Associations of interleukin-6 with vegetative but not affective depressive symptoms in terminally ill cancer patients
Associations of interleukin-6 with vegetative but not affective depressive symptoms in terminally ill cancer patients
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DOI：
10.1007/s00520-013-1767-x
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发表时间：
2013-08-01
影响因子：
3.1
通讯作者：
Uchitomi, Yosuke
中科院分区：
文献类型：
--
作者：
Inagaki, Masatoshi;Akechi, Tatsuo;Uchitomi, Yosuke
先前的研究已经报道了抑郁症状与促炎细胞因子，特别是与非癌症受试者和癌症患者中的白细胞介素-6（IL-6）的相关性。同时，当与抑郁症的其他诊断标准相关联时，疲劳和食欲不振等症状可能是抑郁症的植物性症状。这种植物型症状在癌症患者生命的最后6个月内恶化，可能与情感抑郁症状（如悲伤和紧张）无关。本研究探讨了抑郁症状和血浆IL-6之间的关联，在晚期癌症患者的生存期被证实是未来6个月的后续行动，注意植物人和情感抑郁symptoms.Data的差异，从112个连续招募的晚期癌症患者登记在姑息治疗单位没有任何积极的抗癌治疗。采用电化学发光法测定血浆IL-6水平。抑郁症状包括在DSM-IV和卡瓦诺标准进行了评估，通过结构化访谈，并分为情感症状和植物人症状。情感症状也用医院焦虑和抑郁量表的抑郁子量表测量，其中不包括植物性症状。植物性症状，如食欲不振，失眠和疲劳，与IL-6水平显著相关。然而，无论是情感性症状，也不是他们的严重程度与IL-6水平。IL-6与植物性抑郁症状在晚期癌症患者，但不与情感性抑郁症状，这表明这些症状之间的病理生理机制可能存在差异。
Previous studies have reported associations of depressive symptoms with pro-inflammatory cytokines, especially with interleukin-6 (IL-6) in noncancer subjects and cancer patients. Meanwhile, symptoms such as tiredness and appetite loss may be vegetative symptoms of depression when associated with other diagnostic criteria of depression. Such vegetative-type symptoms worsen during the last 6 months of life in cancer patients and may not be associated with affective depressive symptoms such as sadness and nervousness. This study explored associations between depressive symptoms and plasma IL-6 in terminally ill cancer patients whose survival period was confirmed to be less than 6 months by follow-up, with attention to differences in vegetative and affective depressive symptoms.Data from 112 consecutively recruited terminally ill cancer patients who registered at a palliative care unit without any active anticancer treatment were used. Plasma IL-6 levels were measured using an electrochemiluminescence assay. Depressive symptoms included in the DSM-IV and Cavanaugh criteria were assessed by structured interviews and were categorized into affective symptoms and vegetative symptoms. Affective symptoms were also measured with the depression subscale of the Hospital Anxiety and Depression Scale, which does not include vegetative symptoms.Vegetative symptoms, such as appetite loss, insomnia, and fatigue, were significantly associated with IL-6 levels. However, neither of the affective symptoms nor their severity was associated with IL-6 levels.IL-6 was associated with vegetative depressive symptoms in terminally ill cancer patients but not with affective depressive symptoms, suggesting possible differences in the pathophysiological mechanisms between these sets of symptoms.