Abstract
This meta-analysis on peripheral blood compounds in drug-naïve first-episode patients with either schizophrenia or major depressive disorder (MDD) examined which compounds change following psychopharmacological treatment. The Embase, PubMed and PsycINFO databases were systematically searched for longitudinal studies reporting measurements of blood compounds in drug-naïve first-episode schizophrenia or MDD. For this random-effects meta-analysis, we retrieved a total of 31 studies comprising 1818 schizophrenia patients, and 14 studies comprising 469 MDD patients. Brain-derived neurotrophic factor (BDNF) increased following treatment in schizophrenia (Hedges' g (g): 0.55; 95% confidence interval (CI) 0.39-0.70; p < 0.001) and MDD (g: 0.51; CI 0.06-0.96; p = 0.027). Interleukin (IL)-6 levels decreased in schizophrenia (g: -0.48; CI -0.85 to -0.11; p = 0.011), and for MDD a trend of decreased IL-6 levels was observed (g: -0.39; CI -0.87 to 0.09; p = 0.115). Tumor necrosis factor alpha (TNFα) also decreased in schizophrenia (g: -0.34; CI -0.68 to -0.01; p = 0.047) and in MDD (g: -1.02; CI -1.79 to -0.25; p = 0.009). Fasting glucose levels increased only in schizophrenia (g: 0.26; CI 0.07-0.44; p = 0.007), but not in MDD. No changes were found for C-reactive protein, IL-1β, IL-2 and IL-4. Psychopharmacological treatment has modulating effects on BDNF and TNFα in drug-naïve first-episode patients with either schizophrenia or MDD. These findings support efforts for further research into transdiagnostic preventive strategies and augmentation therapy for those with immune dysfunctions.
Highlights
Schizophrenia and major depressive disorder (MDD) have been regarded as separate clinical disorders, based on their distinct clinical presentation and course of the disorder
From the following eight peripheral blood compounds at least two studies were available for meta-analysis for both disorders: Brain-derived neurotrophic factor (BDNF), C-reactive protein (CRP), interleukin (IL)-1β, IL-2, IL-4, IL-6, tumor necrosis factor alpha (TNFα) and fasting glucose concentration
Due to the relatively small number of available studies for this sensitivity analysis we probably had insufficient power to make conclusive statements. In this meta-analysis, we found that drug-naïve first-episode patients with either schizophrenia or MDD both show changes of peripheral blood compounds in a similar direction following treatment: growth factor BDNF increased with a similar medium effect size and immune factor TNFα decreased in schizophrenia with a small to medium effect size and in MDD with a large effect size
Summary
Schizophrenia and major depressive disorder (MDD) have been regarded as separate clinical disorders, based on their distinct clinical presentation and course of the disorder. Microglia and other glia may reduce their neurotrophic This meta-analysis on peripheral blood compounds in drug-naïve first-episode patients with either schizophrenia or major depressive disorder (MDD) examined which compounds change following psychopharmacological treatment. Brain-derived neurotrophic factor (BDNF) increased following treatment in schizophrenia (Hedges’ g (g): 0.55; 95% confidence interval (CI) 0.39–0.70; p < 0.001) and MDD (g: 0.51; CI 0.06–0.96; p = 0.027). Psychopharmacological treatment has modulating effects on BDNF and TNFα in drug-naïve first-episode patients with either schizophrenia or MDD. These findings support efforts for further research into transdiagnostic preventive strategies and augmentation therapy for those with immune dysfunctions
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