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初发未用药的精神分裂症患者外周炎症标志物与自杀风险的相关性评估

Evaluation of the Correlation Between Peripheral Inflammatory Markers and Suicide Risk in Drug-Naive First-Episode Schizophrenia.

作者信息

Yeşilkaya Ümit Haluk, Şen Meltem, Balcıoğlu Yasin Hasan, Gökçay Hasan, Çelikkıran Pınar, Balcıoğlu Simge Kırlıoğlu, Karamustafalıoğlu Nesrin

机构信息

Department of Psychiatry, Bakirkoy Prof Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey.

Regenerative and Restorative Medicine Research Center (REMER), Institute for Health Sciences and Technologies (SABITA), İstanbul Medipol University, Istanbul, Turkey.

出版信息

Noro Psikiyatr Ars. 2024 Aug 20;67(3):275-280. doi: 10.29399/npa.28663. eCollection 2024.

Abstract

INTRODUCTION

Patients with schizophrenia have a higher lifetime prevalence of suicidal behavior (SB) compared to the general population. Therefore, understanding the possible neurobiology of suicide and predicting the risk of suicide in schizophrenia is a solemnly critical issue.

METHODS

31 drug-naïve first episode schizophrenia (FES) patients with current SB (FES-S), 69 drug-naive patients with first episode schizophrenia without SB (FES-NS), and 69 drug-naïve non-psychotic patients with current SB (NPS) who were diagnosed according to The Diagnostic and Statistical Manual of Mental Disorders - 5 (DSM-5) participated the study. The control group (HC) consisted of 127 individuals matched with the patients. Symptoms at the time of evaluation were assessed using The Positive and Negative Syndrome Scale (PANSS) and Columbia Suicide Severity Rating Scale (CSSRS). Blood samples were collected from all participants to determine White blood cell (WBC), neutrophil, monocyte, albumin, C-reactive protein (CRP), Lymphocyte, and Platelet levels and to measure this protein ratio.

RESULTS

The blood levels of WBC, neutrophil, monocyte, albumin, CRP, and Neutrophil/Albumin Ratio (NAR) were higher in all patient groups compared to HC. CRP/Albumin Ratio (CAR) value was observed to be highest in the NPS group. Monocyte/Lymphocyte Ratio (MLR) value was significantly higher in patients with FES compared to HC. There were no significant differences between the FES-S group and the FES-NS and NPS groups.

CONCLUSION

It can be suggested that although inflammation is not a predictor for suicide attempts in schizophrenia, it is associated with the degree of suicide risk in schizophrenia. In addition, the strong relationship between suicide and psychiatric disorders can be the main reason for high peripheral inflammation levels in suicidal patients.

摘要

引言

与普通人群相比,精神分裂症患者终身自杀行为(SB)的患病率更高。因此,了解自杀可能的神经生物学机制并预测精神分裂症患者的自杀风险是一个极其关键的问题。

方法

31例首次发作且未用药的精神分裂症(FES)患者伴有当前自杀行为(FES-S),69例首次发作且未用药的精神分裂症患者无自杀行为(FES-NS),以及69例首次发作且未用药的非精神病性患者伴有当前自杀行为(NPS),这些患者均根据《精神疾病诊断与统计手册》第5版(DSM-5)进行诊断并参与了该研究。对照组(HC)由127名与患者匹配的个体组成。使用阳性和阴性症状量表(PANSS)和哥伦比亚自杀严重程度评定量表(CSSRS)评估评估时的症状。采集所有参与者的血样以测定白细胞(WBC)、中性粒细胞、单核细胞、白蛋白、C反应蛋白(CRP)、淋巴细胞和血小板水平,并测量该蛋白比值。

结果

与HC相比,所有患者组的WBC、中性粒细胞、单核细胞、白蛋白、CRP和中性粒细胞/白蛋白比值(NAR)的血液水平均较高。观察到NPS组的CRP/白蛋白比值(CAR)值最高。与HC相比,FES患者的单核细胞/淋巴细胞比值(MLR)值显著更高。FES-S组与FES-NS组和NPS组之间无显著差异。

结论

可以认为,虽然炎症不是精神分裂症患者自杀未遂的预测因素,但它与精神分裂症患者的自杀风险程度相关。此外,自杀与精神障碍之间的密切关系可能是自杀患者外周炎症水平升高的主要原因。

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本文引用的文献

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The neurobiology of suicide in psychosis: A systematic review.精神病患者自杀的神经生物学:系统综述。
J Psychopharmacol. 2020 Aug;34(8):811-819. doi: 10.1177/0269881120936919. Epub 2020 Jul 8.
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Schizophrenia-An Overview.精神分裂症概述。
JAMA Psychiatry. 2020 Feb 1;77(2):201-210. doi: 10.1001/jamapsychiatry.2019.3360.

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