Kuo , C. J. Yen , C. H. Chang , C. K. Kuo , J. H. Chen & F. Sorond (2005). Relation of C-reactive protein to stroke, cognitive disorders and depression in the general population: systematic review and meta-analysis. Lancet Neurology 4, 371380.

S. Lanquillon , J. C. Krieg , U. Bening-Abu-Shach & H. Vedder (2000). Cytokine production and treatment response in major depressive disorder. Neuropsychopharmacology 22, 370379.

T. Liukkonen , S. Silvennoinen-Kassinen , J. Jokelainen , P. Rasanen , M. Leinonen , V. B. Meyer-Rochow & M. Timonen (2006). The association between C-reactive protein levels and depression: results from the Northern Finland 1966 Birth Cohort Study. Biological Psychiatry 60, 825830.

E. B. Loucks , L. F. Berkman , T. L. Gruenewald & T. E. Seeman (2006). Relation of social integration to inflammatory marker concentrations in men and women 70 to 79 years. American Journal of Cardiology 97, 10101016.

D. B. Panagiotakos , C. Pitsavos , C. Chrysohoou , E. Tsetsekou , C. Papageorgiou , G. Christodoulou & C. Stefanadis ; ATTICA study (2004). Inflammation, coagulation, and depressive symptomatology in cardiovascular disease-free people: the ATTICA study. European Heart Journal 25, 492499.

T. A. Pearson , G. A. Mensah , R. W. Alexander , J. L. Anderson , R. O. Cannon 3rd, M. Criqui , Y. Y. Fadl , S. P. Fortmann , Y. Hong , G. L. Myers , N. Rifai , S. C. Smith Jr., K. Taubert , R. P. Tracy & F. Vinicor (2003). Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 107, 499511.

B. W. J. H. Penninx , S. B. Kritchevsky , K. Yaffe , A. B. Newman , E. M. Simonsick , S. Rubin , L. Ferrucci , T. Harris & M. Pahor (2003). Inflammatory markers and depressed mood in older persons: results from the Health, Aging and Body Composition Study. Biological Psychiatry 54, 566572.

H. Quan , V. Sundararajan , P. Halfon , A. Fong , B. Burnand , J. C. Luthi , L. D. Saunders , C. A. Beck , T. E. Feasby & W. A. Ghali (2005). Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Medical Care 43, 11301139.

C. L. Raison , L. Capuron & A. H. Miller (2006). Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends in Immunology 27, 2431.

D. Regier , J. Boyd , J. D. Burke Jr., D. S. Rae , J. K. Myers , M. Kramer , L. N. Robins , L. K. George , M. Karno & B. Z. Locke (1988). One-month prevalence of mental disorders in the United States. Archives of General Psychiatry 45, 977986.

P. M. Ridker , M. Cushman , M. J. Stampfer , R. P. Tracy & C. H. Hennekens (1997). Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. New England Journal of Medicine 336, 973979.

E. C. Suarez (2004). C-reactive protein is associated with psychological risk factors of cardiovascular disease in apparently healthy adults. Psychosomatic Medicine 66, 684691.

H. Tiemeier , A. Hofman , H. R. van Tuijl , A. J. Kiliaan , J. Meijer & M. Breteler (2003 a). Inflammatory proteins and depression in the elderly. Epidemiology 14, 103107.

A. J. Thomas , S. Davis , C. Morris , E. Jackson , R. Harrison & J. T. O'Brien (2005). Increase in interleukin-1β in late-life depression. American Journal of Psychiatry 162, 175177.

A. J. Thomas , R. N. Kalaria & J. T. O'Brien (2004). Depression and vascular disease: what is the relationship? Journal of Affective Disorders 79, 8195.

J. Walston , A. McBurnie , A. Newman , R. P. Tracy , W. J. Kop , C. H. Hirsch , J. Gottdiener & L. P. Fried (2002). Frailty and activation of the inflammation and coagulation systems with and without clinical comorbidities: results from the Cardiovascular Health Study. Archives of Internal Medicine 162, 23332341.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *