| Reference code: | PT/FB/BL-2006-036.16 |
| Location: | Arquivo PCA - Pasta 18/2006
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Title:
| The effect of stress and antipsychotic treatment on inflammatory and metabolic markers in first-episode psychosis
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| Publication year: | 2009
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URL:
| http://conferenceservices.elsevier.nl/09ecnp/index.cfm?fuseaction=CIS2002&hoofdnav=Search&content=zk.results_all&topicselected=*&searchtext=Aas&what=AUTHOR&selection=ALL&abstrnbr=P.3.a.011
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| Abstract/Results: | ABSTRACT:
BACKGROUND:
The high incidence of metabolic syndrome and physical illness in patients with psychosis has been mainly attributed to the treatment with antipsychotics (Allison and Casey, 2001). However, it has been recently suggested that psychological stress may also play a role in physical illnesses, inducing a chronic inflammatory process which may predispose to the development of metabolic abnormalities and cardiovascular problems (Dinan, 2004; Black, 2003). The aim of this cross-sectional study was to investigate the association between stress, inflammatory and metabolic markers in subjects with first episode psychosis and healthy controls.
METHODS:
We recruited 30 first episode psychosis patients (mean±SEM age: 27.7±1.0 years; gender: 66.7% males) and 30 healthy controls (age: 26.3±0.7 years; gender: 70% males) as part of the large “Genetics And Psychosis” study carried out in South-East London. We collected information about childhood trauma, recent stressful events and perceived stress, using Childhood Experience of Care and Abuse (CECA) questionnaire, the Brief Life Events Questionnaire and the Perceive Stress Scale. We measured weight, height, body mass index (BMI), waist circumference, and collected blood samples to measure leptin, IL-6, TNF-a, HbA1c, total cholesterol, HDL, LDL, triglycerides, hs-CRP levels in all subjects. An independent t-test was used to analyze differences in these parameters between patients and controls. In order to investigate the possible effect of antipsychotic treatment, a one-way ANOVA was conducted to analyze differences in inflammatory and metabolic parameters among controls, patients with less than 2 weeks of antipsychotic treatment and patients with more that 2 weeks of treatment. Correlation analyses were conducted to investigate the association between stress measurements and inflammatory and metabolic parameters. Results are expressed as mean±SEM.
RESULTS:
Patients had higher levels of stress and childhood trauma compared with controls (p < 0.001). Patients showed significantly higher leptin (17.2±3.5 vs 5.7±1.0 ng/ml, p = 0.002) and hsCRP levels (0.6±0.2 vs 0.1±0.1 mg/dl, p = 0.048) while they did not differ significantly in other inflammatory or metabolic parameters. Patients with less than 2 weeks of antipsychotic treatment presented significantly higher IL-6 levels (5.7±2.3 pg/ml) when compared with both patients treated for longer than 2 weeks (1.4±0.3 pg/ml) and controls (1.5±0.4 pg/ml, p = 0.006). Both patients with less and more than 2 weeks of treatment presented higher leptin levels compared with controls (respectively 16.2±8.7, 17.8±2.9 and 5.7±1.0 ng/ml, p = 0.008). The number of stressful life events was significantly positively correlated with triglycerides levels (p = 0.04) and negatively with HDL (p = 0.04) and leptin levels (p = 0.04) in the patients' group. Patients reporting childhood trauma, in particular physical and sexual abuse, had greater weight (p = 0.03) and waist circumference (p = 0.07).
CONCLUSION:
Our findings suggest that an activation of the inflammatory system is already present in early course of psychosis and precedes clinically relevant changes in metabolic status, which have been observed in patients after longer antipsychotic treatment. Stressful events only partially influence metabolic parameters in first episode psychosis, and this effect does not seem mediated by the inflammatory markers explored in this study. Further studies are needed to clarify underlying mechanisms.
Acknowledgement: This research is funded by NARSAD Mental Health Research Association, British Academy, and NIHR Biomedical Research Centre Institute of Psychiatry (King's College London).
REFERENCES:
1. Allison DB, Casey DE (2001). Antipsychotic-induced weight gain: a review of the literature. J Clin Psychiatry, 62(suppl &):22–31.
2. Black PH (2003). The inflammatory response is an integral part of the stress response: Implications for atherosclerosis, insulin resistance, type II diabetes and metabolic syndrome X. Brain Behav Immun, 17(5):350–64.
3. Dinan T (2004). Stress and the genesis of diabetes mellitus in schizophrenia. Br J Psychiatry Suppl, 47:S72–5.
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| Accessibility: | Document does not exist in file
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Language:
| eng
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Author:
| Mondelli, V.
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Secondary author(s):
| Aas, M., Di Forti, M., Fisher, H., Handley, R., Reis Marques, T., Taylor, H., Dazzan, P., Murray, R., Pariante, C.
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Document type:
| Abstract
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Number of reproductions:
| 1
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Reference:
| Mondelli, V., Aas, M., Di Forti, M., Fisher, H., Handley, R., Reis Marques, T., Taylor, H., Dazzan, P., Murray, R., & Pariante, C. (2009). The effect of stress and antipsychotic treatment on inflammatory and metabolic markers in first-episode psychosis. European Neuropsychopharmacology, 19(Suppl. 3), S486-S486.
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| Indexed document: | Yes
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| Keywords: | Neuroleptics / Antipsychotics / Clinical / Schizophrenia / Stress
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