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Associations between overweight/obesity and increased levels of serum inflammatory markers from prodromal stages to chronic psychosis
- A. Michalczyk, P. Podwalski, K. Waszczuk, E. Tyburski, E. Cecerska-Heryć, J. Samochowiec
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S376
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- Article
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Introduction
Chronic subclinical inflammation is considered to be an important contributor to the development of schizophrenia. Meta-analyses confirm the presence of higher levels of inflammatory markers in schizophrenia and its prodromal stages compared to controls, however studies differ in terms of associated cytokines. Obesity is a common problem in patients with schizophrenia and, at the same time, it is recognized as a source of subclinical inflammation in the general population.
ObjectivesThe aim of the study was to verify if there is an association between the presence of overweight/obesity and higher levels of CRP and IL-6 in various stages of psychotic disorders and if these factors may influence the course of the disease
MethodsStudy was performed in four study groups: 31 healthy controls (HC), 16 patients with ultra-high risk of psychosis (UHR), 30 with first episode of psychosis (FEP) and 71 with chronic schizophrenia (SCH). The severity of psychopathological symptoms in SCH was assed using the Positive and Negative Syndrome Scale (PANSS). The serum levels of inflammatory markers were measured using sensitive ELISA tests.
ResultsStudy groups significantly differed in the levels of CRP and IL-6. The presence of overweight/obesity was associated with significantly higher levels of CRP in CON and UHR and IL-6 in CON, FEP and SCH. IL-6 was positively correlated with the severity of positive symptoms in PANSS in SCH, however neither IM or BMI were associated with other psychopathological symptoms or number and frequency of exacerbations in schizophrenia patients.
ConclusionsOverweight/obesity is associated with subclinical inflammation in both healthy controls and patients with various stages of psychotic disorders. Subclinical inflammation may be correlated with the course of the disease, however we did not find any direct associations between overweight/obesity and the severity of symptoms. Further studies are needed to verify, if reduction of BMI would be beneficial in reducing levels of inflammatory markers and alleviating disease course.
This research was funded by the Polish Minister of Science and Higher Education’s program named “Regional Initiative of Excellence” in 2019–2022, grant number 002/RID/2018/2019 to the amount of 12 000 000 PLN, and the National Science Centre, Poland, grant number 2019/03/X/NZ5/00719.
Disclosure of InterestNone Declared
The Hierarchical Taxonomy of Psychopathology (HiTOP) in psychiatric practice and research
- Roman Kotov, David C. Cicero, Christopher C. Conway, Colin G. DeYoung, Alexandre Dombrovski, Nicholas R. Eaton, Michael B. First, Miriam K. Forbes, Steven E. Hyman, Katherine G. Jonas, Robert F. Krueger, Robert D. Latzman, James J. Li, Brady D. Nelson, Darrel A. Regier, Craig Rodriguez-Seijas, Camilo J. Ruggero, Leonard J. Simms, Andrew E. Skodol, Irwin D. Waldman, Monika A. Waszczuk, David Watson, Thomas A. Widiger, Sylia Wilson, Aidan G. C. Wright
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- Journal:
- Psychological Medicine / Volume 52 / Issue 9 / July 2022
- Published online by Cambridge University Press:
- 02 June 2022, pp. 1666-1678
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The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged out of the quantitative approach to psychiatric nosology. This approach identifies psychopathology constructs based on patterns of co-variation among signs and symptoms. The initial HiTOP model, which was published in 2017, is based on a large literature that spans decades of research. HiTOP is a living model that undergoes revision as new data become available. Here we discuss advantages and practical considerations of using this system in psychiatric practice and research. We especially highlight limitations of HiTOP and ongoing efforts to address them. We describe differences and similarities between HiTOP and existing diagnostic systems. Next, we review the types of evidence that informed development of HiTOP, including populations in which it has been studied and data on its validity. The paper also describes how HiTOP can facilitate research on genetic and environmental causes of psychopathology as well as the search for neurobiologic mechanisms and novel treatments. Furthermore, we consider implications for public health programs and prevention of mental disorders. We also review data on clinical utility and illustrate clinical application of HiTOP. Importantly, the model is based on measures and practices that are already used widely in clinical settings. HiTOP offers a way to organize and formalize these techniques. This model already can contribute to progress in psychiatry and complement traditional nosologies. Moreover, HiTOP seeks to facilitate research on linkages between phenotypes and biological processes, which may enable construction of a system that encompasses both biomarkers and precise clinical description.