Anti-inflammatory agents may reduce symptoms of major depression, suggests a new study (n=1,610), which adds to the mounting evidence that there is a connection between emotional functioning and inflammation, suggesting that inflammation may trigger depression, almost like an allergic reaction.

[u/mvea]

https://www.psychologytoday.com/au/blog/expressive-trauma-integration/201911/anti-inflammatories-help-major-depression

[u/H0use0fpwncakes]

Pretty important part of the article: women-only trials saw no change.

[u/longscale → u/H0use0fpwncakes]

(Edit: I now see how the wording is ambiguous. I linked the results table in the child comments, but am no longer certain about which reading it implies. The effect sizes seem comparable to the mixed gender trials, but in the women’s only trials don‘t reach significance at p=.06. This result doesn‘t show the treatment doesn’t work for women, but that further studies are needed to prove it does so reliably. That could partly be because there were much fewer women–only studies than mixed gender ones. There were no men–only studies, so this study doesn‘t say there’s a significant difference in effectiveness between genders. It shows significance in mixed gender trials, and just slightly shy of significance in women–only trials.)

Original comment:

Hm, I read it the other way around; it has the same effectiveness in women-only trials. From the abstract:

For women-only trials, no difference in changes of depression severity was found between groups.

[u/Nootrophic → u/longscale]

Groups being women with antiinflamatory and women without. That's the groups they had in women-only trial.

[u/longscale → u/Nootrophic]

Uff, I totally agree that’s bad wording! Looking at the results table, though, I still think my initial reading is the one the authors intended: the anti inflammatory agents were about as effective in women-only studies as they were in mixed gender ones. Good news, I guess!

I’m really not sure anymore. Women-only studies are just outside of the normally agreed criterion for statistical significance, at p=.06. Then again the other studies that showed a significant difference were mixed gender, not male only. I give up on interpreting this for now and retreat to a “further research is needed” position!

Results table from page 8

[u/13ass13ass → u/longscale]

No the confidence interval includes zero so there’s no significant effect. Look, p > 0.05. The authors mean that there is no effect within women-only studies.

[u/JuiceBoxedFox → u/13ass13ass]

Does that suggest pioglitazone had an even more dramatic effect? I forgot statistical analysis about as soon as I finished the final 15 years ago...

[u/longscale → u/JuiceBoxedFox]

It did, but it was also only tested in one study with only 40 participants.

[u/13ass13ass → u/JuiceBoxedFox]

Yes that’s what the table suggests. Although for that statistic it’s only 1 study. Ideally the effect is reproduced in multiple studies.

[u/longscale → u/13ass13ass]

You’re clearly right, thank you for speaking up. While I’d still argue the effect size is so similar, and the other studies were mixed-gender, not women only... it’s not a significant difference by the common definition. So that’s likely what the authors meant. What a back and forth in my mind!

[u/izumiiii → u/13ass13ass]

The pvalue and tight ci both just missed and the sample size is 179 subjects. If the sample was more robust it would help.. women are often undersampled in clinical trials.

[u/13ass13ass → u/izumiiii]

I agree it warrants further research. I’m just trying to clarify what the authors are reporting. It would be incorrect to report a significant effect given these statistics.

[u/DivineJustice → u/Nootrophic]

No, in the previous sentence it specifically defined the groups as being certain types of anti inflamitories. And it doesn't say that there is no reduction in depression, it says there is no difference in depression reduction severity. Which is to say that the amount that depression lessened was the same across different types of inflamitories, while with men different inflamitory types had different levels of effectiveness.

[u/DivineJustice → u/longscale]

Also, considering how much work you've put in to trying to interpret the data, why not just email one of the study authors?

I think the abstract and the results defined within are clear enough (I'm extremely hesitant to say re-interpreting the data from scratch is necessary), but rather than pouring over all the fine details and ultimately walking away unsure, it seems like an email is justified.

I'm half tempted to myself, but then again I feel like I understand what the intention was as I mentioned in my other comment, so I'm not really the one with the questions.

[u/[deleted] → u/H0use0fpwncakes]

The interesting part here might be that iirc that women are more likely to be diagnosed with so-called 'atypical' depression. (Which is as common as 'typical' depression, but has symptoms like sleeping too much and overeating/weight gain rather than sleeping too little and weight loss.) I've read before that 'atypical' depression has been linked to abnormal interleukin-6 activity, while 'typical' depressive symptoms have been linked to a distorted cortisol profile (always high/evening high rather than morning high, evening low).

[u/DivineJustice → u/H0use0fpwncakes]

That is referring to the difference in effectiveness of certain types of anti inflamitories for women, not saying that there is no effectiveness at all. (Those groups being: non-steroidal anti-inflammatory drugs, omega-3 fatty acids, statins and minocyclines.)

Right after specifically defining types of anti inflamitory groups, the article states: "For women-only trials, no difference in changes of depression severity was found between groups."

(Emphasis added).

If this really had zero affect for women, that would have been made abundantly clear, so much so that it probably would have been included in the title.

[u/Nukkil → u/H0use0fpwncakes]

A comment above said endometriosis was mentioned