Serum cytokine variations among inpatients with major depression, bipolar disorder, and schizophrenia healthy controls: a prospective ‘true-to-life’ study

Background: There is increasing evidence of the association between chronic low-grade inflammation and severe mental illness (SMI). The objective of our study was to assess serum cytokine levels (SCLs) at admission and discharge in a true-to-life-setting population of inpatients with major depressio...

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Bibliographic Details
Main Authors: Antonio Augusto Schmitt Junior, Lucas Primo de Carvalho Alves, Barbara Larissa Padilha, Neusa Sica da Rocha
Format: Article
Language:English
Published: SAGE Publishing 2023-02-01
Series:Therapeutic Advances in Psychopharmacology
Online Access:https://doi.org/10.1177/20451253221135463
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Summary:Background: There is increasing evidence of the association between chronic low-grade inflammation and severe mental illness (SMI). The objective of our study was to assess serum cytokine levels (SCLs) at admission and discharge in a true-to-life-setting population of inpatients with major depression (MD), bipolar disorder (BD), and schizophrenia (Sz), as well as of healthy controls. Methods: We considered MD, BD, and Sz to be SMIs. We evaluated 206 inpatients [MD, N  = 92; BD, N  = 26; mania (Ma), N  = 44; Sz, N  = 44). Generalized estimating equations were used to analyze variations in SCL [interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin (IL)-2, IL-4, IL-6, IL-10, and IL-17] at hospital admission and discharge. Results of 100 healthy controls were compared with those of SMI patients at both time points. We evaluated patients’ improvement during in-hospital treatment in terms of general psychiatric symptoms, global clinical impression, functionality, and manic and depressive symptoms with validated scales. Results: In all, 68.9% of patients completed the study. Overall, SMI inpatients had higher SCL when compared with controls regardless of diagnosis. There was a significant decrease in Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression–Severity Scale (CGI-S) scores, and an increase in Global Assessment of Functioning (GAF) scores for all disorders evaluated ( p  < 0.001), as well as a significant decrease in HDRS-17 scores among MD inpatients ( p  < 0.001) and in YMRS scores among Ma inpatients ( p  < 0.001). IL-2 and IL-6 levels decreased significantly between admission and discharge only among MD inpatients ( p  = 0.002 and p  = 0.03, respectively). We found no further statistically significant changes in SCL among the remaining disorders (BD, Ma, and Sz). There was no significant decrease in IFN-γ ( p  = 0.64), TNF-α ( p  = 0.87), IL-4 ( p  = 0.21), IL-10 ( p  = 0.88), and IL-17 ( p  = 0.71) levels in any of the evaluated diagnoses. Conclusion: MD inpatients had a decrease in IL-2 and IL-6 levels during hospitalization, which was accompanied by clinical improvement. No associations were found for the remaining SMIs (BD, Ma, and Sz).
ISSN:2045-1261