title: Childhood maltreatment is associated with increased body mass index and increased C-reactive protein levels in first-episode psychosis patients.
abstract: BACKGROUND
  The high incidence of the metabolic syndrome in patients with psychosis is mainly attributed to antipsychotic treatment. However, it is also possible that psychological stress plays a role, inducing a chronic inflammatory process that may predispose to the development of metabolic abnormalities. We investigated the association between childhood maltreatment and inflammatory and metabolic biomarkers in subjects with first-episode psychosis and healthy controls.
  
  
  METHODS
  Body mass index (BMI), weight and waist circumference were measured in 95 first-episode psychosis patients and 97 healthy controls. Inflammatory and metabolic markers were measured in a subsample of 28 patients and 45 controls. In all the subjects we collected information on childhood maltreatment and recent stressors.
  
  
  RESULTS
  Patients with childhood maltreatment had higher BMI [25.0 (S.E.=0.6) kg/m2] and C-reactive protein (CRP) levels [1.1 (S.E.=0.6) mg/dl] when compared with healthy controls [23.4 (S.E.=0.4) kg/m2, p=0.030 and 0.2 (S.E.=0.1) mg/dl, p=0.009, respectively]. In contrast, patients without childhood maltreatment were not significantly different from healthy controls for either BMI [24.7 (S.E.=0.6) kg/m2, p=0.07] or CRP levels [0.5 (S.E.=0.2) mg/dl, p=0.25]. After controlling for the effect of BMI, the difference in CRP levels across the three groups remained significant (F 2,58=3.6, p=0.035), suggesting that the increase in inflammation was not driven by an increase in adipose tissue.
  
  
  CONCLUSIONS
  Childhood maltreatment is associated with higher BMI, and increased CRP levels, in patients with a first-episode psychosis. Further studies need to confirm the mechanisms underlying the putative causal relationship between childhood maltreatment and higher BMI, and whether this is indeed mediated by increased inflammation.
authors.affiliation: King's College London, Institute of Psychiatry, Department of Psychological Medicine, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Hepgul
authors.forename: C M
authors.initials: CM
authors.lastname: Pariante
authors.forename: S
authors.initials: S
authors.lastname: Dipasquale
authors.forename: M
authors.initials: M
authors.lastname: DiForti
authors.forename: H
authors.initials: H
authors.lastname: Taylor
authors.forename: T R
authors.initials: TR
authors.lastname: Marques
authors.forename: C
authors.initials: C
authors.lastname: Morgan
authors.forename: P
authors.initials: P
authors.lastname: Dazzan
authors.forename: R M
authors.initials: RM
authors.lastname: Murray
authors.forename: V
authors.initials: V
authors.lastname: Mondelli
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D014150:Antipsychotic Agents / Q000009:adverse effects; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology / Q000378:metabolism*; D011618:Psychotic Disorders / Q000378:metabolism*; D055105:Waist Circumference
chemical_list: D014150:Antipsychotic Agents; D002097:C-Reactive Protein