Abstract
BackgroundInflammatory processes have been implicated in the etiology of schizophrenia and related psychoses, in which cognitive deficits represent core symptoms. The aim of the present study was to investigate possible associations between the level of the inflammation marker C-reactive protein (CRP) and cognitive performance in patients through the acute phase of psychosis.MethodsA total of 124 patients were assessed at admittance to hospital and 62 patients were retested at discharge or after 6 weeks at the latest, with measurements of the CRP levels and alternative forms of the Repeatable Battery for the Assessment of Neuropsychological Status.ResultsThere was an inverse relationship between overall cognitive performance and CRP level at admittance. The association increased in sub-analyses including only patients with schizophrenia. In cognitive subdomain analyses statistically significant inverse associations were found between the CRP level and Delayed memory and Attention, respectively. No associations were found between CRP level and other measures of psychopathology including psychosis symptoms, depression, or functioning. At follow-up the association between CRP level and cognition was no longer present. There was a significant increase in cognitive performance between baseline and follow-up. There was a stronger increase in overall cognition scores in patients with higher baseline CRP levels.ConclusionsThe findings indicate that signs of inflammation may serve as a state-dependent marker of cognitive dysfunctions in acute psychosis.Trial registrationClinicalTrials.gov ID; NCT00932529, registration date: 02.07.2009
Highlights
Inflammatory processes have been implicated in the etiology of schizophrenia and related psychoses, in which cognitive deficits represent core symptoms
The C-reactive protein (CRP), an acute-phase reactant synthesized in the liver, has for many decades been considered a reliable marker of inflammation [22]
All adult patients were eligible for the study if they were acutely admitted to the emergency ward for symptoms of active psychosis as determined by a score of ≥4 on one or more on the items Delusions, Hallucinatory behavior, Grandiosity, Suspiciousness/persecution, or Unusual thought content in the Positive and Negative Syndrome Scale (PANSS) [31] and were candidates for oral antipsychotic drug therapy
Summary
Inflammatory processes have been implicated in the etiology of schizophrenia and related psychoses, in which cognitive deficits represent core symptoms. The aim of the present study was to investigate possible associations between the level of the inflammation marker C-reactive protein (CRP) and cognitive performance in patients through the acute phase of psychosis. Schizophrenia and related psychoses are severe mental disorders characterized by positive and negative psychotic symptoms, cognitive dysfunction and functional decline, with a lifetime prevalence close to 1 % [1]. A recent meta-analysis by Fernandes et al [27] consistently found elevated serum levels of CRP in both first episode and chronic phase patients, irrespective of medication status. To the best of our knowledge, investigations of associations between the CRP level and cognitive dysfunction in schizophrenia are scarce, an association between CRP levels and cognitive functioning in patients with predominantly chronic schizophrenia has been reported in one crosssectional study [28]. We have previously demonstrated a statistically significant time effect for overall cognitive improvement in acutely admitted psychosis patients during 24 months of follow-up [29], but have not so far examined changes in the acute phase
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