Giné-Servén Eloi, Boix-Quintana Ester, Daví-Loscos Eva, Cepedello Sandra, Moreno-Sancho Lara, Niubó Marta, Hernández-Antón Rebeca, Cuesta Manuel J, Labad Javier
Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain.
Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
Front Psychiatry. 2024 Feb 15;15:1327928. doi: 10.3389/fpsyt.2024.1327928. eCollection 2024.
Previous research has shown that lower lactate dehydrogenase (LDH) concentrations in cerebrospinal fluid (CSF) are associated with longer prodromal symptoms in first-episode psychosis (FEP). We aimed to study whether there is a relationship between the duration of untreated psychosis (DUP) and LDH and other CSF biomarkers in FEP and whether stressful life events moderate this association.
Ninety-five inpatients with FEP and with less than 6 weeks of antipsychotic treatment were included in the study. All participants were informed about the nature of the study, which was approved by the local ethics committee, and signed an informed consent form. A lumbar puncture was performed at index admission (baseline) to measure CSF parameters (glucose, total protein, LDH). The DUP was assessed with the Quick Psychosis Onset and Prodromal Symptoms Inventory (Q-POPSI). Stressful life events (SLEs) in the previous 6 months were assessed with the List of Threatening Experiences. We dichotomized the SLE variable into having experienced at least one SLE or no experience of SLEs. Statistical analyses were performed with SPSS v. 25.0. Total protein and LDH concentrations were natural log transformed (ln) to reduce skewness. Multiple linear regression analyses were conducted to explore the association between the DUP and CSF parameters (considered the dependent variable). Age, sex, DUP and SLEs were considered independent variables. We tested the DUP by SLE interaction. Significant interactions were included in the final model. The threshold for significance was set at p<0.05.
Fifty-four FEP patients (56.8%) reported an SLE in the previous 6 months. There were no significant differences in the DUP between patients with or without SLEs. There were no significant differences in CSF biomarkers between the SLE groups. In the multiple linear regression analyses, we found a significant DUP by SLE interaction effect on CSF LDH concentrations (standardized beta= -0.320, t= -2.084, p= 0.040). In patients with SLEs, a shorter DUP was associated with higher CSF LDH concentrations and vice versa. No significant associations were found between the DUP or SLEs and other CSF biomarkers (glucose, total proteins).
Our study suggests that psychosocial stress moderates the relationship between the onset of psychosis and CSF biomarkers related to bioenergetic systems.
先前的研究表明，脑脊液（CSF）中较低的乳酸脱氢酶（LDH）浓度与首发精神病（FEP）中较长的前驱症状相关。我们旨在研究FEP中未治疗精神病的持续时间（DUP）与LDH及其他CSF生物标志物之间是否存在关联，以及应激性生活事件是否会调节这种关联。
95例接受抗精神病药物治疗少于6周的FEP住院患者纳入本研究。所有参与者均被告知研究性质，该研究已获当地伦理委员会批准，并签署了知情同意书。在首次入院（基线）时进行腰椎穿刺以测量CSF参数（葡萄糖、总蛋白、LDH）。使用快速精神病发作和前驱症状量表（Q-POPSI）评估DUP。使用威胁性经历清单评估过去6个月内的应激性生活事件（SLE）。我们将SLE变量分为经历过至少一次SLE或未经历SLE。使用SPSS v. 25.0进行统计分析。对总蛋白和LDH浓度进行自然对数转换（ln）以减少偏态。进行多元线性回归分析以探索DUP与CSF参数之间的关联（将CSF参数视为因变量）。年龄、性别、DUP和SLE被视为自变量。我们检验了DUP与SLE的交互作用。最终模型纳入显著的交互作用。显著性阈值设定为p<0.05。
54例FEP患者（56.8%）报告在过去6个月内经历过SLE。有或无SLE的患者在DUP方面无显著差异。SLE组之间的CSF生物标志物无显著差异。在多元线性回归分析中，我们发现DUP与SLE对CSF LDH浓度存在显著的交互作用（标准化β=-0.320，t=-2.084，p=0.040）。在有SLE的患者中，较短的DUP与较高的CSF LDH浓度相关，反之亦然。未发现DUP或SLE与其他CSF生物标志物（葡萄糖、总蛋白）之间存在显著关联。
我们的研究表明，社会心理应激调节了精神病发作与与生物能量系统相关的CSF生物标志物之间的关系。
