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Association of high-sensitivity C-reactive protein with de novo major depression

  • Julie A. Pasco (a1), Geoffrey C. Nicholson (a1), Lana J. Williams (a1), Felice N. Jacka (a1), Margaret J. Henry (a1), Mark A. Kotowicz (a1), Hans G. Schneider (a2), Brian E. Leonard (a3) and Michael Berk (a4)...



Although there is cross-sectional evidence that changes in the immune system contribute to the pathophysiology of depression, longitudinal data capable of elucidating cause and effect relationships are lacking.


We aimed to determine whether subclinical systemic inflammation, as measured by serum high-sensitivity C-reactive protein (hsCRP) concentration, is associated with an increased risk of de novo major depressive disorder.


Major depressive disorder was diagnosed using a clinical interview (SCID–I/NP). This is a retrospective cohort study; from a population-based sample of 1494 randomly selected women recruited at baseline during the period 1994–7, 822 were followed for a decade and provided measures of both exposure and outcome. Of these women, 644 (aged 20–84 years) had no prior history of depression at baseline and were eligible for analysis.


During 5827 person-years of follow-up, 48 cases of de novo major depressive disorder were identified. The hazard ratio (HR) for depression increased by 44% for each standard deviation increase in log-transformed hsCRP (ln-hsCRP) (HR = 1.44, 95% CI 1.04–1.99), after adjusting for weight, smoking and use of non-steroidal anti-inflammatory drugs. Further adjustment for other lifestyle factors, medications and comorbidity failed to explain the observed increased risk for depression.


Serum hsCRP is an independent risk marker for de novo major depressive disorder in women. This supports an aetiological role for inflammatory activity in the pathophysiology of depression.

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Corresponding author

Associate Professor Julie A. Pasco, Epidemiology and Biostatistics Unit, Department of Clinical and Biomedical Sciences, Barwon Health, The University of Melbourne, PO Box 281, Geelong 3220, Australia. Email:


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The study was funded by the Victorian Health Promotion Foundation and the National Health and Medical Research Council of Australia.

Declaration of interest

M.B. has received grant/research support from the Stanley Medical Research Foundation, MBF, National Health and Medical Research Council, Beyond Blue, Geelong Medical Research Foundation, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Organon, Novartis, Mayne Pharma, Servier and AstraZeneca. He has been a paid consultant for AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen-Cilag, Lundbeck and Pfizer, and a paid speaker for AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen-Cilag, Lundbeck, Organon, Pfizer, Sanofi Synthelabo, Solvay and Wyeth.



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Association of high-sensitivity C-reactive protein with de novo major depression

  • Julie A. Pasco (a1), Geoffrey C. Nicholson (a1), Lana J. Williams (a1), Felice N. Jacka (a1), Margaret J. Henry (a1), Mark A. Kotowicz (a1), Hans G. Schneider (a2), Brian E. Leonard (a3) and Michael Berk (a4)...


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Association of high-sensitivity C-reactive protein with de novo major depression

  • Julie A. Pasco (a1), Geoffrey C. Nicholson (a1), Lana J. Williams (a1), Felice N. Jacka (a1), Margaret J. Henry (a1), Mark A. Kotowicz (a1), Hans G. Schneider (a2), Brian E. Leonard (a3) and Michael Berk (a4)...
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