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Childhood maltreatment is associated with increased body mass index and increased C-reactive protein levels in first-episode psychosis patients

Published online by Cambridge University Press:  20 January 2012

N. Hepgul ,
C. M. Pariante ,
S. Dipasquale ,
M. DiForti ,
H. Taylor ,
T. R. Marques ,
C. Morgan ,
P. Dazzan ,
R. M. Murray  and
V. Mondelli
N. Hepgul
Affiliation:
King's College London, Institute of Psychiatry, Department of Psychological Medicine, London, UK
C. M. Pariante
Affiliation:
King's College London, Institute of Psychiatry, Department of Psychological Medicine, London, UK
S. Dipasquale
Affiliation:
King's College London, Institute of Psychiatry, Department of Psychological Medicine, London, UK
M. DiForti
Affiliation:
King's College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK
H. Taylor
Affiliation:
King's College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK
T. R. Marques
Affiliation:
King's College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK
C. Morgan
Affiliation:
King's College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK
P. Dazzan
Affiliation:
King's College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK
R. M. Murray
Affiliation:
King's College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK
V. Mondelli*
Affiliation:
King's College London, Institute of Psychiatry, Department of Psychological Medicine, London, UK
*
*Address for correspondence: V. Mondelli, Ph.D., Sections of Perinatal Psychiatry and Stress, Psychiatry and Immunology (SPI-Lab), Centre for the Cellular Basis of Behaviour, The James Black Centre, Institute of Psychiatry, King's College London, 125 Coldharbour Lane, London SE5 9NU, UK. (Email: valeria.mondelli@kcl.ac.uk)
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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.

Method

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 (F2,58=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.

Keywords

Body mass indexchildhood maltreatmentinflammationmetabolic syndromepsychosis
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 9 , September 2012 , pp. 1893 - 1901
Copyright
Copyright © Cambridge University Press 2012

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