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. 2023 Feb 16:13:20451253221135463.
doi: 10.1177/20451253221135463. eCollection 2023.

Serum cytokine variations among inpatients with major depression, bipolar disorder, and schizophrenia versus healthy controls: a prospective 'true-to-life' study

Antonio Augusto Schmitt Junior  1   2   3   4 , Lucas Primo de Carvalho Alves  5 , Barbara Larissa Padilha  2   5   6 , Neusa Sica da Rocha  1   7   3   5   6
Affiliations

Serum cytokine variations among inpatients with major depression, bipolar disorder, and schizophrenia versus healthy controls: a prospective 'true-to-life' study

Antonio Augusto Schmitt Junior et al. Ther Adv Psychopharmacol. .

Abstract

Background: There is increasing evidence of the association between chronic low-grade inflammation and severe mental illness (SMI). The objective of our study was to assess serum cytokine levels (SCLs) at admission and discharge in a true-to-life-setting population of inpatients with major depression (MD), bipolar disorder (BD), and schizophrenia (Sz), as well as of healthy controls.

Methods: We considered MD, BD, and Sz to be SMIs. We evaluated 206 inpatients [MD, N = 92; BD, N = 26; mania (Ma), N = 44; Sz, N = 44). Generalized estimating equations were used to analyze variations in SCL [interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin (IL)-2, IL-4, IL-6, IL-10, and IL-17] at hospital admission and discharge. Results of 100 healthy controls were compared with those of SMI patients at both time points. We evaluated patients' improvement during in-hospital treatment in terms of general psychiatric symptoms, global clinical impression, functionality, and manic and depressive symptoms with validated scales.

Results: In all, 68.9% of patients completed the study. Overall, SMI inpatients had higher SCL when compared with controls regardless of diagnosis. There was a significant decrease in Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression-Severity Scale (CGI-S) scores, and an increase in Global Assessment of Functioning (GAF) scores for all disorders evaluated (p < 0.001), as well as a significant decrease in HDRS-17 scores among MD inpatients (p < 0.001) and in YMRS scores among Ma inpatients (p < 0.001). IL-2 and IL-6 levels decreased significantly between admission and discharge only among MD inpatients (p = 0.002 and p = 0.03, respectively). We found no further statistically significant changes in SCL among the remaining disorders (BD, Ma, and Sz). There was no significant decrease in IFN-γ (p = 0.64), TNF-α (p = 0.87), IL-4 (p = 0.21), IL-10 (p = 0.88), and IL-17 (p = 0.71) levels in any of the evaluated diagnoses.

Conclusion: MD inpatients had a decrease in IL-2 and IL-6 levels during hospitalization, which was accompanied by clinical improvement. No associations were found for the remaining SMIs (BD, Ma, and Sz).

Keywords: cytokines; inflammation; major depression.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Clinical improvement in different patient subgroups. BPRS, Brief Psychiatric Rating Scale; CGI, Clinical Global Impression–Severity Scale; GAF, Global Assessment of Functioning.
Figure 2.
Figure 2.
Serum cytokine level alterations in different patient subgroups. CI, confidence interval; IFN-γ, interferon gamma; IQR, interquartile range; IL, interleukin, TNF-α: tumor necrosis factor alpha.
See this image and copyright information in PMC

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References

    1. Vancampfort D, Stubbs B, Mitchell AJ, et al.. Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis. World Psychiatry 2015; 14: 339–347. - PMC - PubMed
    1. Reininghaus U, Dutta R, Dazzan P, et al.. Mortality in schizophrenia and other psychoses: a 10-year follow-up of the ÆsOP first-episode cohort. Schizophrenia Bulletin 2015; 41: 664–673. - PMC - PubMed
    1. Osborn DPJ, Levy G, Nazareth I, et al.. Relative risk of cardiovascular and cancer mortality in people with severe mental illness from the United Kingdom’s General Practice Research Database. Arch Gen Psych 2007; 64: 242–249. - PubMed
    1. Chang CK, Hayes RD, Perera G, et al.. Life expectancy at birth for people with serious mental illness and other major disorders from a secondary mental health care case register in London. PLoS ONE 2011; 6: e19590. - PMC - PubMed
    1. Lawrence D, Hancock KJ, Kisely S. The gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: retrospective analysis of population based registers. BMJ (Online) 2013; 346: 7909. - PMC - PubMed