March 7, 2018

Levels of C-reactive Protein May Indicate Schizophrenia Prognosis

By Jenny Powers

NICE, France -- March 7, 2018 -- Levels of C-reactive protein (CRP) indicating low-grade inflammation are associated with worsening scores on several psychometric scales and a poorer overall prognosis over a 1-year period in outpatients with stable schizophrenia, according to findings from a follow-up study presented at the 2018 Congress of the European Psychiatric Association (EPA).

“By multiple regression analyses, only CRP levels of 3 to 10 mg/L were associated with a worse clinical course on the PANSS [Positive and Negative Syndrome Scale]-Positive, -General and -Total scales,” commented lead author Leticia Gonzalez-Blanco MD, University of Oviedo, Oviedo, Spain, speaking here on March 5. “Higher baseline CRP levels may be a biomarker of poor clinical course in the first 10 years of schizophrenia.”

Dr. Blanco presented findings on 50 stable outpatients (62% male, mean age 31.1 years) who had been diagnosed with schizophrenia for fewer than 10 years.

During the course of the trial, the overall patient population demonstrated significantly improved scores from baseline (P< .05). Scores after 1 year improved on the PANSS-Total scale (range: 55.8 to 59.9); PANSS-General scale (range: 26.9 to 29.7); and the Clinical Assessment Interview for Negative Symptoms (CAINS)-Expression scale (range: 4.9 to 5.7).

Patients with low-grade inflammation and elevated levels of C-reactive protein (CRP), however, showed worsening scores during the year, which were represented by positive score values. These patients scores were poorer compared with those of patients with normal CRP levels on all PANSS scales; the PANSS Positive scale scores were 0.86 versus -1.3; PANSS Negative scores were 0.86 versus -1.2, the PANSS General scores were 0.93 versus -4.2, and the PANSS Total scores were 2.6 versus -6.7 for patients with high versus normal CRP levels, respectively (P< .05 for all comparisons).

The team stratified subjects according to having low-grade inflammation (n = 14, defined as 3 to 10 mg/L CRP) or normal CRP levels (n = 36, defined as ≤3mg/L CRP). The team excluded patients from the study who had >10mg/L CRP, which represented acute inflammation.

Baseline demographic, clinical, and psychometric variables -- as measured by the PANSS, the Brief Negative Symptom Scale (BNSS), CAINS-Motivation/Pleasure & Expression, and Calgary Depression scales -- were similar between the 2 groups. The team observed differences between the high versus normal CRP groups, however, in the duration of illness (6 versus 3.5 years; P = .02) and in BMI (30.3 versus 26.5; P = .015).

[Presentation title: Higher Baseline C-Reactive Protein Mark Poor Clinical Course in the First Ten Years of Schizophrenia: One-year Follow-up Study. Abstract OR-0096]

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