PTSD patients show increasing cytokine levels during treatment despite reduced psychological distress

Helge Toft,1,2 Jørgen G Bramness,1,3 Lars Lien,1,4 Dawit S Abebe,1,5 Bruce E Wampold,6,7 Terje Tilden,6 Knut Hestad,4,8,9 Sudan Prasad Neupane1,10 1Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Ottestad, Norway; 2Ins...

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Autores principales: Toft H, Bramness JG, Lien L, Abebe DS, Wampold BE, Tilden T, Hestad KA, Neupane SP
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Publicado: Dove Medical Press 2018
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Acceso en línea:https://doaj.org/article/b29589b3851b428fb3f76b4ca906fca4
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spelling oai:doaj.org-article:b29589b3851b428fb3f76b4ca906fca42021-12-02T04:21:53ZPTSD patients show increasing cytokine levels during treatment despite reduced psychological distress1178-2021https://doaj.org/article/b29589b3851b428fb3f76b4ca906fca42018-09-01T00:00:00Zhttps://www.dovepress.com/ptsd-patients-show-increasing-cytokine-levels-during-treatment-despite-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Helge Toft,1,2 Jørgen G Bramness,1,3 Lars Lien,1,4 Dawit S Abebe,1,5 Bruce E Wampold,6,7 Terje Tilden,6 Knut Hestad,4,8,9 Sudan Prasad Neupane1,10 1Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Ottestad, Norway; 2Institute of Clinical Medicine, University of Oslo, Oslo, Norway; 3Institute of Clinical Medicine, UiT, Norway's Arctic University, Tromsø, Norway; 4Department of Health Studies, Inland Norway University of Applied Sciences, Elverum, Norway; 5Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway; 6Research Institute, Modum Psychiatric Center, Vikersund, Norway; 7Department of Counseling Psychology, University of Wisconsin-Madison, Madison, WI, USA; 8Department of Research, Innlandet Hospital Trust, Brumunddal, Norway; 9Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; 10Norwegian Center for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Oslo, Norway Background: A reciprocal relationship between activated innate immune system and changes in mood and behavior has been established. There is still a paucity of knowledge on how the immune system responds during psychiatric treatment. We aimed to explore circulating cytokines and assess psychiatric symptom severity scores during 12 weeks of inpatient psychiatric treatment. Methods: The study was a longitudinal assessment of 124 patients (88 women and 36 men) in treatment at Modum Psychiatric Center, Norway. The patient sample comprised a mixed psychiatric population of whom 39 were diagnosed with posttraumatic stress disorder (PTSD). Serum blood samples for cytokine analysis and measures of mental distress using Global Severity Index were collected at admission (T0), halfway (T1), and before discharge (T2). Other factors assessed were age, gender, and the use of antidepressants and anti-inflammatory drugs. Multilevel modeling was used for longitudinal analyses to assess the repeated cytokine samples within each patient. Results: Overall level of IL-1RA was higher in PTSD patients when compared to those without PTSD (P=0.021). The level of IL-1β, MCP-1, and TNF-α increased over time in PTSD compared to non-PTSD patients (P=0.025, P=0.011 and P=0.008, respectively). All patients experienced reduced mental distress as measured by self-reported Global Severity Index scores. Stratified analysis showed that PTSD patients who used anti-inflammatory drugs had higher levels of IL-1β (P=0.007) and TNF-α (P=0.049) than PTSD patients who did not use such drugs. Conclusion: The study indicates that traumatized patients may have a distinct neuroimmune development during recovery. Their activated immune system shows even further activation during their rehabilitation despite symptom reduction. Keywords: cytokines, trauma, inflammation, PTSD, immune activationToft HBramness JGLien LAbebe DSWampold BETilden THestad KANeupane SPDove Medical PressarticleCytokinestraumainflammationPTSDimmune activationNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 14, Pp 2367-2378 (2018)
institution DOAJ
collection DOAJ
language EN
topic Cytokines
trauma
inflammation
PTSD
immune activation
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
spellingShingle Cytokines
trauma
inflammation
PTSD
immune activation
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Toft H
Bramness JG
Lien L
Abebe DS
Wampold BE
Tilden T
Hestad KA
Neupane SP
PTSD patients show increasing cytokine levels during treatment despite reduced psychological distress
description Helge Toft,1,2 Jørgen G Bramness,1,3 Lars Lien,1,4 Dawit S Abebe,1,5 Bruce E Wampold,6,7 Terje Tilden,6 Knut Hestad,4,8,9 Sudan Prasad Neupane1,10 1Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Ottestad, Norway; 2Institute of Clinical Medicine, University of Oslo, Oslo, Norway; 3Institute of Clinical Medicine, UiT, Norway's Arctic University, Tromsø, Norway; 4Department of Health Studies, Inland Norway University of Applied Sciences, Elverum, Norway; 5Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway; 6Research Institute, Modum Psychiatric Center, Vikersund, Norway; 7Department of Counseling Psychology, University of Wisconsin-Madison, Madison, WI, USA; 8Department of Research, Innlandet Hospital Trust, Brumunddal, Norway; 9Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; 10Norwegian Center for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Oslo, Norway Background: A reciprocal relationship between activated innate immune system and changes in mood and behavior has been established. There is still a paucity of knowledge on how the immune system responds during psychiatric treatment. We aimed to explore circulating cytokines and assess psychiatric symptom severity scores during 12 weeks of inpatient psychiatric treatment. Methods: The study was a longitudinal assessment of 124 patients (88 women and 36 men) in treatment at Modum Psychiatric Center, Norway. The patient sample comprised a mixed psychiatric population of whom 39 were diagnosed with posttraumatic stress disorder (PTSD). Serum blood samples for cytokine analysis and measures of mental distress using Global Severity Index were collected at admission (T0), halfway (T1), and before discharge (T2). Other factors assessed were age, gender, and the use of antidepressants and anti-inflammatory drugs. Multilevel modeling was used for longitudinal analyses to assess the repeated cytokine samples within each patient. Results: Overall level of IL-1RA was higher in PTSD patients when compared to those without PTSD (P=0.021). The level of IL-1β, MCP-1, and TNF-α increased over time in PTSD compared to non-PTSD patients (P=0.025, P=0.011 and P=0.008, respectively). All patients experienced reduced mental distress as measured by self-reported Global Severity Index scores. Stratified analysis showed that PTSD patients who used anti-inflammatory drugs had higher levels of IL-1β (P=0.007) and TNF-α (P=0.049) than PTSD patients who did not use such drugs. Conclusion: The study indicates that traumatized patients may have a distinct neuroimmune development during recovery. Their activated immune system shows even further activation during their rehabilitation despite symptom reduction. Keywords: cytokines, trauma, inflammation, PTSD, immune activation
format article
author Toft H
Bramness JG
Lien L
Abebe DS
Wampold BE
Tilden T
Hestad KA
Neupane SP
author_facet Toft H
Bramness JG
Lien L
Abebe DS
Wampold BE
Tilden T
Hestad KA
Neupane SP
author_sort Toft H
title PTSD patients show increasing cytokine levels during treatment despite reduced psychological distress
title_short PTSD patients show increasing cytokine levels during treatment despite reduced psychological distress
title_full PTSD patients show increasing cytokine levels during treatment despite reduced psychological distress
title_fullStr PTSD patients show increasing cytokine levels during treatment despite reduced psychological distress
title_full_unstemmed PTSD patients show increasing cytokine levels during treatment despite reduced psychological distress
title_sort ptsd patients show increasing cytokine levels during treatment despite reduced psychological distress
publisher Dove Medical Press
publishDate 2018
url https://doaj.org/article/b29589b3851b428fb3f76b4ca906fca4
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