Peripheral sub-inflammation is associated with antidepressant ă consumption in schizophrenia. Results from the multi-center FACE-SZ data ă set
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Objectives: The relation between C-Reactive Protein (CRP), depression ă and antidepressant consumption has been well explored in major ă depressive disorders but not in schizophrenia, which has a high rate of ă depression comorbidity. The objectives of this study were: (i) to ă determine the prevalence of abnormal CRP levels, depression and ă antidepressant consumption in a multicenter community-dwelling sample of ă subjects with schizophrenia (ii) to determine the association between ă abnormal CRP levels, depression and antidepressant consumption in ă schizophrenia. ă Method: 219 stable patients with schizophrenia (mean age=31.6 years, ă 75.3% male gender) were systematically included in the multicentre ă network of FondaMental Expert Center for schizophrenia (FACESZ) and ă assessed with a dedicated electronic medical record including the ă Structured Clinical Interview for DSM-IV Axis I Disorders and Calgary ă Depression Scale for depression. High sensitivity CRP (hs-CRP) was ă measured with an assay using nephelometry (Dade Behring). Abnormal CRP ă level was defined by levels > 3 mg/L. Current medication was recorded. ă Results: Overall, 63 subjects (28.8%) were found to have abnormal CRP ă levels, 43 (20.1%) received a diagnosis of comorbid current depression, ă and 51 (31.9%) had ongoing antidepressant treatment. In univariate ă analysis, abnormal CRP levels were found to be significantly associated ă with body mass index (BMI) (p < 0.0001), hypertriglyceridemia (p ă =0.0015), high waist circumference (p < 0.0001), metabolic syndrome (p= ă 0.0011), abdominal obesity (p < 0.0001) and with antidepressant ă consumption (p= 0.01), while depression, psychotic symptomatology, age ă of onset, illness duration, sociodemographic characteristics, current ă tobacco or cannabis status, hypertension or high fasting glucose were ă not (all p > 0.05). ă In a multivariate model, abnormal CRP was associated with antidepressant ă consumption independently of other confounding variables (adjusted Odds ă Ratio =2.8, 95% confidence interval 1.226.62). Metabolic syndrome was ă also independently associated with abnormal CRP (adjusted Odds Ratio = ă 2.6, 95% confidence interval 1.01-6.71). ă Conclusion: Abnormal CRP levels in schizophrenia were found to be ă associated with antidepressant consumption, but not with depression. The ă potential mechanisms were discussed. Antidepressant consumption should ă be systematically recorded in future studies exploring inflammation in ă schizophrenia. Future clinical trials of interventions directed at ă lowering the level of CRP and other inflammatory markers are discussed. ă (c) 2015 Elsevier BY. All rights reserved.
