Inflammatory markers changes following acceptance-based behavioral psychotherapy in generalized anxiety disorder patients: Evidence from a randomized controlled trial

Lucas Gandarela; Thiago P. de A. Sampaio; Lia Marçal; Emmanuel A. Burdmann; Francisco Lotufo Neto; Marcio A. Bernik

doi:10.1016/j.bbih.2024.100779

Brain, Behavior, & Immunity - Health (Jul 2024)

Inflammatory markers changes following acceptance-based behavioral psychotherapy in generalized anxiety disorder patients: Evidence from a randomized controlled trial

Lucas Gandarela,
Thiago P. de A. Sampaio,
Lia Marçal,
Emmanuel A. Burdmann,
Francisco Lotufo Neto,
Marcio A. Bernik

Affiliations

Lucas Gandarela: Experimental Pathophysiology Program, School of Medicine, University of São Paulo, São Paulo, Brazil; Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil; Corresponding author. , Anxiety Disorders Program Institute of Psychiatry, University of São Paulo, R.Dr. Ovidio Pires de Campos, 785 São Paulo, São Paulo, 05403Brazil.
Thiago P. de A. Sampaio: Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil; Department of Clinical Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
Lia Marçal: LIM 12, Division of Nephrology, School of Medicine, University of São Paulo, São Paulo, Brazil
Emmanuel A. Burdmann: LIM 12, Division of Nephrology, School of Medicine, University of São Paulo, São Paulo, Brazil
Francisco Lotufo Neto: Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil; Department of Clinical Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
Marcio A. Bernik: Experimental Pathophysiology Program, School of Medicine, University of São Paulo, São Paulo, Brazil; Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil

DOI: https://doi.org/10.1016/j.bbih.2024.100779
Journal volume & issue: Vol. 38
p. 100779

Abstract

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Introduction: Generalized anxiety disorder (GAD) has been associated with elevated levels of C-reactive protein (CRP) and proinflammatory cytokines. Despite robust evidence as an effective treatment for GAD, research on the effects of cognitive-behavioral therapies (CBT) in the inflammatory profile of patients with clinical anxiety has presented mixed results. Objective: The present study aimed to investigate the effect of an acceptance-based behavior therapy (ABBT) on inflammatory biomarkers and their association with anxiety levels in GAD patients in comparison to supportive therapy as an active control. Methods: Peripheral inflammatory biomarkers (CRP, IL-1β, IL-4, IL-6, IL-10, TNF-α) were measured in 77 GAD patients who participated in a 14-week 10-session randomized clinical trial of group ABBT (experimental, n = 37) or supportive group therapy (ST: active control group, n = 40). Results: The concentrations of IL-1β decreased in the control group and the concentrations of IL-6 increased in the experimental group from baseline to post-treatment, whereas no difference was identified in IL-4, IL-10, TNF, or CRP. Although anxiety and depression levels decreased in both treatment conditions, no correlation with inflammation markers was found for most clinical and biological variables. A negative correlation between changes in IL-6 and IL-10 and anxiety symptom score changes was identified. Conclusions: The present study results found that a short trial of acceptance-based behavior therapy did not change the proinflammatory profile which may be associated with GAD. Additional research is needed to evaluate the influence of other inflammation-related variables, longer periods of follow-up as well as the effect of supportive therapy on peripheral inflammatory biomarkers in GAD patients.

Published in Brain, Behavior, & Immunity - Health

ISSN: 2666-3546 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry
Website: https://www.journals.elsevier.com/brain-behavior-and-immunity-health

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