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Elevated C-reactive protein levels in schizophrenia inpatients is associated with aggressive behavior

Published online by Cambridge University Press:  23 March 2020

R. Barzilay ,
T. Lobel ,
A. Krivoy ,
D. Shlosberg ,
A. Weizman  and
N. Katz
R. Barzilay*
Affiliation:
Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, 1 Helsinki St. Petah-Tikva, 4910002, Israel Neurosciences laboratory, Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
T. Lobel
Affiliation:
Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, 1 Helsinki St. Petah-Tikva, 4910002, Israel
A. Krivoy
Affiliation:
Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, 1 Helsinki St. Petah-Tikva, 4910002, Israel
D. Shlosberg
Affiliation:
Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, 1 Helsinki St. Petah-Tikva, 4910002, Israel
A. Weizman
Affiliation:
Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, 1 Helsinki St. Petah-Tikva, 4910002, Israel
N. Katz
Affiliation:
Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, 1 Helsinki St. Petah-Tikva, 4910002, Israel
*
*Corresponding author. Ran Barzilay, Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Israel. Tel.: +97 2523 020443; fax: +97 2775 251518.E-mail address:[email protected] (R. Barzilay).
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Abstract

Background

An association between inflammation and behavioral domains of mental disorders is of growing interest. Recent studies reported an association between aggression and inflammation. In this study, we investigated the association between aggressive behavior and inflammatory markers in schizophrenia inpatients.

Methods

Adult schizophrenia inpatients without affective symptoms (n = 213) were retrospectively identified and categorized according to their C-reactive protein measurement at admission as either elevated (CRP > 1 mg/dL; n = 57) or normal (CRP < 1 mg/dL; n = 156). The following indicators of aggression were compared: PANSS excitement component (PANSS-EC), restraints and suicidal behavior during hospitalization. Univariate comparisons between elevated and normal CRP levels were performed and multivariate analysis was conducted to control for relevant covariates.

Results

CRP levels significantly correlated with other laboratory markers indicating increased inflammation including leukocyte count and neutrophil to lymphocyte ratio (r = 0.387, P < 0.0001 and r = 0.356, P < 0.0001) respectively. Inpatients with elevated C-reactive protein displayed increased aggressive behavior compared to patients with normal CRP levels (<1 mg/dL). This was manifested by higher rates of restraint during hospitalization (χ2 = 5.22, P = 0.031) and increased PANSS-EC score (U = 5410.5, P = 0.012). Elevated CRP levels were not associated with suicidal behavior. Multivariate analysis revealed that higher PANSS-EC score was associated with elevated CRP after controlling for the covariates age, sex, BMI and smoking.

Conclusion

This study identified a potential biological correlate (inflammation) of a specific behavioral endophenotype (aggression) in schizophrenia inpatients.

Keywords

SchizophreniaInflammationC-reactive proteinAggressionSuicidal behaviorNeutrophil to lymphocyte ratio
Type
Original article
Information
European Psychiatry , Volume 31 , January 2016 , pp. 8 - 12
Copyright
Copyright © European Psychiatric Association 2015

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