C-reactive protein: A differential biomarker for major depressive disorder and bipolar II disorder

Hui Hua Chang, Tzu Yun Wang, I. Hui Lee, Sheng Yu Lee, Kao Chin Chen, San Yuan Huang, Yen Kuang Yang, Ru Band Lu, Po See Chen

Research output: Contribution to journalArticlepeer-review

40 Citations (Scopus)


Objectives We aimed to examine whether the C-reactive protein (CRP) level could be used to differentiate between major depressive disorder (MDD) and bipolar II disorder (BD II). Methods Ninety-six healthy controls, 88 BD II and 72 MDD drug-naïve patients in their major depressive episodes were enrolled. The fasting plasma level of high-sensitivity CRP was assessed at baseline and after treatment. Results The BD II patients presented significantly higher 17-item Hamilton Depression Rating Scale (HDRS) scores and CRP levels at baseline when adjustment for age, gender, and body mass index (P < 0.001 and P < 0.001, respectively). After treatment the CRP levels remained significantly different (P < 0.001), although the HDRS score was not significantly different between the BD II and MDD patients. A receiver-operating characteristic analysis showed that a baseline CRP level of 621.6 ng/mL could discriminate between BD II and MDD, with an area under the curve of 0.816 and a sensitivity and specificity of 0.699 and 0.882, respectively. Furthermore, the baseline CRP level greater than 621.6 ng/ml had 28.2 higher odds of a diagnosis of BD II (P < 0.001, 95% confidence interval: 10.96–72.35). Conclusions The level of CRP plays a role of biomarker to differentiate between MDD and BD II depression in both their depressed and euthymic state.

Original languageEnglish
Pages (from-to)63-70
Number of pages8
JournalWorld Journal of Biological Psychiatry
Issue number1
Publication statusPublished - 2017 Jan 2

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health
  • Biological Psychiatry


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