Abstract
Schizophrenia is a debilitating mental illness. Levels of oxytocin have been proposed as a biomarker of schizophrenia; however, the observed levels of oxytocin in individuals with schizophrenia have been inconsistent across studies. We performed a meta-analysis to evaluate oxytocin levels in plasma, serum and cerebrospinal fluid to see if there are statistically different concentrations between individuals with schizophrenia and the comparison group. The meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Following the inclusion and exclusion criteria, 14 studies were included in the meta-analysis. The quality of the study was evaluated by the Newcastle-Ottawa Scale (NOS). A random-effects model was performed using the Comprehensive Meta-analysis software with the standardized mean difference (SMD) and 95% confidence intervals (CIs). Serum oxytocin levels in individuals with schizophrenia were significantly lower than that in comparison group (SMD = - 1.74, 95% CI = - 3.22 to - 0.26, p = 0.02) but cerebrospinal fluid oxytocin levels in individuals with schizophrenia were significantly higher than those in the comparison group (SMD = 0.55, 95% CI = 0.05 to 1.04, p = 0.03). Our results suggest that oxytocin levels in cerebrospinal fluid are increased in individuals with schizophrenia but decreased in serum. Therefore, the oxytocin system dysregulation may play a role in the pathophysiology of schizophrenia and it should be measured in more populations for a possible implementation as a biomarker of schizophrenia.
Highlights
There are numerous environmental, biological and genetic factors that interact and contribute to the vulnerability or resilience to develop schizophrenia (SCZ)
A random-effects model was performed using the Comprehensive Metaanalysis software with the standardized mean difference (SMD) and 95% confidence intervals (CIs).Serum oxytocin levels in individuals with schizophrenia were significantly lower than that in comparison group (SMD = − 1.74, 95% CI = − 3.22 to − 0.26, p = 0.02) but cerebrospinal fluid oxytocin levels in individuals with schizophrenia were significantly higher than those in the comparison group (SMD = 0.55, 95% CI = 0.05 to 1.04, p = 0.03)
Our results suggest that oxytocin levels in cerebrospinal fluid are increased in individuals with schizophrenia but decreased in serum
Summary
There are numerous environmental, biological and genetic factors that interact and contribute to the vulnerability or resilience to develop schizophrenia (SCZ). Schizophrenia is characterized by positive, negative and cognitive symptoms. Positive symptoms consist of psychotic symptoms such as hallucinations, delusions that are often paranoid, as well as disorganized speech and behavior. Negative symptoms include flattened affect, poverty of speech, loss of a sense of pleasure and loss of interests and drive; while cognitive symptoms comprise deficits in attention, working memory, and in executive functions (Owen et al, 2016; Perkovic et al, 2017). The etiology of SCZ is multifactorial and reflects an interaction between genetic and environmental contributors. Some risk factors include family history, social isolation, urbanicity, pregnancy and birth complications, acute life events, developmental difficulties, central nervous system infections in childhood and substance abuse (Stilo and Murray, 2019; Wahlberg et al, 2004)
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