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Persistent level of mental distress in PTSD patients is not reflected in cytokine levels one year after treatment.

H. Toft,J. Bramness,T. Tilden,Ingeborg Bolstad,L. Lien

Published 2021 in Acta Neuropsychiatrica

ABSTRACT

OBJECTIVE Cross-sectional data show that Post-Traumatic Stress Disorder (PTSD) patients often have increased levels of circulating inflammatory markers. There is, however, still a paucity of longitudinal studies with long follow-up times on levels of cytokines in such patients. The current study assesses patients with and without PTSD diagnosis one year after discharge from inpatient treatment. METHODS Patients in treatment for serious non-psychotic mental disorders were recruited at the beginning of their treatment stay at a psychiatric center in Norway. Ninety patients submitted serum samples and filled out the Hopkins Symptom Checklist-90 Revised Global Severity Index (HSCL-90R GSI) questionnaire during their main stay and at a follow-up stay one year after discharge. Of these patients, 33 were diagnosed with PTSD, 48 with anxiety, depression or eating disorder, while nine patients had missing data. The patients were diagnosed using the Mini-International Neuropsychiatric Interview (M.I.N.I.). RESULTS At the follow-up stay (T3), PTSD patients had higher levels of GSI scores than non-PTSD patients (p = 0.048). These levels were unchanged from the year before (T2) in both groups. The levels of circulating cytokines/chemokine did not differ between the PTSD and non-PTSD patients at T3. At T2, however, the PTSD and non-PTSD groups exhibited different levels of IL-1β (p = 0.053), IL-1RA (p = 0.042) and TNF-α (p = 0.037), with the PTSD patients having the higher levels. CONCLUSION Despite exhibiting different mental distress scores, the PTSD and non-PTSD patients did not differ regarding levels of circulating inflammatory markers at one-year follow-up. SIGNIFICANT OUTCOME PTSD and non-PTSD patients show persistently different scores of mental distress one year after psychiatric treatment. In contrast, their cytokine levels do not differ one year after discharge from a psychiatric treatment inpatient stay. LIMITATIONS The patients with higher scores of mental distress were those who attended the follow-up stay, introducing a selection bias to the study. Further, it was not assessed whether the patients were fasting or smoking cigarettes prior to blood collection, or their sleeping or physical exercise status.

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