Depressive symptoms and chronic peripheral inflammation are associated with impaired functional remission in schizophrenia independently of psychotic remission.
Depression
Inflammation
Psychiatry
Remission
Schizophrenia
Journal
Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073
Informations de publication
Date de publication:
01 02 2021
01 02 2021
Historique:
received:
31
03
2020
revised:
19
09
2020
accepted:
07
11
2020
pubmed:
22
11
2020
medline:
21
4
2021
entrez:
21
11
2020
Statut:
ppublish
Résumé
While psychotic remission in schizophrenia (SZ) has been defined by consensus and associated with a rank of clinical predictive factors, there is a lack of data of factors associated with functional remission. To identify clinical and biological factors associated with impaired functional remission in a non-selected chronic stabilized SZ outpatients. This study was a cross-sectional study carried out on all admitted SZ stabilized outpatients in an academic daily care psychiatric hospital. Functional remission was defined by a global assessment of functioning score ≥61. Psychotic remission was defined according to international criteria. Depression was assessed with the Calgary Depression Rating scale for Schizophrenia. Sociodemographic variables, tobacco status, clozapine treatment and obesity were reported. Chronic peripheral inflammation was defined by a highly sensitive C-reactive protein serum level ≥3 mg/L and metabolic syndrome according to international recommendations. 273 patients were included, among them 51 (18.7%) were classified in the functional remission group. In the multivariate analysis, higher rate of functional remission was associated with psychotic remission (adjusted Odd ratio = 18.2, p <0.001), lower depressive symptoms (aOR=0.8, p = 0.018) and lower peripheral inflammation (aOR=0.4, p = 0.046). No association of functional remission with age, gender, illness duration, second-generation antipsychotics, clozapine treatment, tobacco smoking, obesity or metabolic syndrome has been found. Depressive symptoms and chronic peripheral inflammation are associated with impaired functional remission in SZ independently of psychotic remission. Future intervention studies should determine if improving depressive symptoms and chronic peripheral inflammation may improve SZ patients reaching functional remission.
Sections du résumé
BACKGROUND
While psychotic remission in schizophrenia (SZ) has been defined by consensus and associated with a rank of clinical predictive factors, there is a lack of data of factors associated with functional remission.
OBJECTIVES
To identify clinical and biological factors associated with impaired functional remission in a non-selected chronic stabilized SZ outpatients.
METHODS
This study was a cross-sectional study carried out on all admitted SZ stabilized outpatients in an academic daily care psychiatric hospital. Functional remission was defined by a global assessment of functioning score ≥61. Psychotic remission was defined according to international criteria. Depression was assessed with the Calgary Depression Rating scale for Schizophrenia. Sociodemographic variables, tobacco status, clozapine treatment and obesity were reported. Chronic peripheral inflammation was defined by a highly sensitive C-reactive protein serum level ≥3 mg/L and metabolic syndrome according to international recommendations.
RESULTS
273 patients were included, among them 51 (18.7%) were classified in the functional remission group. In the multivariate analysis, higher rate of functional remission was associated with psychotic remission (adjusted Odd ratio = 18.2, p <0.001), lower depressive symptoms (aOR=0.8, p = 0.018) and lower peripheral inflammation (aOR=0.4, p = 0.046). No association of functional remission with age, gender, illness duration, second-generation antipsychotics, clozapine treatment, tobacco smoking, obesity or metabolic syndrome has been found.
CONCLUSION
Depressive symptoms and chronic peripheral inflammation are associated with impaired functional remission in SZ independently of psychotic remission. Future intervention studies should determine if improving depressive symptoms and chronic peripheral inflammation may improve SZ patients reaching functional remission.
Identifiants
pubmed: 33220563
pii: S0165-0327(20)32976-1
doi: 10.1016/j.jad.2020.11.046
pii:
doi:
Substances chimiques
Antipsychotic Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
267-271Informations de copyright
Copyright © 2020. Published by Elsevier B.V.