title: Peripheral sub-inflammation is associated with antidepressant consumption in schizophrenia. Results from the multi-center FACE-SZ data set.
abstract: OBJECTIVE
  The relation between C-Reactive Protein (CRP), depression and antidepressant consumption has been well explored in major depressive disorders but not in schizophrenia, which has a high rate of depression comorbidity. The objectives of this study were: (i) to determine the prevalence of abnormal CRP levels, depression and antidepressant consumption in a multicenter community-dwelling sample of subjects with schizophrenia (ii) to determine the association between abnormal CRP levels, depression and antidepressant consumption in schizophrenia.
  
  
  METHODS
  219 stable patients with schizophrenia (mean age=31.6 years, 75.3% male gender) were systematically included in the multicentre network of FondaMental Expert Center for schizophrenia (FACE-SZ) and assessed with a dedicated electronic medical record including the Structured Clinical Interview for DSM-IV Axis I Disorders and Calgary Depression Scale for depression. High sensitivity CRP (hs-CRP) was measured with an assay using nephelometry (Dade Behring). Abnormal CRP level was defined by levels >3mg/L. Current medication was recorded.
  
  
  RESULTS
  Overall, 63 subjects (28.8%) were found to have abnormal CRP levels, 43 (20.1%) received a diagnosis of comorbid current depression, and 51 (31.9%) had ongoing antidepressant treatment. In univariate analysis, abnormal CRP levels were found to be significantly associated with body mass index (BMI) (p<0.0001), hypertriglyceridemia (p=0.0015), high waist circumference (p<0.0001), metabolic syndrome (p=0.0011), abdominal obesity (p<0.0001) and with antidepressant consumption (p=0.01), while depression, psychotic symptomatology, age of onset, illness duration, sociodemographic characteristics, current tobacco or cannabis status, hypertension or high fasting glucose were not (all p>0.05). In a multivariate model, abnormal CRP was associated with antidepressant consumption independently of other confounding variables (adjusted Odds Ratio=2.8, 95% confidence interval 1.22-6.62). Metabolic syndrome was also independently associated with abnormal CRP (adjusted Odds Ratio=2.6, 95% confidence interval 1.01-6.71).
  
  
  CONCLUSIONS
  Abnormal CRP levels in schizophrenia were found to be associated with antidepressant consumption, but not with depression. The potential mechanisms were discussed. Antidepressant consumption should be systematically recorded in future studies exploring inflammation in schizophrenia. Future clinical trials of interventions directed at lowering the level of CRP and other inflammatory markers are discussed.
authors.affiliation: Fondation FondaMental, Créteil, France; INSERM U955, Translational Psychiatry team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France.
authors.forename: G
authors.initials: G
authors.lastname: Fond
authors.affiliation: Fondation FondaMental, Créteil, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, F-75013, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Godin
authors.affiliation: Fondation FondaMental, Créteil, France; INSERM U955, Translational Psychiatry team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France.
authors.forename: L
authors.initials: L
authors.lastname: Brunel
authors.affiliation: Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, F-33076 Bordeaux, France; Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, F-33000 Bordeaux, France.
authors.forename: B
authors.initials: B
authors.lastname: Aouizerate
authors.affiliation: Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France.
authors.forename: F
authors.initials: F
authors.lastname: Berna
authors.affiliation: Fondation FondaMental, Créteil, France; INSERM U955, Translational Psychiatry team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France.
authors.forename: E
authors.initials: E
authors.lastname: Bulzacka
authors.affiliation: Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France.
authors.forename: D
authors.initials: D
authors.lastname: Capdevielle
authors.affiliation: Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France.
authors.forename: I
authors.initials: I
authors.lastname: Chereau
authors.affiliation: Fondation FondaMental, Créteil, France; Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est BP 300 39 - 95 bd Pinel - 69678 BRON Cedex, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Dorey
authors.affiliation: Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France.
authors.forename: C
authors.initials: C
authors.lastname: Dubertret
authors.affiliation: Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France.
authors.forename: J
authors.initials: J
authors.lastname: Dubreucq
authors.affiliation: Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Faget
authors.affiliation: Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France.
authors.forename: F
authors.initials: F
authors.lastname: Gabayet
authors.affiliation: Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Le Strat
authors.affiliation: Bordeaux Sleep Clinique, Pellegrin University Hospital, Bordeaux University, USR CNRS 3413 SANPSY, Research Unit, 33000 Bordeaux, France.
authors.forename: J A
authors.initials: JA
authors.lastname: Micoulaud-Franchi
authors.affiliation: Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, F-33076 Bordeaux, France; CNRS UMR 5287-INCIA, France.
authors.forename: D
authors.initials: D
authors.lastname: Misdrahi
authors.affiliation: Fondation FondaMental, Créteil, France; Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est BP 300 39 - 95 bd Pinel - 69678 BRON Cedex, France.
authors.forename: R
authors.initials: R
authors.lastname: Rey
authors.affiliation: Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France.
authors.forename: R
authors.initials: R
authors.lastname: Richieri
authors.affiliation: Fondation FondaMental, Créteil, France; Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France.
authors.forename: C
authors.initials: C
authors.lastname: Passerieux
authors.affiliation: Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France.
authors.forename: A
authors.initials: A
authors.lastname: Schandrin
authors.affiliation: Fondation FondaMental, Créteil, France; INSERM U955, Translational Psychiatry team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France.
authors.forename: F
authors.initials: F
authors.lastname: Schürhoff
authors.affiliation: Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France.
authors.forename: A M
authors.initials: AM
authors.lastname: Tronche
authors.affiliation: Fondation FondaMental, Créteil, France; Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France.
authors.forename: M
authors.initials: M
authors.lastname: Urbach
authors.affiliation: Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France.
authors.forename: P
authors.initials: P
authors.lastname: Vidalhet
authors.affiliation: Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France.
authors.forename: P M
authors.initials: PM
authors.lastname: Llorca
authors.affiliation: Fondation FondaMental, Créteil, France; INSERM U955, Translational Psychiatry team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France.
authors.forename: M
authors.initials: M
authors.lastname: Leboyer
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D015331:Cohort Studies; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000097:blood / Q000188:drug therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000139:chemically induced; D007249:Inflammation / Q000097:blood / Q000139:chemically induced*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000139:chemically induced; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000097:blood* / Q000150:complications; D055105:Waist Circumference
chemical_list: D000928:Antidepressive Agents; D015415:Biomarkers; D002097:C-Reactive Protein
keywords: Abdominal obesity; Antidepressant; C-reactive protein (CRP); Depression; Metabolic syndrome; Schizophrenia