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Inflammatory evidence for the psychosis continuum model.

Ragni H Mørch1, Ingrid Dieset1, Ann Færden1

  • 1NORMENT, KG Jebsen Centre for Psychosis Research, University of Oslo and Oslo University Hospital, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Ullevål, Oslo, Norway.

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Summary

Inflammation markers, including soluble tumor necrosis factor receptor 1 (sTNF-R1) and interleukin 1 receptor antagonist (IL-1Ra), are elevated in severe mental disorders, particularly in schizophrenia spectrum disorders. These findings support inflammatory mechanisms in disease pathophysiology.

Keywords:
AntipsychoticsBipolar disorderInflammationPsychosis continuum modelSchizophrenia

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Area of Science:

  • Neuroscience
  • Immunology
  • Psychiatry

Background:

  • Inflammation and immune activation are increasingly recognized in the pathophysiology of severe mental disorders.
  • Previous research on inflammatory markers has yielded inconsistent results, necessitating further investigation.

Purpose of the Study:

  • To quantify the effect sizes of inflammatory marker alterations across the psychosis continuum.
  • To explore the association between these markers and antipsychotic medication use.

Main Methods:

  • Plasma levels of sTNF-R1, IL-1Ra, OPG, and vWf were measured in 992 patients with schizophrenia spectrum (SCZ), schizoaffective disorder (SA), affective spectrum disorders (AFF), and 638 healthy controls (HC).

Main Results:

  • Elevated levels of sTNF-R1 and IL-1Ra were observed in patients compared to healthy controls.
  • The SCZ group exhibited higher sTNF-R1 and IL-1Ra levels than HC, with sTNF-R1 also elevated in SA and AFF groups.
  • SCZ patients showed increased IL-1Ra and vWf compared to AFF patients, with no significant association found between inflammatory markers and antipsychotic use.

Conclusions:

  • A modest increase in sTNF-R1 and IL-1Ra supports the role of inflammation in severe mental disorders.
  • The more pronounced increase in SCZ compared to AFF supports a psychosis continuum model linked to immune factors.