80. Meta-analysis of monocytes and lymphocytes in schizophrenia: Clinical status and antipsychotic effects

Abstract

Background: Schizophrenia is associated with immune dysfunction, including abnormal immune cell parameters. We performed a meta-analysis of these associations, considering effects of clinical status and antipsychotic treatment following acute psychosis. Methods: We identified articles in Pub Med, PsychInfo, and ISI, and associated reference lists. Results: Eighteen studies met the inclusion criteria. Effect sizes were similar in direction and magnitude for studies of acutely relapsed inpatients (AR) and first-episode psychosis (FEP), with a significant increase in CD4 levels and the CD4/CD8 ratio, and decrease in CD3%. CD4/CD8 and CD4 levels appeared to be state-related markers, as they were increased during acute psychosis (AR and FEP) and decreased following antipsychotic treatment. CD56 levels appeared to be a trait marker, as levels remained increased in acute psychosis and following antipsychotic treatment. CD3%, which was significantly decreased in both acute psychosis and stable outpatients, may also be a trait marker. Two studies found an increased proportion of CSF macrophages in acute psychosis. Discussion: Similar effect sizes in AR and FEP suggest an association between immune cell abnormalities and acute psychosis that is independent of antipsychotic medications. While some parameters (CD4 and CD4/CD8) may be state markers for acute psychosis, others (CD56, CD3%) may be trait markers. Although these results could provide the basis for future hypothesis testing, a majority of studies did not control for potential confounding factors.