Inflammation in young Swedish men and risk of adult-onset depression defined by prescription of antidepressant medications

Abstract: Background: Depression is a major disability that has been studied extensively in regard to systemic inflammation. Cross-sectional studies have shown that systemic inflammatory parameters are raised in individuals with depression, but few studies have explored the longitudinal direction of associations. The aim of this study is to investigate whether heightened ESR-levels during adolescence increases the risk of subsequent depression during adulthood measured by antidepressant medication. Methods: This register-based cohort study included 196,667 Swedish men who were born in 1952 to 1956, attended mandatory military conscription assessments in late adolescence, and were followed up to 2009 through linkages of various national registers. The association between erythrocyte sedimentation rate, measured at conscription examination, and antidepressant treatment in middle age was examined using logistic regression with adjustment for confounding by BMI, stress resilience, socioeconomic index and household crowding. Results: Erythrocyte sedimentation rate was not positively associated with an increased subsequent risk of antidepressant treatment. The characteristics of >18,5 BMI, low stress resilience, lower household crowding and the socioeconomic index belonging to ‘office worker’, were of higher risk for antidepressant treatment. Conclusion: This study shows that the systemic inflammatory marker erythrocyte sedimentation rate is not positively associated with subsequent development of depression defined by antidepressant treatment.