Biomarcadores de estrés e inflamación en la psicosis temprana

Identificador:  TDX:2681

Handle: https://hdl.handle.net/20.500.11797/TDX2681

Autors:  Stojanovic Pérez, Alexander Reinaldo

Resum:
Schizophrenia is a serious mental disorder, with devastating consequences, that affects how a person thinks, feels and acts. It has a serious impact on the population though early recognition and treatment of individuals is fundamental, because having a long duration of untreated psychosis leads to worse prognosis. Its precise origin is unknown, but schizophrenia patients show increased inflammatory markers and prolactin, as well as dysregulation of the hypothalamic-pituitary-adrenal axis. Although schizophrenia remains a fundamentally clinical diagnosis, it is imperative to identify biomarkers that improve the predictive value of the high-risk criteria in susceptible subjects. This doctoral thesis aims to identify biomarkers in subjects with At-Risk Mental State (ARMS) for psychosis and patients with an early psychosis (EP) disorder. IL-6, CRP, albumin, cortisol and prolactin in serum, plasma fibrinogen, basal cortisol and cortisol awakening response (CAR) in saliva were quantified. The rs1800795 was genotyped. Finally, the patients were assessed by means of the Spanish adaptation of the SCAN, obtaining DSM-IV diagnoses. The ARMS subjects were assessed using the CAARMS. In ARMS subjects and EP patients the severity of the psychotic symptoms (PANSS), the perceived stress (SRRS), the psychological perception of stress (PSS), and the depressive symptoms (HDRS and CDSS) were assessed. We demonstrated increased levels of IL-6 in EMAR subjects versus controls. Also, we observed a positive association between IL-6 and negative symptoms (ARMS and EP), and a positive (ARMS) and negative (EP) relationship between IL-6 and positive symptoms. ARMS subjects that made the transition to psychosis (EMAR-P) had a non-significant increase in IL-6 compared to the non-psychosis group (EMAR-NP). Also, increased prolactin and low albumin levels were demonstrated in EMAR-P versus EMAR-NP and controls, in addition to significant differences in CAR. We confirm that antidepressant treatment is associated with low levels of CRP and fibrinogen in EP patients.