Elsevier

Journal of Affective Disorders

Volume 277, 1 December 2020, Pages 940-948
Journal of Affective Disorders

Review article
Depression and inflammation among children and adolescents: A meta-analysis

https://doi.org/10.1016/j.jad.2020.09.025Get rights and content
Under a Creative Commons license
open access

Highlights

  • This meta-analysis of twenty-two studies (20,791 participants) finds that depression is positively associated with concurrent and future inflammation.

  • Inflammation is also a significant predictor of future depression.

  • Results suggest a link between depression and inflammation among children and adolescents and points to the need for future research to disentangle this bidirectional association.

Abstract

Background

Increasing evidence suggests that youth with Major Depressive Disorder (MDD) exhibit early indicators of cardiovascular disease. A leading hypothesized mechanism of this association is via inflammatory pathways, however, results examining this direct association are mixed. Our objective was to synthesize and quantify observational studies examining the association of depression and inflammation among children and adolescents.

Methods

Electronic searches were conducted in MEDLINE, Embase, PsycINFO, and Scopus, yielding 2,757 non-duplicate records from 1946 to 2019. The included studies measured depression or depressive symptoms and examined its association with inflammation in participants younger than 18 years. All relevant articles were reviewed and data extracted by two independent coders. Estimates were examined by using random-effects meta-analysis.

Results

Twenty-two studies (20,791 participants) were included. Significant associations were observed between concurrent depression and CRP (n = 7; r = 0.12; 95% confidence interval [CI] = 0.04 to 0.19), and IL-6 (n = 7; r = 0.17; 95% CI= 0.10 to 0.24). Longitudinal analyses revealed that depression is a significant predictor of IL-6 (n = 3; r = 0.29; 95% CI= 0.04 to 0.50) and conversely, that inflammation (measured by CRP or IL-6) predicts future depression (n = 4; r = 0.04; 95% CI= 0.00 to 0.08).

Limitations

Results are limited by the small number of studies preventing examination of some moderator variables. Findings are correlational, not causal.

Conclusion

Depression is positively associated with concurrent and future inflammation among children and adolescents. Results suggest that bidirectional associations may exist between depression and a pro-inflammatory state.

Keywords

Depression
Depressive symptoms
Inflammation
Cytokines
Children
Adolescents

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